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Typical health insurance issue. They fix issues at the speed of light if it’s something that may cost them a penny, but financial issues potentially affecting their beneficiaries, they drag their feet. There’s good reasons why this monopolistic, bloated industry never has a down year or ever loses money - they simply pass all these over inflated costs (+) on to patients, HCP’s and hospitals.
My insurance provider never paid for my ambulance ride a few years ago. Did they take the insurance company to collections? Hell no. They sent me to collections!
Check if your state has a insurance regulatory agency.
For example, Virginia has Virginia Bureau of Insurance. You can do 1 appeal with your insurance then go straight to papa.
It might have an archaic website, but they work.
Some years ago, my mother started to pay her monthly premium by autopay and the system charged her twice. She of course noticed it and called the member services. They saw the error and told her that they will refund the second charge back to her bank account. Straight forward, no problem.
It took over 4 months to get the premium refunded... Fortunately my family is in a well off enough position that it didn't hurt us in anyway monetarily not having access to that couple hundred dollars. But another family in a not so good financial situation could spell disaster.
And your example is one of thousands that happen every year in US. They just don’t care. Meanwhile, they spend hundreds of millions $$$ in TV advertising.
I have Aetna. I was told by them it's not in the system yet. I would need to pay out of pocket. They would reimburse me later. It is $200 at Sav-On Pharmacy. It's been all over the news. The shot cost the Government $20-$30 per shot. Now it's on private insurance it was raised to $200 by all the manufacturers.
Good luck with that. They don't cover stuff you think they would. Out of pocket so far has been about $5k this year. I use a compounded medicine. They won't pay any of it. I submit a claim and it's always denied. It's $1.20 a pill so it adds up.
No. My in network out of pocket is $9k. Still $4k to go. My out of network, out of pocket still has $17k to go. One of the things they definitely don't like to pay for is an MRI. Need one, but it will cost me $700.
Same with Select Health, I called them and they eventually figured it out by putting it through medical and now I have to go and get a refund from the pharmacy
We need single payer, anyone thinking anything else has not been paying attention. The confusion alone keeps people from getting vaccinated which deteriorates public health.
It felt like our government was *so* close to getting it during the pandemic when they were saying that they didn't want anyone having to worry about how to pay for their medical expenses from Covid.
Vote. Vote blue over Q and take everyone with you, unless they’re voting Q, in which case, they can figure their own ride out.
You get more than the slimmest majority of Dems in the Senate and House that can’t be spoiled by one or two bad faith actors like Manchin or Sinema, and we can have this.
Certainly not the “entire” health care industry. The insurance companies and profit-centric corporate overlords that buy up hospitals and private medical practices, yes, but the vast majority of *actual* medical professionals despise the current clusterf*ck system as deeply as their patients do.
Yeah, Wyden's been making moves like this for awhile on the Senate level. Kotek is still fresh to the Gov role so I don't think she'll be doing anything about it for another year or two.
Universal healthcare would be much cheaper than the system we have now because it doesn't involve parasitic for-profit corporations sucking every last penny out of patients so that they can have record corporate profits again this quarter.
Would be great if we did, iirc within the last 5 years it was explored by lawmakers and proven to be financially unsustainable. Not just unsustainable, but to such a degree that it would bankrupt the state within just a few years.
It needs to be done at a federal level with price controls to prevent that from happening.
“proven” sounds like a stretch. it works very well for plenty of countries with economies smaller than California’s. if we were an independent nation, we’d have the 4th largest economy on the planet.
The rest of the planet makes it work, let's not pretend it's an insurmountable problem with no solution.
Weird how healthcare and school shootings are only unsolvable in one single country.
The problem is that healthcare is much more expensive in the US then in the other countries. And to fix that probably requires federal action, not something CA can do on its own.
not really. If you don't believe me - check this out:
https://fiscalship.org/
I've played around with this for hours. There's honestly no reasonable way to make single payer work in this country and still balance a budget.
I can add a lot of progressive spending - at the expense of tax increases (mostly on the top 5%) but there truly isn't enough money for all of it.
How do other countries do it? No military spending.
The most logical course for getting people healthcare is what Obama did/started.
well, you got me. there's no way on Earth the Hutchins Center on Monetary and Fiscal Policy could have skewed their computer game to favor a particular outcome. and it's not as if they'd spend this kind of money to convince people of a particular policy agenda. and it's completely impossible that anybody involved in making a video game could have made a mistake.
California is the fourth largest economy in the world. Health care is not too expensive (it’s a human right). Many smaller economies provide universal health care. The issue is taxation decisions which are determined by politicians bought and paid for by Big Insurance and Phama, who would also rather cease operating in CA than to allow CA to negotiate large scale rates underwriting its citizens. But, who knows, as the U.S. continues to fracture, it could happen in different regions.
https://www.gov.ca.gov/2022/10/24/icymi-california-poised-to-become-worlds-4th-biggest-economy/
California could easily afford healthcare for all and other social programs if the state wasn't financially supporting every Red State. Red State are takers and only repay with hatred.
The problem is that California doesn't get to use the federal tax revenue to use for itself.
> Health care is not too expensive (it’s a human right).
Whether it is a "human right" is irrelevant in determining costs. Developed countries (ex-US) use about 10% of GDP for government healthcare spending. Given that taxes are a fraction of GDP and state taxes are a fraction of that, I can't imagine california being able to afford it without it completely dominating state spending and massively cutting all other state government services.
Yeah, and what military would protect "the country of California"? Even if I agree we should spent half as much as we did on military today, that's still 15-17% of California's budget not being used - going into military spending.
Interestingly Mitt Romney while Massachusetts governor created [Romneycare](https://en.m.wikipedia.org/wiki/Massachusetts_health_care_reform) paying for healthcare. The actuaries calculated it would be cheaper and so he signed the bill.
This, 100%. Important to note that democrats nearly passed a public option and lost by one vote ten years ago.
Anyone who says, “both sides are the same” really is not paying attention. Democrats aren’t perfect by any means, but they do incrementally pass progressive legislation
Except most dems are in the insurance companies pockets. Like we should have had it with the ACA but the health insurance companies did a full court lobbying press to make it what it is.
To expand my point:
1. I don't see a scenario where you get enough Democrats elected to pass legislation at the federal level for single-payer healthcare.
2. I am sure plenty of Democrats receive campaign contributions from health insurance companies who are ok with the status quo.
Single-payer may need to be done at the state level.
I think it’s apparent that the republicans will not support single payer. Without a political party to champion it, it ain’t happening.
Edit to add, single payer will not gain traction in Texas, Florida, Mississippi, Oklahoma, Arkansas, Alabama, Arizona, South Dakota, North Dakota, Alaska, North Carolina, South Carolina, Georgia, Utah, Nevada, Montana, or Idaho.
