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Sting of flu vaccine hits us all -- in the pocket
Flu season is upon us, and you or a loved one might be rolling up your sleeves to get the annual vaccination against the influenza virus.
Here's my question for you: How are you paying for it?
If you have health insurance coverage through your employer, you might think you're doing the right thing if you go to your doctor's office for the shot. But are you?
Many people -- both insured and uninsured -- go to their local Walgreens, CVS or Target pharmacy for flu shots. They charge $25 to $30 per shot and some offer discount coupons for a few dollars off. That's the total cost. But, if you go to your doctor's office for the flu vaccine, the total cost can be much more -- for the same vaccine.
Why the cost difference?
And at the doctor's office, there's a nurse administering the shot -- not an M.D. Why the difference?
I e-mailed my HMO last year to ask why they didn't completely cover the flu vaccine and eliminate the office co-pay charge. I got a non-response, but they politely thanked me for my inquiry.
It was at the height of the H1N1 (aka swine flu) outbreaks. School activities were being canceled and some schools closed because of concerns about students contracting the virus. Parents were urged to have their children vaccinated, and anyone in high-risk groups (pregnant women, the elderly or anyone with compromised immune systems) was urged to take the shot. I never recall anyone saying: "Get the shot at a pharmacy because the overall cost is cheaper." Yet, shouldn't that be part of the public service announcement to reduce health care costs? I think it should.
If getting the flu shot decreases the likelihood of flu outbreaks in the office this winter, why isn't that preventive measure completely covered by all insurance plans? Would the cost of hospitalization and treatment of an influenza patient be far greater than the cost of vaccines for everyone?
More employers are passing the cost of health care on to workers. Keeping health care costs down for the employer may help keep costs down for employees as well.
New flu card recognizes lower-cost pharmacies
Here's how it works:
If an employee decides not to use the card, it expires after a certain period, such as at the end of the flu season. Current cards, for example, expire Feb. 1, 2011. The cards can only be used for flu shots, so you can't buy over-the-counter medicines or groceries with them.
According to Andy Radlow, Citi's vice president of health management, the old cards are "destroyed in a secure and environmentally friendly way."
"There is no paperwork from an insurance perspective. That's another hidden cost in terms of time and effort," says Nina Das, a Citi spokeswoman.
Companies can distribute the cards to all workers or only to a targeted group of employees -- such as "those with pre-existing lung conditions and are over a certain age or any other number of risk factors," Radlow says. "You can target the higher risk populations. You certainly want to do everything you can to reduce the risk and reduce your health care costs."
He says companies like the "just-in-time" payment feature of the card. If employers were to issue debit cards for flu shots, they would have to set aside funds to cover the cost -- regardless of whether employees use the cards. "You have to lock up all sorts of funds on the [debit] cards," Radlow says. Citi bills the company for the cost of the shot once the card is used.
Citi claims using the card at retail pharmacies can reduce overall company costs for flu vaccines by 63 percent. A shot that could cost the employer $80 if given at a doctor's office would cost only about $30 at a local pharmacy.
So far, Citi has contracted with several of the major pharmacy chains: CVS, Target, RiteAid, MinuteClinic, The Little Clinic and Kroger. Those pharmacies have 17,000 retail locations nationwide. Radlow says Citi is negotiating with other retail pharmacy chains to accept the card. Employers participating in the program include "Fortune 100 companies," Radlow says. He declines to name the participants, however, because the companies have not authorized him to do so.
A different approach next year
Do you have one of these new Flu Care cards? If so, let us know how it is working for you.
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