Yet another shining example of how the US has the bestest medical system in the whole world!
I’m going through my own medical hell after a bike crash. I had to go to the ready/quick care for an xray to see if anything is broken in my shoulder but then have to schedule a real appointment with my primary doc (quickcare is only useful for checking for broke things…they wouldn’t even clean wounds or bandage me up since I’d already done the best I could on my own). We have a shortage of general doctors around here and that appointment is over a month out. Oh, I also need a general checkup but they don’t allow those two things in the same visit so my general checkup appt is end of October.
Sorry for sidetrack. US has a messed up medical system and it is getting worse all the time.
No its absolutely important she gets it (she got RSV last year so any immunity will likely have subsided), her doctors are all in agreement, its just the kafkaesque US healthcare/insurance system that is causing a problem. I mean kafkaesque is a bit of a misnomer, Joseph K’s trial seems logical and transparent compared to the US healthcare system
But remember we can’t get universal healthcare or our healthcare system will become a complex inefficient bureaucracy that doesn’t care about patient needs
I found a Walgreen’s branded urgent care center (“village medical”). Woot! They will be able to bill it. And i confirmed they can. Except they aren’t administering this vaccine.
I just spoke to the pharmacist at the retail place. They are still working on it, and she thinks they might be able to work it out. But they’ve confirmed that my pharmacy insurance doesn’t cover it. (which I already knew. but I don’t blame them for trying again.)
Walmart also can’t cover it under medical coverage, they need prescription coverage. But they found partial coverage under the Caremark prescription plan, with a $70 co-pay.
I’ve now wasted about 2.5 hours of pharmacist time, as well as my own time. Tell me again why universal healthcare would be less efficient than the mess we have?
On the other hand, if Caremark will give partial coverage to Walmart, it’s possible that they will give full coverage at a CVS. UHC didn’t contract with CVS under my employer’s plan, but maybe that’s because they want me to go through Caremark at CVS.
That’s why we pay more for drugs than any other nation. But i don’t think that’s really what props up our shitty health-reimbursment-system. Most of the money goes to mid-level jobs. Accountants, nurses clerks who decide whether something is covered, actuaries, etc. Very little of the frictional costs go to the vet wealthy.
I think it’s more about the irrational fear of government and socialism.
I’ve gotten at least my last Covid booster, both of my shingles vaccines, at least one flu shot, and a tetanus shot at CVS without any billing issues. (Not to mention also getting a $5 gift card.) In October I’ll be getting this year’s flu shot and the latest Covid booster. I did ask my doctor about getting the RSV shot, and he said not to get it just yet.
Initially, I asked my doctor about covid, flu, and RSV this fall, and he replied, “yes, all are recommended”. But the RSV certainly isn’t an urgent need. The nice lady at Walmart suggested I wait a few months, and see if my insurance doesn’t sort itself out, and when I asked my doctor if his hospital could do it, he said, “you could wait until you plan to be near an infant under 6 months old”.
Nonetheless, I’m going to try CVS and see what happens. And if they can’t get reimbursed by Caremark, I will either put it off, or more likely, just forget about this one.
Good luck with that. CVS and Caremark like to pretend they’re different companies when it suits them and they like to pretend they’re the same company when it suits them. The one constant is that “when it suits them” is not when it suits you.
Random aside that made me think of this thread. While visiting Walgreens yesterday at the end of the latest long Kafkaesque bureaucratic Odyssey over one of my daughters prescriptions I realized the person ahead of me was enduring their own long Kafkaesque bureaucratic Odyssey over some prescription. Not only that I realize every single time I have been there (without the slightest hyperbole literally every time) I have overheard someone going through the same thing. Every single time there is someone in heated conversation with the pharmacist while on the phone with their insurance (or sitting waiting while the pharmacist attempts to unravel some bureaucratic conundrum with the insurance)!
But still, again, we can’t have universal healthcare or our healthcare system will dissolve in a faceless bureaucratic quagmire, and we can’t have that
Today i got a call from UHC. I want able to take the call, but the message says that the person i spoke with wasn’t completely accurate, and this person wants to help me.
I’m pretty sure I’ve chewed up more cost in employee time (at UHC as well as at multiple pharmacies) than anyone is paying for the damn vaccine.
I’ll call back on Tuesday, because I’m curious what the new story is.
By the way, i did get the vaccine at CVS Thursday, and paid the $70 copay. Side effects are a slightly sore arm. I’m at a wedding weekend, and some woman kept tapping me on the arm last night, just where it’s sore, but otherwise i wouldn’t have noticed it much.