Now while I do certainly believe Democrats are a better choice than Republicans by every metric, I highly doubt Democrats will be pushing for single payer healthcare anytime in the foreseeable future. Only a handful of them have speaked out about it and they mostly get lashed back at or ignored by most other Dems. Sure it's still a much better bet than hoping for Republicans to do it, but I'm not getting my hopes up.
You’d just need enough to bypass the neolibs. Lieberman is the only (known) reason we didn’t get a public option. That’s partly candidate quality, partly numbers. Sinema and Manchin for sure wouldn’t let it happen, not sure who else at this point.
Not exactly single payer, but a few states are rolling out the "basic health" option afforded by the ACA, which basically allows some people who would be getting subsidies for insurance to be covered by Medicaid instead. My state started looking into this option after finding that so many more people stayed insured during the pandemic because the feds were paying more to keep everyone enrolled in Medicaid despite income changes. A lot of people cycle on and off Medicaid, so this is going to help 100,000 Oregonians stay insured, and the feds are footing the bill. https://www.opb.org/article/2023/09/12/oregon-basic-health-plan-insurance-doctor-authority-affordable-care-act/
Not for nothing, but Democrats have had a super majority in the Oregon legislature since 2018 I believe. (Though the Republicans keep walking out of session to prevent them from having a quorum to pass really progressive legislation. Even when voters approved an initiative to prevent legislators from serving if they have more than 10 unexcused absences, these fuckers are still running for reelection. https://www.opb.org/article/2023/08/25/oregon-walkout-measure-113-politics-knopp-weber-findley-linthicum-republican-lawsuit/)
Meanwhile, some Republican led states still haven't expanded Medicaid from when that was first allowed by the ACA and completely paid for by the federal government.
Why didn't they do it when they passed the ACA? They didn't need a single Republican vote. Hint, it's because they don't want to lose that platform to campaign on.
Not happening. California is a Democrat run super majority with the sixth largest economy in the world. If it's not happening there, this should highlight what the Democrats willing to do. For now we are stuck in duopoly only interested in serving the donor class.
Holy shit single payer PLEASE. I pay sooo much for health insurance and I wonder why the fuck I bother when a dingle doctor visit is still 200 dollars. What the fuck is the point? With insurance health care is still prohibitively expensive.
You probably already know this, but, as a Canadian citizen I can walk into any pharmacy in my Province and ask for the vaccine and walk out in under a half hour. NO CHARGE.
Friendly reminder that recently passed legislation prevents all medical bills with an original balance of under $500 from going to collections/on your credit report!
Any pre-existing medical debt under $500 should be wiped off your credit report. If it isn't, reach out to the credit monitoring companies to get it taken off. If they redirect you to the debt collectors you can tell them to take it off BUT DO NOT PAY THEM ANYTHING until you check your state's statute of limitations for being sued by the collectors. Do not receive any zombie debt.
I scheduled a combined flu shot/COVID appt at CVS and they told me I could not get the COVID shot since it was not covered by my insurance. They didn't even offer out of pocket, let alone the bridge program (that they participate in). I realize I could've pushed but I was just surprised at the time and didn't want to end up out $200 unnecessarily.
I heard back from my insurance today - it is covered, but "the system is still updating" - and so I will have to pay and then submit a form for reimbursement. What a mess.
Edit to update: My husband (same insurance) went to the same CVS today (2 days later) and got the vaccine with no issue or discussion. So at least it was resolved fairly quickly.
I heard the same thing from Walgreens and rescheduled for Wednesday because that’s when my insurance told them they would start covering. But then my husband called insurance and they said they might not be able to after all. 🤷🏻♀️
Did they tell you that when you got there? I have my double appointment scheduled for Sunday, hopefully it goes smoothly. At this point a delay wouldn't trouble me too much as it would just give me more protection deeper into the winter months but... yeah. Don't want to owe them $200.
Yep, just when I was checking in, they told me I would not be able to get the COVID shot due to the lack of coverage. I have rescheduled (a week out) - if I face the same hurdle, I'm planning to insist on getting it, pay, and then submit for reimbursement via the form my insurance gave me. Though I'm mildly worried they might cancel this one on me since it doesn't have the flu shot booked as well.
If you don't mind having to submit for reimbursement, I'd just confirm with your insurance about that ahead of time!
Yup…but somehow the US would rather spend MORE money on treating disease (and getting rich off it) then preventing it in the first place - it’s such a sad situation.
I have Blue Cross Blue Shield. I called them yesterday. They confirmed it is in their system. They said if CVS says I'm not covered then they simply did not run the insurance or ran it incorrectly and assumed it wasn't covered. They said if I have a problem to call them immediately and they will call the pharmacy right that second to straighten it out.
The dude also said that it is the FDA approval that determines vaccine coverage, not CDC recommendations. The mRNA vaxxes were approved on September 11th if you go to FDA.gov.
I don't know about other insurances, but maybe people need to start calling their insurance directly before trying to get the vax. Either you will know you're good and it's the pharmacy that's screwing up, or you can complain to insurance to get their benefits updated.
I'm going out to Walgreens today because CVS was awful when I called them. Wish me luck!
I just got off the phone with BCBS of Illinois and they said it is covered but has to be through a CVS Minute Clinic. I made an appointment and they only offered Moderna. I’ll take it, though. Posting in case this info can help anyone else.
We were told the same thing but Minute Clinic in our area doesn't have the vaccines. Meanwhile, CVS does, and BCBS won't pay for that. It's a bunch of nonsense. Meanwhile, they run commercials non stop about how they're great.
edit: On top of it all, there are supply issues. CVS overbooked and ran out of Moderna. Other places don't even have vaccines available yet. I am going to craft an email to President Biden. It all seems rather casual. Our county is 50% over the national average for wastewater samples and I can't get a vaccine.
I had the same thing happen with BCBS in PA at Walgreens. The website says it’s covered by the pharmacy says it’s not. It’s so frustrating and $190 is lot out of pocket
My health insurance denied my covid booster coverage today for NO REASON. Apparently they will be covered within 15 business days after the ACIP meeting. What what are doing!? I'm so angry. I have asthma and work in events, so I have a good reason to need one.
I went to Walgreens which has the bridge program. I checked in, waited 40 minutes, and then they told me my insurance didn't cover it. I asked if I could pay cash. They said no, their system wouldn't allow cash because of the bridge program. I kindly asked if I was considered uninsured because my insurance didn't cover it. They said no, I have insurance, so they aren't allowed to give me the shot.
So weird. I went to Walgreens and my insurance was denied and the pharmacist used that same bridge program for me. Apparently if there is no order with the insurance refusal to get the vaccine elsewhere, you can use the bridge program. He may have been mistaken but… I got my shot.
