Grocery store didn't tell me Shingrix was $160

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Normchad
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Re: Grocery store didn't tell me Shingrix was $160

Post by Normchad »

cheese_breath wrote: Wed Sep 16, 2020 3:52 pm I can't count the number of threads I see with people complaining about something because "I didn't know" or "They didn't tell me." What ever happened to the concept of personal responsibility?

Now I step off soapbox.
Personal responsibility should apply to the pharmacist too. He didn’t ask for money. He should own his mistake and stop asking fir money after the fact.
squirm
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Re: Grocery store didn't tell me Shingrix was $160

Post by squirm »

Can't you submit a claim to your insurance?
Broken Man 1999
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Re: Grocery store didn't tell me Shingrix was $160

Post by Broken Man 1999 »

Normchad wrote: Wed Sep 16, 2020 3:44 pm
Broken Man 1999 wrote: Wed Sep 16, 2020 3:33 pm I'll be paying $20 to get the first shot tomorrow at Publix.

So far as OP's issue:
1. The price of $160 doesn't seem to be a rip-off price at all (which OP is NOT suggesting), so that was good.
2. I subscribe to the notion that I am the only one responsible for looking out for WHERE my dollars and HOW MANY of them choose to leave me. No one looks out for me better than me.

But, that's just me.

Broken Man 1999
I see what you are saying. But this is not the OPs fault, it is the system.

Suppose your grocery store called you up at night, and said there was now a special $500 fee for the cake frosting you bought earlier that day? Would we all be okay with “well, you should have asked if there were any special cake frosting fees?”

Of course not, that is preposterous. Every other item in that store is required by law to display the price. There is a reason the prices need to be shown. It’s complete crap that the pharmacy couldn’t figure this out and tell the OP at the point of service. (My grocery store did).

If I was the OP, I wouldn’t pay it. Wait a few months and see what happens.
Well, some folks accept responsibility for their actions (and debts) and some don't.

We will just have to agree to disagree. You do you, and I'll do me.

Broken Man 1999
“If I cannot drink Bourbon and smoke cigars in Heaven then I shall not go. " -Mark Twain
Angst
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Re: Grocery store didn't tell me Shingrix was $160

Post by Angst »

I'm also in the Broken Man 1999 school of thought. I never consume medical care of any kind without asking up front about cost and insurance coverage. That doesn't work so well for some things, like surgery or emergencies, but I always try. It's just the nature of the buyer beware world of healthcare we have here in the US. I sympathize with the OP nonetheless.
Northern Flicker
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Re: Grocery store didn't tell me Shingrix was $160

Post by Northern Flicker »

Don't most healthcare benefits that the VA provides to veterans have a nonzero cost if the veteran chooses to get the care elsewhere? Why should it be free at a grocery store?
Risk is not a guarantor of return.
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SmileyFace
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Re: Grocery store didn't tell me Shingrix was $160

Post by SmileyFace »

MathWizard wrote: Wed Sep 16, 2020 2:46 pm Flu shots at the grocery store are $35 to $65.

They are free at the Dr's office.

We'll wait a week and get them for free.
Your Dr's Office does them for free?? No Charge to your insurance company?

In my case - the Doctor's Office costs way more than the local drug store or grocery store - getting the local drug store through my insurance can be a bit tougher though.
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BogleFanGal
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Re: Grocery store didn't tell me Shingrix was $160

Post by BogleFanGal »

FelixTheCat wrote: Wed Sep 16, 2020 2:59 pm
LadyIJ wrote: Wed Sep 16, 2020 1:27 pm I am arguing that they should have told me - as I stated above, if they had told us, we would have gone to the VA for free.
I've had an HMO for 4+ decades. I've never had anyone tell me the cost of any medical procedure (hospital visit, checkups, shots, etc) before the service.
Right? I'm on a HDHP and we've been burned several times trying to ask about costs in advance. Was told "couple hundred dollars" but paid nearly $1k for a Sat visit to an in-network urgent care - just for a doc's eval and blood test for flu. Paid $100+ for tamiflu when I could have paid just $20 through goodrx (didn't know about goodrx at the time - pharmacist said "nope" when I asked about any industry discounted programs or coupons that could help defray part of the cost. Not his job to help, but still....he could have been nice enough to volunteer it.)

