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-   -   Why is the new shingles vaccine (Shingrix) so expensive for Part D of Medicare? (https://www.talkofthevillages.com/forums/medical-health-discussion-94/why-new-shingles-vaccine-shingrix-so-expensive-part-d-medicare-310146/)

MandoMan 08-17-2020 08:24 AM

Quote:

Originally Posted by Miguel 1952 (Post 1818565)
We seniors need this new shingles vaccine yet is very expensive with Part D prescription. I have SilverScripts and is $155 per vaccine and we must have two spread apart by several months.
Really disappointed as I really like Medicare with my supplemental and my Part D prescription.

Get the Shingrix two part vaccine, which is thought to be 89% to 95% effective against shingles, rather than the Zostavax, which is only about 50% effective. If you ever get shingles, you will definitely wish you had had the vaccine, whatever the cost.

I’ve had both, and I got them both for free (to me) due to the health insurance I had when employed. However, my health insurance was billed about $360 for the Shingrix vaccine two part combo. That’s a lot of money, but there are drugs used for treating shingles once you get it that cost a lot more than that!

Shingles is a herpes-based Disease, like chicken-pox. If you get the regular herpes people talk about, the antiviral drugs that can keep you from having attacks cost around $1,000 a month, I believe. If you are taking PReP to keep from getting HIV, I think that is also about $1,000 a month. If you have HIV and are taking drugs to stay alive, I believe that cocktail costs about $2,000 a month. I have two dear friends in Hobe Sound, Florida, in adjacent rooms, fighting for their lives right now to survive Covid-19. They have both had convalescent plasma antibodies—the man has had two doses. I have no idea what that costs, but I’d be very surprised if it was less than $5,000 a dose.

This is why the total cost of health care is so high. If my friends, age 91 and 85, with big health problems before catching Covid-19, are in the hospital under continuous, high-quality care for a month, whether or not they live, I’m sure they will have cost we the people a million dollars, even if they don’t have to pay much of it. Their Medicare Advantage plan will pay, and other people with that plan will then have to pay the premiums. This is how it works. And Medicare will pay, and all taxpayers pay for that. I’d rather pay my taxes than have shingles or herpes or HIV or Covid-19. I’m grateful for the excellent and seamless care my friends are receiving and the dedicated people helping them.

CWGUY 08-17-2020 08:31 AM

Quote:

Originally Posted by Scorpyo (Post 1818838)
Yeah, you would think the shots should be covered 100% given that it should, in my opinion, be considered preventative medicine. I have Humana Advantage in GA. My portion was $153.83 at Walmart Pharmacy. I'm not complaining about the cost especially considering the alternative. I wonder how much more than the $153.83 it would have cost Humana had I contracted Shingles?

:shocked: We have a Humana Advantage Plan and the co-pay was $1 each shot. I guess they have a number of different plans???

PugMom 08-17-2020 08:32 AM

Quote:

Originally Posted by OrangeBlossomBaby (Post 1818606)
I paid nothing with my Connecticare, in February 2019. But that was in Connecticut. I don't know anything about coverage for Shingrix down here. Different plans offer different coverage. Connecticare was comprehensive.

my friends who had Connecticare RAVED about it-said it was better than BC/BS

merrymini 08-17-2020 08:37 AM

I was going to have the Shingrix shot but decided to call my insurance when I found out how much it cost. Then the china flu happened and they did not do any shots at Walgreens. I have very good coverage but it does not cover this shot according to Walgreen’s. It seems impossible to talk to anyone on the phone now but plan to take asap.

Spike380 08-17-2020 08:56 AM

I also only paid $45 for the 1st shot. Haven't had the 2nd one yet.

kendi 08-17-2020 09:04 AM

We paid nothing with UHC in Cincinnati.

Skip 08-17-2020 09:36 AM

When you say "I paid $1 or I paid nothing", you need to state which type you received: Shingrix or Zostavax. Both are available. They have different co-pays too.
For Tier 5 drugs you usually have a $395 deductible first then you pay 25% of the total cost after that deductible on an "Advantage Plan".
Skip

Sheila Fisher 08-17-2020 11:11 AM

What phase of your plan are you in?

Snorkl46 08-17-2020 11:51 AM

I got my first in 2019 and second in 2020. They both cost $28.50 at Walgreen's. The difference must be in the type of Part D that you have.

dpmers 08-17-2020 12:07 PM

I got both shots at Publix $40 ea, after my horrible bout with shingles I would have paid much much more to have avoided that experience. It's been 11 years since my bout and I still have occasional light pain

Nealg 08-17-2020 12:28 PM

Quote:

Originally Posted by Miguel 1952 (Post 1818565)
We seniors need this new shingles vaccine yet is very expensive with Part D prescription. I have SilverScripts and is $155 per vaccine and we must have two spread apart by several months.
Really disappointed as I really like Medicare with my supplemental and my Part D prescription.

Read about the side effects carefully..

rstebbins 08-17-2020 12:29 PM

it’s more than likely your deductible depending on what other prescriptions you take. I only take tier 1 and 2 generic so none of the small costs get charged to the annual 435 (2020) deductible. So i had to pay the full cost of the shingles shots. On part D you are responsible for the first 435 in 2020

YouNeverKnow 08-17-2020 12:32 PM

Quote:

Originally Posted by riley2011 (Post 1818673)
If you think that’s bad the doctor I go to is charging $2100 for a prolia shot (for osteoporosis).

My Doctor charges 1800.00 plus 110.00 to give the shot (which takes all of 10 seconds and is given by the blood draw person in a lab.)
You have to get a shot every six months!

Miguel 1952 08-17-2020 01:16 PM

Shingrix vs. Zostavax
 
Quote:

Originally Posted by Eg_cruz@comcast.net (Post 1818732)
Why do you need the new one......did you not get the old one
If you got the original one why do you need an other.

I did get the old one in 2013. But Shingrix is 97% effective at preventing shingles. The Zostavax is between 50-64% at preventing shingles.

bpascani 08-17-2020 06:22 PM

I was wondering that as well.


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