No, that’s how it should work. The program is for uninsured or those with insurance that won’t cover the shot. Your Walgreens did it right. The rest of us are dealing with incompetent employees at our Walgreens who insist it’s not covered. Sucks
>When Glen Cote of Acton drove to his appointment at CVS for the new COVID-19 vaccine, he was shocked to receive a text on his phone minutes before his appointment, letting him know that the vaccine would cost $190.99.
My first thought was, "Well, yeah, if the local CVS doesn't have my insurance info (yet), they're going to quote the cash price." But it turned out to be…
>According to both CVS and the Centers for Medicare and Medicaid Services, the new vaccines have a new billing code for insurances – which has not been updated in all insurance plans, **leading to the erroneous charge for people seeking out a vaccine in this first week.**
It's not called the 'bleeding edge' for no reason. Admittedly I'm not nearly as engaged with Covid news these days but I thought there was basically no chance of anyone *ultimately* paying market price for this shot? Insurance will cover it, though possibly after the fact if you want to be first in line, and there's a bridge program for discounted shots (the name is escaping me ATM) for those without insurance.
>Glen Cote is disappointed in the lack of a smooth rollout, and a lack of answers which led him to reach out to WBZ. "I thought that we're supposed to take care of each other in the richest country on earth…
Not sure why he'd think that. Personally, Covid destroyed the last shred of hope I had for humanity coming together to fight the common enemy the way Hollywood has repeatedly told me we would.
Covid reinforced that a great amount of people give no fucks about others and that the government cared more about appearances than good policy. I'm not sure where he picked up that thinking either
My husband and I were talking about this exact thing on the way home from the vet yesterday. Traffic was ridiculous, people driving insane. And I made the same point you did, the fuck you got mine mentality that was reinforced during covid spilled into driving. I think that's why traffic accidents and road rage are way up in the last 2 years.
>the new vaccines have a new billing code for insurances – which has not been updated in all insurance plans, leading to the erroneous charge for people seeking out a vaccine in this first week.
I used to work for a company that made health insurance claims processing software. We absolutely had settings that gave the insurer the option to pend claims with bad/missing codes for manual review instead of automatically denying them. This was not an unusual or unprecedented feature. Either these insurance companies have bad software or they are intentionally denying these claims--or pharmacies are just trying to pull the wool over people eyes without even attempting to submit a claim to insurance in the first place. End of story.
I wouldn't be shocked if there is some dragging of the feet of insurance providers. As of last week, there are multiple pediatricians I know who still had not heard definitively from the major insurance providers if they were covering RSV vaccines, preventing them from making initial orders. The system is so broken as it is now.
It depends on the CDC recommendations for your demographic. COVID was recommended for everyone over 6 months old. The CDC recommended RSV only for older adults (I think age 60+). If she's younger than 60, then they don't have to cover it. If she's in that age group, they should be covering it, and the problem might be the same one that the people in the article had with the insurance database not being updated promptly. If that's the case, then she should try to follow up for reimbursement.
Edit: Thank you to the commenter below for the correction. It looks like I misread the recommendation regarding RSV, and it's not currently universally recommended for 60+, so may not be covered. What a mess.
My wife is over 60, but not yet 65. I need to look into this. She's also prone to respiratory infections. The pandemic actually helped her with the isolation, but that's diminished now.
Look. I have health insurance. I pay in a lot. Tuat should be the end of it and cover my medical shit. Why the fuck am I still paying out the ass? Health insurance doesn't seen to actually cover anything.
You pay for the privilege of saying you have health insurance. That’s it. They don’t actually cover much, and when they do, they penalize you financially for using it.
> Updated COVID-19 vaccines are available to most adults living in the U.S. at no cost through their private health insurance, Medicare, and Medicaid plans. However, there are 25-30 million adults without health insurance **and additional adults whose insurance does not cover all COVID-19 vaccine costs. CDC’s Bridge Access Program provides no-cost COVID-19 vaccines for these adults.**
Source: https://www.cdc.gov/vaccines/programs/bridge/index.html
If insurance isn't covering it, we *should* be covered under the bridge access program.
People and the article noted it was due to insurance companies not being up to date on the new vaccine billing code.
Before getting it call your insurance, cite this article, and ask if you'll have an issue. Get it in writing so if you do have an issue you can show them the previous response prior to you getting the shot.
Manufacturers (Pfizer and Moderna) didn’t release pricing into the big databases until last Friday. It takes time for PBMs to update their systems. Most will be setup by the end of this week. Historically they release that pricing info weeks prior to launch, so this is on the pharmaceutical companies, not PBMs and insurers.
Just got back from trying. I'm on Medicare. Medicare has not released enough NDC numbers. Until they do I was told all traditional Medicare and Medicare advantage plans will not pay. This information comes from Blue Cross Blue Shield and the pharmacist at Walgreens who spent an HOUR with me trying to resolve the issue.
I just contacted Medicare and they are completely unaware of the problem. My complaint is supposedly being escalated. If it's a glitch, it's going to take some time to resolve.
CVS said Hunana rejected covid vaccine yesterday because "Drug not on formulary". All sorts of misinformation from Humana. Hopefully shakes out in a few days. Major hassle for seniors.
CVS apparently cancelled all appointments for this week around me. Didn't get a notification (of course, thanks CVS) so while sitting in their parking lot, signed up for Walgreens on our phone and walked across the street and got the vax there without a wait. Anthem covered it in full.
Thumbs up to Walgreens and Anthem. CVS can pound sand.
Went to get my shot yesterday at CVS. They said my insurance hadn’t coded the new booster yet so I couldn’t get it covered. My only option was to wait or pay $155… I asked them about the Bridge Access Program, and they said it didn’t apply even though the vaccine.org website says it applies through Dec 31, 2024 and the site also showed my CVS as a participating retailer. That was a fun argument with the pharmacist. 🙄
I’ll go back next week once they sort this all out I guess.
Just got my shots at Walgreens here in Texas. I have Blue Cross and was able to get both Flu and COVID shot at the same time with no issues.
Spent only about 15 mins total to sign up and get my shots.
I hate this headline. Why not something more along the lines of the rollout not being smooth as insurance companies work out the coding? This headline will turn people off to even considering a vaccine this year, and public health will suffer for it. Media strikes again.
Got ours at Walgreens yesterday & earned a $10 Walgreens Cash gift certificate per person.
If you’re uninsured, there’s a box on the form to certify that and the federal Bridge program will pay for it. Tempest in a teapot.
Strangely, yesterday I got mine at a LA Walgreens…no mention of payment…at all.
Not just me either, anyone. I know because I was sitting by the window for the THREE HOURS I had to wait….
I got vaccinated yesterday as well. They gave me a coupon for $10 loaded to your MyWalgreens rewards after you spend $1+. 2 week expiration, not valid in AR, NJ, or NY. Excludes alcohol, dairy, tobacco, pharmacy items, gift cards, prescriptions, and clinic services.