I was very pleasantly surprised during a followup appt at a specialist recently: the office staff actually called me in advance leaving a voicemail re: exactly how much the visit would cost based upon my insurance - and it wasn't a penny more. I almost fell over in shock.
"Life would be infinitely happier if we could only be born at the age of eighty and gradually approach eighteen." Mark Twain
Xrayman69
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Re: Grocery store didn't tell me Shingrix was $160

Post by Xrayman69 »

Normchad wrote: Wed Sep 16, 2020 3:44 pm
Broken Man 1999 wrote: Wed Sep 16, 2020 3:33 pm I'll be paying $20 to get the first shot tomorrow at Publix.

So far as OP's issue:
1. The price of $160 doesn't seem to be a rip-off price at all (which OP is NOT suggesting), so that was good.
2. I subscribe to the notion that I am the only one responsible for looking out for WHERE my dollars and HOW MANY of them choose to leave me. No one looks out for me better than me.

But, that's just me.

Broken Man 1999
I see what you are saying. But this is not the OPs fault, it is the system.

Suppose your grocery store called you up at night, and said there was now a special $500 fee for the cake frosting you bought earlier that day? Would we all be okay with “well, you should have asked if there were any special cake frosting fees?”

Of course not, that is preposterous. Every other item in that store is required by law to display the price. There is a reason the prices need to be shown. It’s complete crap that the pharmacy couldn’t figure this out and tell the OP at the point of service. (My grocery store did).

If I was the OP, I wouldn’t pay it. Wait a few months and see what happens.
The store charged the same for everyone. It would be fraud if they only charged the OP the price and everyone else something else. The store apparently had a fixed and “knowable” price. OP made presumption that was incorrect. Sure the store may have a bad process but that’s up to the consumer to choose where they spend their hard earned dollars.

The claim of the store calling you back later to charge you for frosting that has already been paid for is a straw man argument.
Last edited by Xrayman69 on Wed Sep 16, 2020 4:11 pm, edited 1 time in total.
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unclescrooge
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Re: Grocery store didn't tell me Shingrix was $160

Post by unclescrooge »

sport wrote: Wed Sep 16, 2020 1:58 pm
RudyS wrote: Wed Sep 16, 2020 1:25 pm I had to pay about that amount, but knew up front that Medicare would not cover it, nor my drug coverage.
My Medicare Advantage plan paid the full cost. The grocery pharmacy even gave me a $5 coupon to use in the store.
Sounds like insurance fraud.

J/K. :mrgreen:
Normchad
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Re: Grocery store didn't tell me Shingrix was $160

Post by Normchad »

Xrayman69 wrote: Wed Sep 16, 2020 4:03 pm
Normchad wrote: Wed Sep 16, 2020 3:44 pm
Broken Man 1999 wrote: Wed Sep 16, 2020 3:33 pm I'll be paying $20 to get the first shot tomorrow at Publix.

So far as OP's issue:
1. The price of $160 doesn't seem to be a rip-off price at all (which OP is NOT suggesting), so that was good.
2. I subscribe to the notion that I am the only one responsible for looking out for WHERE my dollars and HOW MANY of them choose to leave me. No one looks out for me better than me.

But, that's just me.

Broken Man 1999
I see what you are saying. But this is not the OPs fault, it is the system.

Suppose your grocery store called you up at night, and said there was now a special $500 fee for the cake frosting you bought earlier that day? Would we all be okay with “well, you should have asked if there were any special cake frosting fees?”

Of course not, that is preposterous. Every other item in that store is required by law to display the price. There is a reason the prices need to be shown. It’s complete crap that the pharmacy couldn’t figure this out and tell the OP at the point of service. (My grocery store did).

