Medicare problem

[magenta]

This is a warning about medicare and immunizations. Last month, my doctor told me I was overdue for a tetanus booster, or rather the TDaP, tetanus, diptherea and pertusis. I said, yes, i should get this, and shortly after, the nurse came in and administered it.

Recently, I got a bill for this shot. It turns out that it is not covered under Medicare part B, but part D, so my insurance would not cover it without my filing a separate form and waiting for reimbursement. I have one set of forms, and I am waiting on another. This took 2 phone calls, and may take more calls and work and forms. There is no way to tell in advance when this sort of thing will happen. And I have a Medicare supplement that is supposed to include everything.

I don't need this kind of s**t. I can afford to pay the $98 and wait for a check, but what if I couldn't? What if that made me late on my bills, or not able to get enough food? This is completely ridiculous - and why we need singe payer health care. Basic medical care should be completely covered, seamlessly, for everyone. This sort of c**p may also be why measles, whooping cough, and the like are coming back. Yes, some of it is the dreadful anti-vaxxers. But if I was close to the bone financially, I might skip this and other medical care I need.  

Comments

[dreamshark]

I have Medicare AAdvantage which seamlessly covers Parts B and D, so that particular thing doesn't happen. However, until this year Medicare did not cover the shingles vaccines AT ALL, no matter what kind of coverage you had. That totally sucked and made no sense at all, since the vaccine is particularly important for people over 65. And it was really expensive - almost $400 for the two-shot regimen. I think that has finally been remedied starting in 2023.

Incidentally, newer studies have debunked the old belief that you need a tetanus shot every 8-10 years. Not sure about pertussis or diptheria.

https://news.ohsu.edu/2016/03/22/study-shows-tetanus-shots-needed-every-30-years-not-every-10

[carbonel]

I ran into the same thing when I got my TDAP a couple of months ago. Turns out it's covered by Medicare (as of this year) as a pharmacy cost, but since I had it done by a nurse at a clinic, I had to pay $96. At least I can afford that.

I am at higher risk than the average person for tetanus, since I work with raw sheep fleece and pointy objects (combs), so I'll probably keep up with whatever is recommended for an interval.