Talk of The Villages Florida

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-   Medical and Health Discussion (https://www.talkofthevillages.com/forums/medical-health-discussion-94/)
-   -   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/)

OrangeBlossomBaby 08-17-2020 06:33 PM

Quote:

Originally Posted by PugMom (Post 1818855)
my friends who had Connecticare RAVED about it-said it was better than BC/BS

It's awesome. The downside is that the coverage is only awesome if you're in Connecticut. If you move outside Connecticut and seek medical care in another state, you're out of network and not covered at all.

I believe if you go to a participating national pharmacy you're still covered for prescriptions and vaccines in other states though, which would be handy for snowbirders who haven't had their flu shot yet and get their shot at CVS in September in Florida.

RVJim 08-17-2020 08:02 PM

Why are we seniors always looking for something to be handed to us for free or reduced cost? We are the entitled generation, we take in more than we ever produced. We should be happy and grateful with what we get and not complain about having to pay for something. For god sakes, we live in The Villages, we live in a hermetically sealed world far away from everyday troubles. Paying a bit for a shingles vaccine is a trifle not to be worried about.

OrangeBlossomBaby 08-17-2020 09:26 PM

Quote:

Originally Posted by RVJim (Post 1819132)
Why are we seniors always looking for something to be handed to us for free or reduced cost? We are the entitled generation, we take in more than we ever produced. We should be happy and grateful with what we get and not complain about having to pay for something. For god sakes, we live in The Villages, we live in a hermetically sealed world far away from everyday troubles. Paying a bit for a shingles vaccine is a trifle not to be worried about.

Generally - I tend to agree with you with regards to this particular issue.

However there are people living in the Villages on a fixed income, relying on Medicare, paying extra for prescription coverage, and then on top of that having to pay a couple hundred more dollars for a common, recommended vaccine that the prescription coverage doesn't cover.

Most of us can afford it. But not all of us can. Being retired doesn't mean being wealthy. Living in the Villages doesn't mean being wealthy. Some of us have to pick and choose where our money goes, and there isn't much left over at the end of the month.

graciegirl 08-18-2020 05:32 AM

Quote:

Originally Posted by OrangeBlossomBaby (Post 1819147)
Generally - I tend to agree with you with regards to this particular issue.

However there are people living in the Villages on a fixed income, relying on Medicare, paying extra for prescription coverage, and then on top of that having to pay a couple hundred more dollars for a common, recommended vaccine that the prescription coverage doesn't cover.

Most of us can afford it. But not all of us can. Being retired doesn't mean being wealthy. Living in the Villages doesn't mean being wealthy. Some of us have to pick and choose where our money goes, and there isn't much left over at the end of the month.

Some of those issues too rest on whether a person is sufficiently financially prepared to move to another state and stop working. We moved here in our late sixties. My husband worked remotely here until two years ago.

We have always been extremely careful and saving and financially conservative.

It is better to have extra when you need it, even if you do without or have to wait for good things to happen.

La lamy 08-18-2020 06:55 AM

I'm sorry you feel $310 (2 shots) for approximately a 5 year protection is expensive, but if you look it from another perspective, it's only 17 cents a day!

Joanne19335 08-18-2020 07:00 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.

I got shingles before I knew what it was. I was 52 years old and living in Arizona. It was the worst experience of my life. I was unable to get a vaccine until I was 60 years old. I paid $300 and had to get the vial, put it on ice and go to my PCP and have it injected. Once I moved here, a new vaccine replaced the first as it was determined that the first one was not as effective and I could get reinfected. Fortunately, I paid nothing and had to get a booster in six months. I paid nothing for the booster. As a former pharmacy technician, I recall that most people were unable to receive the booster because of the demand and short supply. Once you pass the six-month period, you would have to get the first one again and wait another six months.

I am surprised that all Part D plans do not pay 100% for this important vaccine, but having had shingles once, I would pay anything they asked and not look back.

Pedrocarrasco01@yahoo.com 08-18-2020 07:02 AM

Have Humana PPO
 
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.

We got the shingle vaccine in Boynton Beach, have Humana and we did not pay for it, it was included on our plan, that might have changed as it was 4 years ago!!!!!

kendi 08-18-2020 07:04 AM

Quote:

Originally Posted by Skip (Post 1818913)
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

Shingrix. I cannot get a live vaccine. Received both injections and paid nothing. I was told by the pharmacist they don’t give the other much any more. We have UHC with annual deductible, not on Medicare yet.

Skip 08-18-2020 07:47 AM

Quote:

Originally Posted by kendi (Post 1819230)
Shingrix. I cannot get a live vaccine. Received both injections and paid nothing. I was told by the pharmacist they don’t give the other much any more. We have UHC with annual deductible, not on Medicare yet.

That's the difference. You or your employer are paying premiums for non-Medicare (better )coverage.
Skip...

Stu from NYC 08-18-2020 08:10 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?

We had a Humana Advantage plan in Va and if I remember correctly each shot was about $ 90 each.

When we thought I had contracted shingles after the vaccinations my nurse sister pushed me to go to a local emergency room for treatment.

The nurse practitioner who saw me first decided it was a bug bite but asked him if there was a more senior physician there would could give me a second opinion.

He walked in and 15 seconds later said you have shingles and gave the NP a bit of a lesson on diagnosing shingles.

Gave me prescription for an antiviral. Bill for emergency room was somewhere about $ 1500 and Humana brought it down to about $ 500 and we paid about $ 100. Money well spent by us.

Apparently the Humana Gold plan sold here in Florida would give much better coverage at a cheaper price for all kinds of things medical.

bjd0105 08-18-2020 11:39 AM

I am a pharmacy technician and I have suggested to my patients that have a high copay to call their insurance. Ask them if they can lower the copay and some have done it. It doesn't hurt to ask.

Stu from NYC 08-18-2020 12:04 PM

Quote:

Originally Posted by RVJim (Post 1819132)
Why are we seniors always looking for something to be handed to us for free or reduced cost? We are the entitled generation, we take in more than we ever produced. We should be happy and grateful with what we get and not complain about having to pay for something. For god sakes, we live in The Villages, we live in a hermetically sealed world far away from everyday troubles. Paying a bit for a shingles vaccine is a trifle not to be worried about.

I do not see it that way. Why not get the biggest bang for your buck?

New Adventures 08-18-2020 01:04 PM

[QUOTE=Miguel 1952;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.[/QUO

I got mine at CVS in Wildwood for $20. My doctor's always suggest that I get this shot from a pharmacy as it is much cheaper. I have BC/BS Medicare coverage.

OrangeBlossomBaby 08-18-2020 02:28 PM

Quote:

Originally Posted by graciegirl (Post 1819172)
Some of those issues too rest on whether a person is sufficiently financially prepared to move to another state and stop working. We moved here in our late sixties. My husband worked remotely here until two years ago.

We have always been extremely careful and saving and financially conservative.

It is better to have extra when you need it, even if you do without or have to wait for good things to happen.

Yes, we had extra for when we needed it. And then - we needed it. Now we don't have that extra anymore, because we needed it.

That's how "for when you need it" works.

Stu from NYC 08-18-2020 03:13 PM

Quote:

Originally Posted by OrangeBlossomBaby (Post 1819494)
Yes, we had extra for when we needed it. And then - we needed it. Now we don't have that extra anymore, because we needed it.

That's how "for when you need it" works.

Very true


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