I love passing on my health insurance tribulations, especially for those who have some kind of national health service, just so you know what you're missing. The latest:
Last year, I went to CVS (national drug/chemist chain and my pharmacy) to get my shingles vaccine. This is a two-part shot, and not covered by insurance because I'm under 60yo. No worries.
While I was getting that, the pharmacist asked, "Do you want your pneumonia vaccine? It's covered by your insurance, so no cost."
"Let me check with my doctor first, I don't know when I had it last."
That was September. Checked with my doc's office in November, they couldn't find my pneumonia shot.
Back to the pharmacy for shingles part two, now December, and she asked me again whether I wanted my pneumonia shot, and that it was covered by insurance. I again declined until I had a chance to meet with my doctor in person and ask about.
I did that this week. She was able to track down my shot and said I was definitely due. Great!
Back to CVS. Waited a bit, finally got seen:
"I'm here for my pneumonia vaccine."
Tappity-tap-tap on the computer...
"This isn't covered by your insurance, so if you want it, it's $145."
"That's weird. Before, it was covered."
"Let me call it in, just wait a bit."
Tick...tock...tick...tock...
"No, they're telling me it's definitely not covered. Maybe call your insurance and see what's up?"
So home I went, on the phone with the insurance company:
"Hi. Does my plan cover a pneumonia vaccine? That seems pretty basic."
"Let me check..."
Tick...tock...tick...tock...
"Yes, it's covered, 100%, that's a basic service."
"Thanks. I went to CVS today, and they said it wasn't covered. They checked twice. Any ideas?"
"Yeah, most likely, they're reading as out-of-network. Let me get you a list of in-network providers near you, and that should work."
Now, I should point out that CVS is hardly out-of-network. They're either the first or second largest drug store in the US, and I get all my prescriptions there, have done for years, and they're associated with my employer for all my prescriptions, like a preferred vendor/supplier.
"Ok, Mr. Tasty, I'm showing the closest walk-in clinic to you is... 123 Main Street, Next-Town-Over, Ohio. Does that work for you?"
"Yep, that's about 20 minutes from me, that's fine. Thanks for the help!"
Got off the phone, plugged in the address, and...it's the freaking CVS the next town past mine! It's going to be the same issue when I go there.