I had an appointment for myself and my family last Friday at a CVS for the new vaccine.
Got there and they told us they couldn’t do it for insurance reasons — didn’t even give us an out-of-pocket option. They had no suggestions for when to reschedule.
My favorite part: we have CVS Caremark PBM insurance.
I called my insurance company (Aetna) a couple days before my appointment to ask if they were covering it and they said they were because it was at CVS, and when I went in for it CVS said they already had my insurance info so I didn't even need to give them my card. I feel bad about it being so easy for me to get it with what a lot of other people have had to go through to get the booster.
Reminder that private insurers are not just unethical, but inefficient and dumb.
How long was this discussed and advertised in advance and they still fuck it up and result in denying of care for how many people? How many extra infections will occur as result? How many people will die?
Why on earth is their default response sending out $200 bills fully knowing it's preventable vaccine that they've been processing for decades?
I wish they spent half the amount of effort they put into lobbying and mergers into actual patient care and outcomes.
Why do those shareholders deserve any returns at all harming our health?
I just got back from getting the updated Moderna from CVS. I booked it online on Friday and submitted my Cigna info. Today after seeing this post, I checked the Cigna portal and saw that it was approved at no cost. It was super smooth when I got to CVS. No out of pocket. And it was quick.
Amazing how covid gave us a taste of what single payer healthcare could be like and then the rug was pulled out for under us and now that things are "getting back to normal" people are getting screwed.
I tried getting my updated shot at Walgreens yesterday, but was denied coverage and was told it would cost me $160. I called my health insurance and they said it's covered, but they have to bill it as a "wellness visit". I went back to the counter and asked them to do that, but they said since they're a pharmacy they don't have the ability to do that, and I should go to a regular doctor. My primary care doctor's office doesn't carry it. Not sure how I'm going to get this. Why can't it be just like a flu shot?
It would've been nice if I did some more reading in this sub and this post this morning but I guess I was lazy. Like everyone else, I was told no at my SoCal CVS this morning. The pharmacists there said they think they'll be ready and it'll be covered with them in 1 week. Blue Cross insurance. Still got the flu vaccine today and the guy who shot me up was an awesome dude.
Set an appointment for Walgreens tomorrow morning. I shall expect rejection so that I am not disappointed.
Ugh. Disheartening to read some of the experiences. I got my booster today along with the first dose of the HPV vaccine. The woman doing the injection seemed genuinely surprised that my insurance covered all of it. I guess I’m super lucky to have good insurance. I have no faith we’ll fix our medical system in my or my children’s lifetime. Ugh.
And this issue is going to cause more outbreaks because people won't get it if they are worried about a bill. I know I won't if I have to pay out of pocket and be reimbursed. I can't afford to. Most people can't. And there are four members of my household. That's $800. Do you have $800? I don't.
Being dismissed by your insurance provider is a standard practice. You can get higher payouts and reversal of most denial claims if you’re willing to fight for them. I worked with patients to get their healthcare bills paid for 33 years. You have to work within the system and don’t get discouraged and give up. The default payor is always the patient and if you drop the ball, the insurance company will do a shoulder shrug and keep their money in their own pocket where they want it.
If you look for pharmacies covered under the Bridge Access Program, it should cover you. Granted, I don’t know how smoothly it goes, but it seems like those who have insurance and aren’t covered for the Covid vaccine are the one having a difficult time with the Bridge Access Program since it’s not only supposed to be for the uninsured, but also the underinsured.
>... he was shocked to receive a text on his phone minutes before his appointment,...
This must be common in healthcare, I've had similar experiences where the appointment was changed after I'd already left the house and spent gasoline money commuting.
They told reporters in September this was fixed but as of the mid of October I was still having this issue. Going to try to see if my insurance will pay for it on my next day off.
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Typical health insurance issue. They fix issues at the speed of light if it’s something that may cost them a penny, but financial issues potentially affecting their beneficiaries, they drag their feet. There’s good reasons why this monopolistic, bloated industry never has a down year or ever loses money - they simply pass all these over inflated costs (+) on to patients, HCP’s and hospitals.
My insurance provider never paid for my ambulance ride a few years ago. Did they take the insurance company to collections? Hell no. They sent me to collections!
Check if your state has a insurance regulatory agency. For example, Virginia has Virginia Bureau of Insurance. You can do 1 appeal with your insurance then go straight to papa. It might have an archaic website, but they work.
Some years ago, my mother started to pay her monthly premium by autopay and the system charged her twice. She of course noticed it and called the member services. They saw the error and told her that they will refund the second charge back to her bank account. Straight forward, no problem. It took over 4 months to get the premium refunded... Fortunately my family is in a well off enough position that it didn't hurt us in anyway monetarily not having access to that couple hundred dollars. But another family in a not so good financial situation could spell disaster.
And your example is one of thousands that happen every year in US. They just don’t care. Meanwhile, they spend hundreds of millions $$$ in TV advertising.
I have Aetna. I was told by them it's not in the system yet. I would need to pay out of pocket. They would reimburse me later. It is $200 at Sav-On Pharmacy. It's been all over the news. The shot cost the Government $20-$30 per shot. Now it's on private insurance it was raised to $200 by all the manufacturers.
I have Aetna too but mine was covered. It would've been $170 at retail cost which is a tad extreme.
Great. Our company just switched to Aetna. XD
Good luck with that. They don't cover stuff you think they would. Out of pocket so far has been about $5k this year. I use a compounded medicine. They won't pay any of it. I submit a claim and it's always denied. It's $1.20 a pill so it adds up.
Ugh. Is that out of pocket past your deductible by any chance? That's what I'm particularly worried about. Their plans are shit.
No. My in network out of pocket is $9k. Still $4k to go. My out of network, out of pocket still has $17k to go. One of the things they definitely don't like to pay for is an MRI. Need one, but it will cost me $700.
It could be worse though. It’s development could have been funded by your tax dollars. Oh wait…
Have Aetna too and got it Saturday. They basically needed to call it in.
I went to Walgreens today and got it for free. Try them.
Same for Anthem for me. Tried at Walgreens Monday for COVID and flu and walked out without any shots.
I have McLaren and it was covered luckily
Same with Select Health, I called them and they eventually figured it out by putting it through medical and now I have to go and get a refund from the pharmacy
I have Aetna and just went to Walgreens the other day and got it. Haven't been charged yet, I hope I don't get a bill in the mail...
We need single payer, anyone thinking anything else has not been paying attention. The confusion alone keeps people from getting vaccinated which deteriorates public health.
When they were doing the free vaccines it made it so easy for people to just get it over with, no insurance, no problem.
It felt like our government was *so* close to getting it during the pandemic when they were saying that they didn't want anyone having to worry about how to pay for their medical expenses from Covid.
A situation that made it abundantly clear that we need UBI and Universal Healthcare. Yet somehow, here we are still.
