Vaccine & Insurance

Something just occurred to me

When we were COVID tested, it all showed up in my insurance as fully paid for. When I drove my wife to her appointment, I asked if I could get tested too, I was told, no appointment only and I realized it made sense as they had none of my information.

Moving forward to vaccines. Same basic information provided for my appointment, so I expect to see it on my insurance, once I get it. But what about all the EXTRA DOSE people? Are they only getting it if insurance information is provided? Or just listed as uninsured and the Gov’t covers it, since the waste is a bigger sin? Just wondering how much information is collected at the time, if prior appointment not made.

I guess could be some as a walk-up

you don’t need insurance to get the vaccine. why even bother putting it down?

i’m confused by and not following your question though tbh.

I didn’t provide any insurance info. Or any detailed info for that matter.

This. “No insurance information provided”.

Government is already paying for the doses, just the administration would be billed. $28 for a single dose, or $16+$28 for two doses (subject to negotiation but those are Medicare rates). Government is already paying for Medicare and Medicaid patients, which is a huge chunk of adults, so the extra admin on these extra doses isn’t going to break the bank and I think the government would be happy paying that little bit extra to get another person vaccinated.

I have to provide Insurance Card and proof of ID.

i don’t think that’s true. I don’t think you need insurance to get the vaccine. proof of id, sure.

I don’t think you need it everywhere, but where I got mine it was required.
EDIT - I didn’t “need” insurance card if I didn’t have one since government would pay, but they did request if if I had it.

Is that how this works? If you have insurance/Medicaid/Medicare, they pay for the drug admin charge? But if you’re uninsured, does the federal govt pay?

Yeah that’s how it works. Just mandated that the patient has no cost, so no copays if you have insurance but they’ll cover the admin fee

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Mayan is correct, but I do think there are a lot of vaccines given to people on commercial insurance plans that are not being billed. I think a lot of mass vax sites do not bill (somehow the govt is covering all of that?), but if you get a shot at a pharmacy or doc office it is getting billed.

We saw a similar thing with Covid testing. A lot of the mass testing sites didn’t bill insurance. But the testing sites affiliated with pharmacies and doc offices did do insurance.

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Last week CMS raised the rates to $40/shot for each. That is causing a lot of hand-wringing in my parts…

I would suspect, but don’t know, that some sites are offering the space for free, and perhaps some/many/most providers are volunteers.

Agreed. Hard to get good data on these. This happens to a lesser extent with the flu shot as some people just pay the small fee at Costco/wherever if they don’t have their card on them, but given it’s free to the person and the provider is getting reimbursed either way not many people at the point of contact seem to care strongly.

Missed that - ouch. I work over in VBC side of things these days, so I’m not always up to speed on the latest changes anymore.

We are asked if we have insurance and if so they copy the card. I have seen charges come thru for my daughter and me, but not my hubby who got his at work.

I declined to provide insurance information when I signed up for my vaccination.

I did play around with CVS’s website this morning, as part of my prep work for the rush when my wife’s becomes eligible (along with everyone else aged 16+) in a week and a half. I noticed that CVS actually indicated they wanted insurance information to be able to bill for their services and therefore the registrant should please have their insurance card handy before starting the registration process.

That seems wrong, given that taxpayers are already on the hook for the bill.

What I read is that the federal government has paid for the vaccine, but the vaccination is paid for locally: first by your insurer, if you have one, and if not, by your state.

Surely we have someone here who works in health insurance and actually knows?

My daughter had her vaccine at Sams Club. The charge was $20.42 and insurance paid the full amount.

Mine was at an “event” and turned out it was administered by the health system my doctor belongs to. The charge was $33.88 and insurance paid half, $16.94.

Both of us received the Moderna vaccine.

and YOU paid the other half?

It has been explained above, no?

For each shot, there is the serum charge and an administration charge. Govt pays for both charges for Medicare/Medicaid patients. For commercial/individual, Govt pays for the serum and insurance compnay pays for the administration at 100% (meaning no out of pocket payments for the member).

But there are cases (mainly community sites) where insurance is not billed. In those cases I assume the money is coming from the Govt in the form of the the Cares Act.

Just like a fence!