Oh joy! Went to get my COVID vax update this morning (timing makes sense for me: students pouring back with cases at peak, yuck), and…
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They have a solution:
- Pay for the shot out of pocket now (which is $200).
- Save the receipt.
- Bring the receipt back to the pharmacy after Saturday (physically, this can’t happen over the phone, not that CVS is reachable over the phone anyway), and ask them to refund and rebill, and then it should go through.
- If that doesn’t work, upload receipt to HealthPartners and ask for reimbursement by going to their web site > Log in > My plan > Overview > Find a Form❮post truncated for length❯3/
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Consider:
- I can afford to pop $200 out of pocket and get reimbursed later. Not everyone can.
- I can afford 15 minutes wasted on the phone. Not everyone can.
- I can get back to the pharmacy easily for the billing retry. Not everyone can.
- I’m sufficiently fluent, pushy, and culturally privileged to navigate this whole stupid situation. Not everyone is.Each of those “not everyone”s is somebody who doesn’t get vaccinated — at who knows what cost to themselves and to us all.
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Paul Cantrellreplied to Paul Cantrell last edited by [email protected]
THE BIG QUESTION: What purpose does this serve?
It wasted a lot of people’s time: mine, the pharmacist’s, the support person at HealthPartner’s, presumably a bunch of people deep inside the pipeline of this whole stupid machine.
Did it improve care? No. Did it improve outcomes? No. Did help allocate some resource more efficiently or more effectively? No.
Did it even improve net •profit• across the whole health system? No!
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Paul Cantrellreplied to Paul Cantrell last edited by [email protected]
What purpose does this serve?
Well, we’ve set up a hideous Nash Equilibrium where health providers, insurers, pharma corps, and governments all stand to save money by relentlessly trying to gouge one of the others into paying for everything.
We are simultaneously trying to (1) sort of externalize the cost of health care (lest the market price individual human lives (not that it doesn’t, but we try)) while (2) using the market to make things efficient…somehow. Outcome: nonsense.
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I don’t love the idea of nationalizing all health care — I think it’s good to have many •strictly nonprofit• hospitals, docs, etc with some degree of autonomy — but I am ready to see private insurance eliminated completely. I don’t see that it adds any value whatsoever.
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That said, stories like this one from @daniel remind us of the danger of one central system making a bad decision for everyone at once:
https://social.treehouse.systems/@daniel/113040800671835057In the US, I do at least have the privilege of getting 2 boosters a year, simply because I think it’s a good idea. I don’t want to pretend utopia exists somewhere else.
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TL;DR:
- Paul is grumpity.
- US folks, if your insurance hasn’t caught up with the updated COVID shot, pay out of pocket if you can and fight for a reimbursement. And maybe write to your electeds (I am).
/end
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@inthehands I just went to my CVS appointment and they also told me that they don't contract with my insurance. I walked out with no shot, hoping to schedule with Walgreens, but they're two weeks out already. I really wanted that vax today
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@inthehands @daniel How are you getting 2 boosters a year? Are you paying cash for one of them?
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@DeweyOxberger
Go back, see if you can pay out of pocket…if you can afford to ride the 200 on your CC bill for a few weeks… -
@fuzzychef @daniel
Yes to 1, no to 2. -
@inthehands @daniel Sorry, I don't quite understand your answer.
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@DeweyOxberger @inthehands Also, with #Walgreens I found that their online scheduling didn’t match the reality of #vaccine availability in each store.
I called three locations and spoke with three frazzled employees who provided different ETA’s for the vaccine at their store.
I went with the store that thought they’d get it the soonest (1-2 weeks), but they advised that I call on the scheduled day to make sure that it’s really there.
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@fuzzychef @daniel
Sorry! Yes getting two boosters a year, no not paying out of pocket. (Insurer never seems to object.) -
Paul Cantrellreplied to Concept of a Pat 🇺🇸 🌊 last edited by
@patmadigan @DeweyOxberger
I now refuse to get early shots from Walgreens for exactly this reason. -
Michael Dekkerreplied to Paul Cantrell last edited by
@inthehands https://www.cdc.gov/iis/code-sets/fall-season-respiratory-codes.html CDC guidance on how to bill for fall 2024 vaccines is dated August 26. Not much time to get systems updated. Perhaps ask CDC whether payers received enough advance notice? (I work for a payer, but not this part of the shop. Opinions are my own.)
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Paul Cantrellreplied to Michael Dekker last edited by
@dekk
My mom has a saying: “When everyone’s watching the baby, no one is watching the baby.”
Should the CDC have figured all of this out weeks or months ago? Should insurers have internal processes set up to handle this expeditiously? Should this all just be on a regular schedule, like flu? Yes to all the above. -
@inthehands In #Ireland, we can’t get a #COVID vaccine for love or money.
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Probably depressedreplied to Paul Cantrell last edited by
@inthehands
I’ve worked at HealthPartners. This is the least surprising thing I’ve heard about HealthPartners. In fact, this just sounds like a random Tuesday in April. -
@aral why, in this great year of 2024…