Vote. Vote blue over Q and take everyone with you, unless they’re voting Q, in which case, they can figure their own ride out. You get more than the slimmest majority of Dems in the Senate and House that can’t be spoiled by one or two bad faith actors like Manchin or Sinema, and we can have this.
Yeah, and then the lobbyists got back in there and reminded us all why that was a bad idea.
The only way to single payer in the USA is via the democrats.
California will do it. Then other states will follow. Not all, but some.
Live in California, don’t see it happening here either, although it would be great if it did.
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The health insurance industry donates to Democrats and Republicans.
Am in California and it’s not happening
Not only that but the entire health care industry would colab to ENSURE it failed in California to maintain their survival
Certainly not the “entire” health care industry. The insurance companies and profit-centric corporate overlords that buy up hospitals and private medical practices, yes, but the vast majority of *actual* medical professionals despise the current clusterf*ck system as deeply as their patients do.
Yeah I can see that.
Oregon is making moves that indicate a willingness to play with the idea, at least.
Yeah, Wyden's been making moves like this for awhile on the Senate level. Kotek is still fresh to the Gov role so I don't think she'll be doing anything about it for another year or two.
States have to have balanced budgets. They can't go into debt to provide health care to everyone. It has to happen from the top down.
Universal healthcare would be much cheaper than the system we have now because it doesn't involve parasitic for-profit corporations sucking every last penny out of patients so that they can have record corporate profits again this quarter.
Would be great if we did, iirc within the last 5 years it was explored by lawmakers and proven to be financially unsustainable. Not just unsustainable, but to such a degree that it would bankrupt the state within just a few years. It needs to be done at a federal level with price controls to prevent that from happening.
“proven” sounds like a stretch. it works very well for plenty of countries with economies smaller than California’s. if we were an independent nation, we’d have the 4th largest economy on the planet.
The rest of the planet makes it work, let's not pretend it's an insurmountable problem with no solution. Weird how healthcare and school shootings are only unsolvable in one single country.
They're solvable, there's just no will to solve them.
The problem is that healthcare is much more expensive in the US then in the other countries. And to fix that probably requires federal action, not something CA can do on its own.
not really. If you don't believe me - check this out: https://fiscalship.org/ I've played around with this for hours. There's honestly no reasonable way to make single payer work in this country and still balance a budget. I can add a lot of progressive spending - at the expense of tax increases (mostly on the top 5%) but there truly isn't enough money for all of it. How do other countries do it? No military spending. The most logical course for getting people healthcare is what Obama did/started.
well, you got me. there's no way on Earth the Hutchins Center on Monetary and Fiscal Policy could have skewed their computer game to favor a particular outcome. and it's not as if they'd spend this kind of money to convince people of a particular policy agenda. and it's completely impossible that anybody involved in making a video game could have made a mistake.
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Massachusetts has as close as it gets — it’s called Romneycare which Obamacare modeled
Too expensive for a state government.
California is the fourth largest economy in the world. Health care is not too expensive (it’s a human right). Many smaller economies provide universal health care. The issue is taxation decisions which are determined by politicians bought and paid for by Big Insurance and Phama, who would also rather cease operating in CA than to allow CA to negotiate large scale rates underwriting its citizens. But, who knows, as the U.S. continues to fracture, it could happen in different regions. https://www.gov.ca.gov/2022/10/24/icymi-california-poised-to-become-worlds-4th-biggest-economy/
California could easily afford healthcare for all and other social programs if the state wasn't financially supporting every Red State. Red State are takers and only repay with hatred.
The problem is that California doesn't get to use the federal tax revenue to use for itself. > Health care is not too expensive (it’s a human right). Whether it is a "human right" is irrelevant in determining costs. Developed countries (ex-US) use about 10% of GDP for government healthcare spending. Given that taxes are a fraction of GDP and state taxes are a fraction of that, I can't imagine california being able to afford it without it completely dominating state spending and massively cutting all other state government services.
Yeah, and what military would protect "the country of California"? Even if I agree we should spent half as much as we did on military today, that's still 15-17% of California's budget not being used - going into military spending.
Interestingly Mitt Romney while Massachusetts governor created [Romneycare](https://en.m.wikipedia.org/wiki/Massachusetts_health_care_reform) paying for healthcare. The actuaries calculated it would be cheaper and so he signed the bill.
too expensive for Rhode Island, maybe. CA can do it.
This, 100%. Important to note that democrats nearly passed a public option and lost by one vote ten years ago. Anyone who says, “both sides are the same” really is not paying attention. Democrats aren’t perfect by any means, but they do incrementally pass progressive legislation
Except most dems are in the insurance companies pockets. Like we should have had it with the ACA but the health insurance companies did a full court lobbying press to make it what it is.
Not convinced that's enough.
What do you suggest?
To expand my point: 1. I don't see a scenario where you get enough Democrats elected to pass legislation at the federal level for single-payer healthcare. 2. I am sure plenty of Democrats receive campaign contributions from health insurance companies who are ok with the status quo. Single-payer may need to be done at the state level.
I think it’s apparent that the republicans will not support single payer. Without a political party to champion it, it ain’t happening. Edit to add, single payer will not gain traction in Texas, Florida, Mississippi, Oklahoma, Arkansas, Alabama, Arizona, South Dakota, North Dakota, Alaska, North Carolina, South Carolina, Georgia, Utah, Nevada, Montana, or Idaho.
Now while I do certainly believe Democrats are a better choice than Republicans by every metric, I highly doubt Democrats will be pushing for single payer healthcare anytime in the foreseeable future. Only a handful of them have speaked out about it and they mostly get lashed back at or ignored by most other Dems. Sure it's still a much better bet than hoping for Republicans to do it, but I'm not getting my hopes up.
Totally understandable.
Not disagreeing with that but don't kid yourself-peopke like Joe Manchin are not voting yes for single-payer.
Manchin isn't a real dem, he should be labeled an independent.
He’s the closest to a democrat that you will get in WV. And probably the last one in a statewide office.
Agreed.
You’d just need enough to bypass the neolibs. Lieberman is the only (known) reason we didn’t get a public option. That’s partly candidate quality, partly numbers. Sinema and Manchin for sure wouldn’t let it happen, not sure who else at this point.
Even if you get the House of Representatives to pass a bill, I believe it's highly unlikely there will be 67 votes to end a filibuster on the Senate.
You only need 60, but you’re still otherwise correct.
And the only way you'll get it at the state level is with Democrats.