If I was the OP, I wouldn’t pay it. Wait a few months and see what happens.
The store charged the same for everyone. It would be fraud if they only charged the OP the price and everyone else something else. The store apparently had a fixed and “knowable” price. OP made presumption that was incorrect. Sure the store may have a bad process but that’s up to the consumer to choose where they spend their hard earned dollars.

The claim of the store calling you back later to charge you for frosting that has already been laid for is a straw an argument.
Why is this different than cake frosting? Why are they allowed to not tell you the price until after the service is rendered?

Maybe they do this in purpose, because a lot of people would go elsewhere if they knew the price beforehand?
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onthecusp
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Re: Grocery store didn't tell me Shingrix was $160

Post by onthecusp »

It ticks me off too, but it is how it works. I have a medication that I can get 90 days for $9 using a manufacturer coupon that stays on file with the grocery pharmacy. Invariably if I forget to tell them to change it from my insurance to the coupon they want over $1,000! When I tell them they look at me like I grew an extra arm, the price is the price, right?

I can give that back, a shot is non-returnable. Just about every aspect of medical insurance is messed up in my opinion.
inbox788
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Re: Grocery store didn't tell me Shingrix was $160

Post by inbox788 »

LadyIJ wrote: Wed Sep 16, 2020 3:04 pmcorrect - I never agreed, was not told - and protocol is they should tell you upfront. I have a call in to the manager to discuss.
When I got the Flu shot at CVS, I had to sign a bunch of stuff on that little screen and agree to stuff. And walked away with a pile of papers and several feet of receipts and coupons.

The long, long history of long, long CVS receipts
Why is a receipt for cough drops the height of a small child?
https://www.vox.com/the-goods/2018/10/1 ... ts-so-long
UpperNwGuy
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Re: Grocery store didn't tell me Shingrix was $160

Post by UpperNwGuy »

Normchad wrote: Wed Sep 16, 2020 3:44 pm If I was the OP, I wouldn’t pay it. Wait a few months and see what happens.
What will happen is that your credit report will get dinged.
Xrayman69
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Re: Grocery store didn't tell me Shingrix was $160

Post by Xrayman69 »

Normchad wrote: Wed Sep 16, 2020 4:12 pm
Xrayman69 wrote: Wed Sep 16, 2020 4:03 pm
Normchad wrote: Wed Sep 16, 2020 3:44 pm
Broken Man 1999 wrote: Wed Sep 16, 2020 3:33 pm I'll be paying $20 to get the first shot tomorrow at Publix.

So far as OP's issue:
1. The price of $160 doesn't seem to be a rip-off price at all (which OP is NOT suggesting), so that was good.
2. I subscribe to the notion that I am the only one responsible for looking out for WHERE my dollars and HOW MANY of them choose to leave me. No one looks out for me better than me.

But, that's just me.

Broken Man 1999
I see what you are saying. But this is not the OPs fault, it is the system.

Suppose your grocery store called you up at night, and said there was now a special $500 fee for the cake frosting you bought earlier that day? Would we all be okay with “well, you should have asked if there were any special cake frosting fees?”

Of course not, that is preposterous. Every other item in that store is required by law to display the price. There is a reason the prices need to be shown. It’s complete crap that the pharmacy couldn’t figure this out and tell the OP at the point of service. (My grocery store did).

If I was the OP, I wouldn’t pay it. Wait a few months and see what happens.
The store charged the same for everyone. It would be fraud if they only charged the OP the price and everyone else something else. The store apparently had a fixed and “knowable” price. OP made presumption that was incorrect. Sure the store may have a bad process but that’s up to the consumer to choose where they spend their hard earned dollars.

The claim of the store calling you back later to charge you for frosting that has already been laid for is a straw an argument.
Why is this different than cake frosting? Why are they allowed to not tell you the price until after the service is rendered?

