Plan B Forum

Dear god...

Those who have health insurance have it paid at 100%, just like any vaccine. This is the ACA preventive care requirement, and the CARES Act contained a broader mandate for the COVID vaccine. Medicare, Medicaid, exchange plans, etc. all cover at 100%. There is a reimbursement fund for uninsureds. The only health plan not required to pay at 100% are plans "grandfathered" from ACA requirements (covering a small sliver of the population), and everyone of those that I know of are paying at 100%.

Since my carrier isn’t contracted with Walgreens, that means I paid the full cost they’re charging folks which is $2.59.

Obviously totally free is best, but less than a Dunkin’ coffee is a manageable copay for most people, even poor folks. I’m glad to know Walgreens didn’t take the opportunity to gouge - though I don’t know if that was altruism or if there were terms in the procurement contract with the feds which limited the copay range allowed.

One point I would make about my experience, which I chatted about last night with the other home health worker who looked to be my age or slightly older: the technology involved to sign up with Walgreens to be able to make a vaccination appointment was borderline frustrating, and that was the second step after navigating the state website to find the map with locations where appointments could be made. Presently very elderly are being vaccinated through this stage if they live in congregant settings, but it’s just a few days until they are all age eligible (February 1st), and I think a great many are going to struggle with the registration process for a vaccination appointment unless they have family or other help with navigating it. I hope Massachusetts has a very solid proactive plan in place to outreach to the elderly, many of whom are physically isolated and not plugged into the internet.

Just to clarify in light of Long Run’s post - yes I have health insurance but my insurer like all in the USA contracts with preferred pharmacies and Walgreens is not now a contractual partner which is why my vaccine copay wasn’t covered.

The truth in America is that even if fully insured you don’t really get to pick your doctor, your pharmacy, or your hospital in most circumstances- you get to pick only from a list your insurer is in profit-sharing bed with.

It's a lottery. If BSG had gone to CVS for example (another pharmacy chain similar to Walgreen's) they might have had a different contractual agreement with her insurer and it might have cost more or less. I have Medicare for my insurance because I am old (and not to go off on a tangent but all these people who are against 'socialized medicine' and would go to the barricades to defend against it would not ever hear a word against Medicare) and I got my jab through a hospital system hence no charge.

There's another wrinkle with Medicare. You have to sign up for a drug provider in addition to the insurance company who partners with Medicare. How do you choose which drug provider to go with? Give your insurance agent (thus a second layer of additional charges to the program) a list of all your medications. He or she plugs them into a program which knows the fee that each insurance has negotiated with the drug company for that pill. In my case XXX Drug Pushers Inc. were the cheapest. "Go with them, then" said the agent. "What happens if my needs change and my doc prescribes something else?" I asked. "Tough." (Or words to that effect.)

Yes CVS is where I get my prescriptions for a very small copay - I’m on MassHealth Medicaid for poor adults. There’s a CVS a block from me, but they aren’t set up to provide covid19 vaccines yet - only testing.

I already scheduled my 2nd dose at the same Walgreens on February 17. So I’ll spend just over $5 total for the privilege.

My arm hurts quite a bit this morning and I am experiencing general malaise and queasy tummy.

Andy--

"Go with them, then" said the agent. "What happens if my needs change and my doc prescribes something else?" I asked. "Tough." (Or words to that effect.)

My understanding is that you can change coverage every year during hte open enrollment period (around December) so it would be best to run that drug check every year to be sure you are in the best program, whether it is a medicare advantage plan or medigap and a separate drug coverage. But you are correct, if the doc changes prescriptions mid year, you may be out of luck; most physicians will work with you to stay within your plan if possible.

As I’m sure you’ve all experienced yourselves to one degree or another, it’s a nightmare navigating the healthcare and insurance systems in America and even more so for all the millions of folks who lack the aptitude of folks here. This is why so many people stay sick and die early and suffer unnecessarily. All of which ends up costing us so much more than national single payer healthcare would.

But as the GameStop shares fiasco shows, there is no room for regular people to be advantaged at the cost of the crazy wealthy. A lot of huge fortunes were built and are maintained on this messed up system.

That’s true, and why I used quotes around “rugged individualism.” None of those types are actually rugged individualists. They rely on federal government handouts to and favoritism of large corporations and their investors.

Despite the mandate for healthcare here in Massachusetts, the Commonwealth is doing a piss poor job of rolling out the vaccine. The problem, or at least one of them, is that cities and towns have done vaccination programs for decades here, and yet the state is trying to run the show and has essentially cut out the people who actually know how to do this well. It is a nightmare. We are well behind many other states on terms of getting people vaccinated. I’ll be lucky to get my vaccine by Memorial Day, at this rate.

Best places to be stuck. (Take heart, Taff)



But we're screwed:

Yep, I'm relived Hen Hatch and co, are in Aus!

The health ministry says it has a bilateral deal with the Serum Institute of India, the world's biggest vaccine-maker, for 1.5 million doses.

The country wants to vaccinate healthcare workers initially. But with the number of workers estimated at 1.2 million, the first batch doesn't look like it will be enough . . . However, critics suggest that South Africa - as the richest country in Africa - should not be in this position.

"The stunning reality is that it [South Africa] has neither a secured vaccine supply nor a plan for mass inoculation in the foreseeable future that can withstand scrutiny," says the Progressive Health Forum, a group of leading medical experts in the country.

I have a sneaking suspicion that furriners are going to be behind the last citizen in the queue.

So the policy in South Africa is depopulation? Or is this just utter incompetence in the public health sector?

There may be a competency issue. There is definitely a delay issue which is partly explained by the devotion of a lot of time to figuring out how to do this without all the usual corruption. As I've put it before, half the government is working to prevent that while the other half is working to get around whatever the first half is doing.

Two comments on a newspaper story about Government-issued tender for storage facilities:


casper1 1 day ago
Looters please queue from the left — Patients please be patient.

Mmmm 10 hours ago
Who in his right mind will allow someone “contracted” by a corrupt anc government to come anywhere near you with an injection needle??? To them its just about money. Nothing to do with “health”.
TSK!!!

-"BB"-

-"BB"-

New "mega-site" opened near me (well, it's 20 minutes away, so close enough). Got an appointment for 2/17, so will now dump the 3/1 slot I had. I want it, and I want it as soon as possible.

I'm getting the first shot tomorrow afternoon at 2 PM. The whole notification process went surprisingly quickly.

I’ll be lucky if I’m vaccinated by Memorial Day. Bah. I suppose I should not complain, since I’m neither old nor ill.

Sue U wrote: ↑

Sun Feb 07, 2021 3:25 pm

New "mega-site" opened near me (well, it's 20 minutes away, so close enough). Got an appointment for 2/17, so will now dump the 3/1 slot I had. I want it, and I want it as soon as possible.

Can’t you threaten them with your space laser so you can jump line? I am beginning to suspect that you’re not as powerful as alleged.

TPFKA@W wrote: ↑

Sun Feb 07, 2021 9:08 pm

Can’t you threaten them with your space laser so you can jump line? I am beginning to suspect that you’re not as powerful as alleged.

The rules are we can't use the space laser for personal gain, just for collective world domination. Besides, as I told XKA, I'm not scheduled for laser duty again til May.