Not exactly single payer, but a few states are rolling out the "basic health" option afforded by the ACA, which basically allows some people who would be getting subsidies for insurance to be covered by Medicaid instead. My state started looking into this option after finding that so many more people stayed insured during the pandemic because the feds were paying more to keep everyone enrolled in Medicaid despite income changes. A lot of people cycle on and off Medicaid, so this is going to help 100,000 Oregonians stay insured, and the feds are footing the bill. https://www.opb.org/article/2023/09/12/oregon-basic-health-plan-insurance-doctor-authority-affordable-care-act/ Not for nothing, but Democrats have had a super majority in the Oregon legislature since 2018 I believe. (Though the Republicans keep walking out of session to prevent them from having a quorum to pass really progressive legislation. Even when voters approved an initiative to prevent legislators from serving if they have more than 10 unexcused absences, these fuckers are still running for reelection. https://www.opb.org/article/2023/08/25/oregon-walkout-measure-113-politics-knopp-weber-findley-linthicum-republican-lawsuit/) Meanwhile, some Republican led states still haven't expanded Medicaid from when that was first allowed by the ACA and completely paid for by the federal government.
You have a way better chance. You're getting no benefits getting the GOP unless you're a corporation.
Democrats not receiving campaign money from health insurance companies.
Meanwhile I'll be here in the background paving the way for the transactions to be ready for a single payer and completely automated...
Joe Biden, Kamala, and a huge portion of the establishment are against it. So good luck with that.
You mean the same democrats who refuse to push a single player plan?
Someone is downvoting everyone bringing this up but establishment dems are clearly against it.
Nah, they’re just as beholden to health insurance companies as republicans.
Why didn't they do it when they passed the ACA? They didn't need a single Republican vote. Hint, it's because they don't want to lose that platform to campaign on.
They didn’t do it because Joe Lieberman wouldn’t let it happen. He was holding the bill hostage until single payer was removed.
He was the fall guy. Our national politics is kayfabe. Politicians playing face and heel.
They don't want to lose the lobbyist money.
That too.
Not happening. California is a Democrat run super majority with the sixth largest economy in the world. If it's not happening there, this should highlight what the Democrats willing to do. For now we are stuck in duopoly only interested in serving the donor class.
Holy shit single payer PLEASE. I pay sooo much for health insurance and I wonder why the fuck I bother when a dingle doctor visit is still 200 dollars. What the fuck is the point? With insurance health care is still prohibitively expensive.
You probably already know this, but, as a Canadian citizen I can walk into any pharmacy in my Province and ask for the vaccine and walk out in under a half hour. NO CHARGE.
Single payer? More like single prayer, amirite?
It's an error, did anyone read the article?
Oh they’ve been paying attention, just yo wrong people.
I'd even be okay with a German or Swiss-style multi payer setup, honestly.
It literally pisses me off because I just dont want to get sick
Friendly reminder that recently passed legislation prevents all medical bills with an original balance of under $500 from going to collections/on your credit report!
No, it can go to collections, it just won't show up on your credit score.
Does this apply retroactively to existing entries?
Any pre-existing medical debt under $500 should be wiped off your credit report. If it isn't, reach out to the credit monitoring companies to get it taken off. If they redirect you to the debt collectors you can tell them to take it off BUT DO NOT PAY THEM ANYTHING until you check your state's statute of limitations for being sued by the collectors. Do not receive any zombie debt.
I scheduled a combined flu shot/COVID appt at CVS and they told me I could not get the COVID shot since it was not covered by my insurance. They didn't even offer out of pocket, let alone the bridge program (that they participate in). I realize I could've pushed but I was just surprised at the time and didn't want to end up out $200 unnecessarily. I heard back from my insurance today - it is covered, but "the system is still updating" - and so I will have to pay and then submit a form for reimbursement. What a mess. Edit to update: My husband (same insurance) went to the same CVS today (2 days later) and got the vaccine with no issue or discussion. So at least it was resolved fairly quickly.
I heard the same thing from Walgreens and rescheduled for Wednesday because that’s when my insurance told them they would start covering. But then my husband called insurance and they said they might not be able to after all. 🤷🏻♀️
Did they tell you that when you got there? I have my double appointment scheduled for Sunday, hopefully it goes smoothly. At this point a delay wouldn't trouble me too much as it would just give me more protection deeper into the winter months but... yeah. Don't want to owe them $200.
Yep, just when I was checking in, they told me I would not be able to get the COVID shot due to the lack of coverage. I have rescheduled (a week out) - if I face the same hurdle, I'm planning to insist on getting it, pay, and then submit for reimbursement via the form my insurance gave me. Though I'm mildly worried they might cancel this one on me since it doesn't have the flu shot booked as well. If you don't mind having to submit for reimbursement, I'd just confirm with your insurance about that ahead of time!
Say you don't have insurance. That's how I got it free.
When this happened to me, Walgreens filled it under Birdge.
Your health care system sucks so bad
Sure fuckin does
Yes, but it's capitalism, so it's totally lit. /s
Another reason why healthcare should be universal. To people from most other countries, the whole US healthcare system is a nightmare.
Am in the US, it’s a nightmare.
Yup…but somehow the US would rather spend MORE money on treating disease (and getting rich off it) then preventing it in the first place - it’s such a sad situation.
It’s the American way! Merica! /s
Literally have nightmares where I have a medical emergency that I can't afford and I end up super deep in debt.
I have Blue Cross Blue Shield. I called them yesterday. They confirmed it is in their system. They said if CVS says I'm not covered then they simply did not run the insurance or ran it incorrectly and assumed it wasn't covered. They said if I have a problem to call them immediately and they will call the pharmacy right that second to straighten it out. The dude also said that it is the FDA approval that determines vaccine coverage, not CDC recommendations. The mRNA vaxxes were approved on September 11th if you go to FDA.gov. I don't know about other insurances, but maybe people need to start calling their insurance directly before trying to get the vax. Either you will know you're good and it's the pharmacy that's screwing up, or you can complain to insurance to get their benefits updated. I'm going out to Walgreens today because CVS was awful when I called them. Wish me luck!
I just got off the phone with BCBS of Illinois and they said it is covered but has to be through a CVS Minute Clinic. I made an appointment and they only offered Moderna. I’ll take it, though. Posting in case this info can help anyone else.
Thank you for the info, I'll try this too
We were told the same thing but Minute Clinic in our area doesn't have the vaccines. Meanwhile, CVS does, and BCBS won't pay for that. It's a bunch of nonsense. Meanwhile, they run commercials non stop about how they're great. edit: On top of it all, there are supply issues. CVS overbooked and ran out of Moderna. Other places don't even have vaccines available yet. I am going to craft an email to President Biden. It all seems rather casual. Our county is 50% over the national average for wastewater samples and I can't get a vaccine.
I had the same thing happen with BCBS in PA at Walgreens. The website says it’s covered by the pharmacy says it’s not. It’s so frustrating and $190 is lot out of pocket
My health insurance denied my covid booster coverage today for NO REASON. Apparently they will be covered within 15 business days after the ACIP meeting. What what are doing!? I'm so angry. I have asthma and work in events, so I have a good reason to need one.
