Medicare and new RSV vaccine (medical, plan, coverage, Florida)

[Vision67]

Some Older Adults Are Being Charged Over $300 for the New R.S.V. Vaccine

The shot is covered by Medicare Part D, but some with private prescription drug coverage are being asked to pay out of pocket.

free link: https://www.nytimes.com/2023/08/25/w...smid=url-share

"A spokeswoman for the Centers for Medicare & Medicaid Services confirmed in an email to The New York Times that the R.S.V. vaccines should be available free of charge to people with Medicare Part D. If people are told otherwise when they go to get the vaccine, they should call 1-800-MEDICARE for assistance."

[mike1003]

Ours were covered 100% at Kroger

[ihatetodust]

Any side effects?

[Lillie767]

The mass media is creating some mass hysteria. The RSV vaccine is not covered under Medicare Part B. However, the RSV vaccine is covered under Part D.

Even so, not every Medicare eligible participant has signed up for Part D.

Those who do not have Part D coverage, may have to pay for the shot.

"Several common vaccines, including those for the flu and COVID-19, are included under Medicare Part B, which provides medical coverage. However, the RSV vaccines, as well as a few others, including the vaccine for shingles, are covered under Medicare Part D, which pays for prescription drugs. As a result, Medicare enrollees without a Part D plan — roughly 16 million people — may have to pay for the RSV vaccine out of pocket depending on their non-Medicare prescription drug coverage."

https://news.yahoo.com/older-adults-...141236747.html

[slb7]

I keep reading the RSV vaccine WILL BE COVERED 100% by Medicare Part D.......NOT TRUE!! I have Aetna Silver Script and have gone back and forth with them and different pharmacies and they DO NOT cover it yet. I've argued that ALL recommended vaccines that aren't covered by Part B are suppose to be covered by Pt. D, but they keep denying it as it isn't in their formulary yet, but "keep checking back."

[lyndyb]

Coverage may be dependent on the medical insurance provider you have coverage with. I went to Rite Aid last Saturday, blithely assuming the RSV Vaccine was covered. We got the vaccine at no cost to us, covered by our prescription plan provider, Wellcare. The paperwork indicated the cost was $368.99!!!!

We had no side effects that either of us noticed. I have felt a little tired this week, but we've been very busy.

[Brave Stranger]

Originally Posted by slb7

I keep reading the RSV vaccine WILL BE COVERED 100% by Medicare Part D.......NOT TRUE!! I have Aetna Silver Script and have gone back and forth with them and different pharmacies and they DO NOT cover it yet. I've argued that ALL recommended vaccines that aren't covered by Part B are suppose to be covered by Pt. D, but they keep denying it as it isn't in their formulary yet, but "keep checking back."

It's covered now, at least at CVS, by Aetna Silver Script.

[wizrap]

I have Medicare Part D and my RSV vaccine was covered 100%. Just got it today. Had the shot at a Publix in north central Florida. My Part D is with Florida Blue.

I also got my flu shot at the same time, both in the same arm. Let’s see how sore I am tomorrow!

[Wile E. Coyote]

I got the RSV vaccine Friday night. I was tired Saturday, but, I was in a sleep deficit. Sunday I took about 10 naps (and I don't take naps). I felt lifeless without any energy. Still a bit out of it today, but, somewhat better. The pharmacist told me it would make my arm sore and might give me a headache. No headache, but, my big concern is always the fatigue and this was an issue with me (I am immunocompromised). My arm was massively inflamed and it's still pretty blown up.

Mine was covered under BCBS so I cannot add to that part of the discussion.

[SanyBelle]

Originally Posted by Brave Stranger

It's covered now, at least at CVS, by Aetna Silver Script.

I looked up it up online on the Aetna Silver Script website and it's covered by my Publix in Miami too.