Maybe they do this in purpose, because a lot of people would go elsewhere if they knew the price beforehand?
The price was available and transparent. The same price for everyone who chose to receive the product. Prices are MANDATED for grocery stores. It was just not OBVIOUS and conspicuous.
GmanJeff
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Re: Grocery store didn't tell me Shingrix was $160

Post by GmanJeff »

cheese_breath wrote: Wed Sep 16, 2020 3:52 pm I can't count the number of threads I see with people complaining about something because "I didn't know" or "They didn't tell me." What ever happened to the concept of personal responsibility?

Now I step off soapbox.
Exactly.
ddurrett896
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Re: Grocery store didn't tell me Shingrix was $160

Post by ddurrett896 »

Tell them you though it was free and ask for a return.
inbox788
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Re: Grocery store didn't tell me Shingrix was $160

Post by inbox788 »

Northern Flicker wrote: Wed Sep 16, 2020 3:58 pm Don't most healthcare benefits that the VA provides to veterans have a nonzero cost if the veteran chooses to get the care elsewhere? Why should it be free at a grocery store?
VA healthcare has been backlogged and there are expanded options. Don't know why a grocery store per say would be included or excluded, but my understanding is that it's for care when VA system is unavailable.

Veterans' Access to Care through Choice, Accountability, and Transparency Act of 2014
https://en.wikipedia.org/wiki/Veterans% ... ct_of_2014

Veterans to get expanded access to private doctors at VA expense starting Thursday (June 5, 2019 article)
https://www.usatoday.com/story/news/pol ... 345046001/
Lalamimi
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Re: Grocery store didn't tell me Shingrix was $160

Post by Lalamimi »

You should have asked. We have Medicare and Plan D. First one in Dec was $150 on that plan. We changed in January and I realized I better get the 2nd one in May. Went to Kroger and asked. She said "its not covered, its $175. Really, it was covered but fell under the "meet deductible". So, I checked Costco and it was $160. Its not like the free flu shot. And he did get the first one free. Should have asked, but agree, they should have told you. But in this crazy time, no one is thinking.
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unclescrooge
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Re: Grocery store didn't tell me Shingrix was $160

Post by unclescrooge »

UpperNwGuy wrote: Wed Sep 16, 2020 4:23 pm
Normchad wrote: Wed Sep 16, 2020 3:44 pm If I was the OP, I wouldn’t pay it. Wait a few months and see what happens.
What will happen is that your credit report will get dinged.
Wouldn't that be a HIPPA violation?
skepticalobserver
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Re: Grocery store didn't tell me Shingrix was $160

Post by skepticalobserver »

Some FEHBs (GEHA) will cover it with no co-pay if you're 50 or over.
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cheese_breath
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Re: Grocery store didn't tell me Shingrix was $160

Post by cheese_breath »

unclescrooge wrote: Wed Sep 16, 2020 4:49 pm
UpperNwGuy wrote: Wed Sep 16, 2020 4:23 pm
Normchad wrote: Wed Sep 16, 2020 3:44 pm If I was the OP, I wouldn’t pay it. Wait a few months and see what happens.
What will happen is that your credit report will get dinged.
Wouldn't that be a HIPPA violation?
I doubt they provide that kind of information to the credit bureaus. I suspect it's more on the level of here's an unpaid charge for so much on such and such a date.
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unclescrooge
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Re: Grocery store didn't tell me Shingrix was $160

Post by unclescrooge »

cheese_breath wrote: Wed Sep 16, 2020 4:54 pm
unclescrooge wrote: Wed Sep 16, 2020 4:49 pm
UpperNwGuy wrote: Wed Sep 16, 2020 4:23 pm
Normchad wrote: Wed Sep 16, 2020 3:44 pm If I was the OP, I wouldn’t pay it. Wait a few months and see what happens.
What will happen is that your credit report will get dinged.
Wouldn't that be a HIPPA violation?
I doubt they provide that kind of information to the credit bureaus. I suspect it's more on the level of here's an unpaid charge for so much on such and such a date.
But if you contested it, the collection agency wouldn't be able to provide proof regarding what the charge was for and then they'd have to remove it, no?
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cheese_breath
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Re: Grocery store didn't tell me Shingrix was $160