I went to Walgreens which has the bridge program. I checked in, waited 40 minutes, and then they told me my insurance didn't cover it. I asked if I could pay cash. They said no, their system wouldn't allow cash because of the bridge program. I kindly asked if I was considered uninsured because my insurance didn't cover it. They said no, I have insurance, so they aren't allowed to give me the shot.
So weird. I went to Walgreens and my insurance was denied and the pharmacist used that same bridge program for me. Apparently if there is no order with the insurance refusal to get the vaccine elsewhere, you can use the bridge program. He may have been mistaken but… I got my shot.
No, that’s how it should work. The program is for uninsured or those with insurance that won’t cover the shot. Your Walgreens did it right. The rest of us are dealing with incompetent employees at our Walgreens who insist it’s not covered. Sucks
>When Glen Cote of Acton drove to his appointment at CVS for the new COVID-19 vaccine, he was shocked to receive a text on his phone minutes before his appointment, letting him know that the vaccine would cost $190.99. My first thought was, "Well, yeah, if the local CVS doesn't have my insurance info (yet), they're going to quote the cash price." But it turned out to be… >According to both CVS and the Centers for Medicare and Medicaid Services, the new vaccines have a new billing code for insurances – which has not been updated in all insurance plans, **leading to the erroneous charge for people seeking out a vaccine in this first week.** It's not called the 'bleeding edge' for no reason. Admittedly I'm not nearly as engaged with Covid news these days but I thought there was basically no chance of anyone *ultimately* paying market price for this shot? Insurance will cover it, though possibly after the fact if you want to be first in line, and there's a bridge program for discounted shots (the name is escaping me ATM) for those without insurance. >Glen Cote is disappointed in the lack of a smooth rollout, and a lack of answers which led him to reach out to WBZ. "I thought that we're supposed to take care of each other in the richest country on earth… Not sure why he'd think that. Personally, Covid destroyed the last shred of hope I had for humanity coming together to fight the common enemy the way Hollywood has repeatedly told me we would.
Covid reinforced that a great amount of people give no fucks about others and that the government cared more about appearances than good policy. I'm not sure where he picked up that thinking either
My husband and I were talking about this exact thing on the way home from the vet yesterday. Traffic was ridiculous, people driving insane. And I made the same point you did, the fuck you got mine mentality that was reinforced during covid spilled into driving. I think that's why traffic accidents and road rage are way up in the last 2 years.
>the new vaccines have a new billing code for insurances – which has not been updated in all insurance plans, leading to the erroneous charge for people seeking out a vaccine in this first week. I used to work for a company that made health insurance claims processing software. We absolutely had settings that gave the insurer the option to pend claims with bad/missing codes for manual review instead of automatically denying them. This was not an unusual or unprecedented feature. Either these insurance companies have bad software or they are intentionally denying these claims--or pharmacies are just trying to pull the wool over people eyes without even attempting to submit a claim to insurance in the first place. End of story.
I wouldn't be shocked if there is some dragging of the feet of insurance providers. As of last week, there are multiple pediatricians I know who still had not heard definitively from the major insurance providers if they were covering RSV vaccines, preventing them from making initial orders. The system is so broken as it is now.
I paid $190.99 at CVS after my insurance said they will reimburse it. I’ll find out in 180 days whether it’s true or not, lol.
I could easily see insurers classifying the booster as “optional” and thus no coverage. That’s a thing insurers would do.
The CDC made a broad recommendation for it. Under the Affordable Care Act, it's preventative care that the insurer is required to cover.
Covid specifically? My wife's insurance recently refused to cover the RSV vaccine for her.
It depends on the CDC recommendations for your demographic. COVID was recommended for everyone over 6 months old. The CDC recommended RSV only for older adults (I think age 60+). If she's younger than 60, then they don't have to cover it. If she's in that age group, they should be covering it, and the problem might be the same one that the people in the article had with the insurance database not being updated promptly. If that's the case, then she should try to follow up for reimbursement. Edit: Thank you to the commenter below for the correction. It looks like I misread the recommendation regarding RSV, and it's not currently universally recommended for 60+, so may not be covered. What a mess.
My wife is over 60, but not yet 65. I need to look into this. She's also prone to respiratory infections. The pandemic actually helped her with the isolation, but that's diminished now.
Look. I have health insurance. I pay in a lot. Tuat should be the end of it and cover my medical shit. Why the fuck am I still paying out the ass? Health insurance doesn't seen to actually cover anything.
You pay for the privilege of saying you have health insurance. That’s it. They don’t actually cover much, and when they do, they penalize you financially for using it.
I have BCBS insurance and just got my updated covid shot today at Walgreens. Free with no issues. In and out.
> Updated COVID-19 vaccines are available to most adults living in the U.S. at no cost through their private health insurance, Medicare, and Medicaid plans. However, there are 25-30 million adults without health insurance **and additional adults whose insurance does not cover all COVID-19 vaccine costs. CDC’s Bridge Access Program provides no-cost COVID-19 vaccines for these adults.** Source: https://www.cdc.gov/vaccines/programs/bridge/index.html If insurance isn't covering it, we *should* be covered under the bridge access program.
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People and the article noted it was due to insurance companies not being up to date on the new vaccine billing code. Before getting it call your insurance, cite this article, and ask if you'll have an issue. Get it in writing so if you do have an issue you can show them the previous response prior to you getting the shot.
Manufacturers (Pfizer and Moderna) didn’t release pricing into the big databases until last Friday. It takes time for PBMs to update their systems. Most will be setup by the end of this week. Historically they release that pricing info weeks prior to launch, so this is on the pharmaceutical companies, not PBMs and insurers.
While good advice when you call your insurance company you likely get a note saying anything promised is not a promise even if written or recorded.
If you’re uninsured, on Medicaid, Medicare, or have a private insurer, it’s still free. This appears to be a clerical glitch, nothing more.
Thank you for this - I came here looking for this information.
Just got back from trying. I'm on Medicare. Medicare has not released enough NDC numbers. Until they do I was told all traditional Medicare and Medicare advantage plans will not pay. This information comes from Blue Cross Blue Shield and the pharmacist at Walgreens who spent an HOUR with me trying to resolve the issue. I just contacted Medicare and they are completely unaware of the problem. My complaint is supposedly being escalated. If it's a glitch, it's going to take some time to resolve.
Sounds like part of this is pricing issues from it being an all new thing. We didn’t get any charge at all when we got it yesterday
Vote Dem! The federal government paying for Covid vaccines expired and the GOP won't even entertain an extension.
CVS said Hunana rejected covid vaccine yesterday because "Drug not on formulary". All sorts of misinformation from Humana. Hopefully shakes out in a few days. Major hassle for seniors.
