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Valarie, Nurse (RN)
Category: Health
Satisfied Customers: 1228
Experience:  36+ yrs exprience medical, surgical, wound/skin care, nutrition, geriatrics, rehab, management
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I watched my mother suffer from shingles. It was the first

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I watched my mother suffer from shingles. It was the first time in my life I ever saw my mother cry. It totally wore her down until she died. I'm petrified of the disease. When I asked at my doctor's office about the shot to prevent this horrible disease, they said that they did not give it. A local drugstore offers it, but they want $200 and then you have to file your own insurance. I am 74 years old and on an extremely low income. I can't afford the $200. Yet, friends of mine in MI and MN were simply given the shot at their doctor's offices. They know how debilitating this disease is to the elderly, especially. I need to know if Medicare covers this and why it isn't simply available at our doctors' offices. I live in AR.



The reason the vaccine is not given at your doctor's office is because Medicare B does not cover it. Your doctor's office bills Medicare B for services and other vaccines like flu, and Hepatitis B. The shingles vaccine is covered by Medicare D, which is the coverage for your prescription drugs. If you don't have Medicare D, then you would have to pay for the vaccine privately.


If you do have Medicare D, the coverage is still tricky. Your doctor's office has to be set up to be able to bill Medicare D for you in connection with your pharmacy that supplies your medications under your Medicare D health plan. Some doctor's offices are probably either not set up for this, or don't want to deal with the extra paperwork. So, your friends may have a doctor's office that is willing to do the extra billing procedures, or they will later get a bill for the vaccine that they will have to pay for out-of-pocket.


If you do have aMedicare D plan, you can get the vaccine at the pharmacy you deal with, and the pharmacist is allowed to administer it unless you live in the state of Maine.


It is very confusing. Here is a link to Does Medicare pay for the Shingles shot? from AARP's Bulletin News.

Valarie and 5 other Health Specialists are ready to help you
Customer: replied 7 years ago.
Thank you. You are the first one who honestly answered my question. My drug plan is with Humana. I will have to check with them. Thank you for you prompt response.

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