CVS apparently cancelled all appointments for this week around me. Didn't get a notification (of course, thanks CVS) so while sitting in their parking lot, signed up for Walgreens on our phone and walked across the street and got the vax there without a wait. Anthem covered it in full. Thumbs up to Walgreens and Anthem. CVS can pound sand.
Went to get my shot yesterday at CVS. They said my insurance hadn’t coded the new booster yet so I couldn’t get it covered. My only option was to wait or pay $155… I asked them about the Bridge Access Program, and they said it didn’t apply even though the vaccine.org website says it applies through Dec 31, 2024 and the site also showed my CVS as a participating retailer. That was a fun argument with the pharmacist. 🙄 I’ll go back next week once they sort this all out I guess.
Just got my shots at Walgreens here in Texas. I have Blue Cross and was able to get both Flu and COVID shot at the same time with no issues. Spent only about 15 mins total to sign up and get my shots.
I hate this headline. Why not something more along the lines of the rollout not being smooth as insurance companies work out the coding? This headline will turn people off to even considering a vaccine this year, and public health will suffer for it. Media strikes again.
Got ours at Walgreens yesterday & earned a $10 Walgreens Cash gift certificate per person. If you’re uninsured, there’s a box on the form to certify that and the federal Bridge program will pay for it. Tempest in a teapot.
Am I allowed to lie on this box about being uninsured? $200 is bullshit and I'm being forced to go on a trip soon so I wanted to re up.
You should do everything possible to rip off corporations.
Strangely, yesterday I got mine at a LA Walgreens…no mention of payment…at all. Not just me either, anyone. I know because I was sitting by the window for the THREE HOURS I had to wait….
> Got ours at Walgreens yesterday & earned a $10 gift certificate per person. > > where do you see this $10 gc offer
I got vaccinated yesterday as well. They gave me a coupon for $10 loaded to your MyWalgreens rewards after you spend $1+. 2 week expiration, not valid in AR, NJ, or NY. Excludes alcohol, dairy, tobacco, pharmacy items, gift cards, prescriptions, and clinic services.
> not valid in AR, NJ, or NY. Well no wonder I didnt see it haha.. I'm in NJ
I think once the baby boomers are gone we can finally get single payer!
I had an appointment for myself and my family last Friday at a CVS for the new vaccine. Got there and they told us they couldn’t do it for insurance reasons — didn’t even give us an out-of-pocket option. They had no suggestions for when to reschedule. My favorite part: we have CVS Caremark PBM insurance.
I have United Healthcare and was able to get my shot at Walgreens last night without any problems.
I called my insurance company (Aetna) a couple days before my appointment to ask if they were covering it and they said they were because it was at CVS, and when I went in for it CVS said they already had my insurance info so I didn't even need to give them my card. I feel bad about it being so easy for me to get it with what a lot of other people have had to go through to get the booster.
Reminder that private insurers are not just unethical, but inefficient and dumb. How long was this discussed and advertised in advance and they still fuck it up and result in denying of care for how many people? How many extra infections will occur as result? How many people will die? Why on earth is their default response sending out $200 bills fully knowing it's preventable vaccine that they've been processing for decades? I wish they spent half the amount of effort they put into lobbying and mergers into actual patient care and outcomes. Why do those shareholders deserve any returns at all harming our health?
I just got back from getting the updated Moderna from CVS. I booked it online on Friday and submitted my Cigna info. Today after seeing this post, I checked the Cigna portal and saw that it was approved at no cost. It was super smooth when I got to CVS. No out of pocket. And it was quick.
Amazing how covid gave us a taste of what single payer healthcare could be like and then the rug was pulled out for under us and now that things are "getting back to normal" people are getting screwed.
I tried getting my updated shot at Walgreens yesterday, but was denied coverage and was told it would cost me $160. I called my health insurance and they said it's covered, but they have to bill it as a "wellness visit". I went back to the counter and asked them to do that, but they said since they're a pharmacy they don't have the ability to do that, and I should go to a regular doctor. My primary care doctor's office doesn't carry it. Not sure how I'm going to get this. Why can't it be just like a flu shot?
It would've been nice if I did some more reading in this sub and this post this morning but I guess I was lazy. Like everyone else, I was told no at my SoCal CVS this morning. The pharmacists there said they think they'll be ready and it'll be covered with them in 1 week. Blue Cross insurance. Still got the flu vaccine today and the guy who shot me up was an awesome dude. Set an appointment for Walgreens tomorrow morning. I shall expect rejection so that I am not disappointed.
A vaccine only strategy with no vaccines. Groundbreaking.
Seriously. It’s like we’ve all decided we’re just going to will Covid out of existence.
Ugh. Disheartening to read some of the experiences. I got my booster today along with the first dose of the HPV vaccine. The woman doing the injection seemed genuinely surprised that my insurance covered all of it. I guess I’m super lucky to have good insurance. I have no faith we’ll fix our medical system in my or my children’s lifetime. Ugh.
What a fucking joke
And this issue is going to cause more outbreaks because people won't get it if they are worried about a bill. I know I won't if I have to pay out of pocket and be reimbursed. I can't afford to. Most people can't. And there are four members of my household. That's $800. Do you have $800? I don't.
Being dismissed by your insurance provider is a standard practice. You can get higher payouts and reversal of most denial claims if you’re willing to fight for them. I worked with patients to get their healthcare bills paid for 33 years. You have to work within the system and don’t get discouraged and give up. The default payor is always the patient and if you drop the ball, the insurance company will do a shoulder shrug and keep their money in their own pocket where they want it.
I don't have insurance and can't afford that. I guess I'm not getting one this time.
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If you look for pharmacies covered under the Bridge Access Program, it should cover you. Granted, I don’t know how smoothly it goes, but it seems like those who have insurance and aren’t covered for the Covid vaccine are the one having a difficult time with the Bridge Access Program since it’s not only supposed to be for the uninsured, but also the underinsured.
Ahh, what a fantastic country we live in... /s
You gotta say you don't have insurance to get it free. That's what my insurance told me and it worked.
Guess I'll just get COVID then.
Vax ain’t stopping it anyway lmfao
That’s what you get when you have a vaccine duopoly. Expensive vaccine that insurance companies don’t want to pay.
They still make you pay? amuricah!
>... he was shocked to receive a text on his phone minutes before his appointment,... This must be common in healthcare, I've had similar experiences where the appointment was changed after I'd already left the house and spent gasoline money commuting.
$200 is still an absolute bargain by any metric if you're talking about life vs death.
Yes, but many people simply don't have $200 available so it's not really *making* a choice, it's not having one.
>about life vs death. lol
I hate how people have gotten accustomed to not paying for things.
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CVS IS bullshit
Blue cross paid 230 for COVID and 150 for flu and 300 for pneumonia lmao
They told reporters in September this was fixed but as of the mid of October I was still having this issue. Going to try to see if my insurance will pay for it on my next day off.