Post by cheese_breath »

unclescrooge wrote: Wed Sep 16, 2020 4:57 pm
cheese_breath wrote: Wed Sep 16, 2020 4:54 pm
unclescrooge wrote: Wed Sep 16, 2020 4:49 pm
UpperNwGuy wrote: Wed Sep 16, 2020 4:23 pm
Normchad wrote: Wed Sep 16, 2020 3:44 pm If I was the OP, I wouldn’t pay it. Wait a few months and see what happens.
What will happen is that your credit report will get dinged.
Wouldn't that be a HIPPA violation?
I doubt they provide that kind of information to the credit bureaus. I suspect it's more on the level of here's an unpaid charge for so much on such and such a date.
But if you contested it, the collection agency wouldn't be able to provide proof regarding what the charge was for and then they'd have to remove it, no?
You might have me there. I've contested a couple credit card charges, but I've never had to have anything removed from my credit report.
The surest way to know the future is when it becomes the past.
Onlineid3089
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Re: Grocery store didn't tell me Shingrix was $160

Post by Onlineid3089 »

Normchad wrote: Wed Sep 16, 2020 4:12 pm
Xrayman69 wrote: Wed Sep 16, 2020 4:03 pm
Normchad wrote: Wed Sep 16, 2020 3:44 pm
Broken Man 1999 wrote: Wed Sep 16, 2020 3:33 pm I'll be paying $20 to get the first shot tomorrow at Publix.

So far as OP's issue:
1. The price of $160 doesn't seem to be a rip-off price at all (which OP is NOT suggesting), so that was good.
2. I subscribe to the notion that I am the only one responsible for looking out for WHERE my dollars and HOW MANY of them choose to leave me. No one looks out for me better than me.

But, that's just me.

Broken Man 1999
I see what you are saying. But this is not the OPs fault, it is the system.

Suppose your grocery store called you up at night, and said there was now a special $500 fee for the cake frosting you bought earlier that day? Would we all be okay with “well, you should have asked if there were any special cake frosting fees?”

Of course not, that is preposterous. Every other item in that store is required by law to display the price. There is a reason the prices need to be shown. It’s complete crap that the pharmacy couldn’t figure this out and tell the OP at the point of service. (My grocery store did).

If I was the OP, I wouldn’t pay it. Wait a few months and see what happens.
The store charged the same for everyone. It would be fraud if they only charged the OP the price and everyone else something else. The store apparently had a fixed and “knowable” price. OP made presumption that was incorrect. Sure the store may have a bad process but that’s up to the consumer to choose where they spend their hard earned dollars.

The claim of the store calling you back later to charge you for frosting that has already been laid for is a straw an argument.
Why is this different than cake frosting? Why are they allowed to not tell you the price until after the service is rendered?

Maybe they do this in purpose, because a lot of people would go elsewhere if they knew the price beforehand?
I'm not sure you're making a fair comparison. I have never had a 3rd party involved in my cake frosting purchases. They have always been a 100% cash out of pocket payment at the time of service - I certainly wouldn't expect to eat my cake frosting and owe nothing for it or have someone else pick up the tab based on a "proprietary and confidential" fee schedule that the third party negotiated on my behalf.

Now, if they intended to do it as self pay you have a great point and a fair comparison. OP hasn't mentioned any other insurance. If her husband only has VA they may have been planning on self pay as I don't know that there would be any expectation that the VA would pay for it in a non-VA setting if it wasn't pre-approved. It has been a while since I have been in a position to see one, but from what I remember the VA authorizations were very specific on what provider was authorized, an eligible date range, and there would be a sheet of specific CPT codes that were allowed.
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ram
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Re: Grocery store didn't tell me Shingrix was $160

Post by ram »

I simply know that my grocery store does not give me anything for free.
Ram
Northern Flicker
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Re: Grocery store didn't tell me Shingrix was $160

Post by Northern Flicker »

inbox788 wrote: Wed Sep 16, 2020 4:43 pm
Northern Flicker wrote: Wed Sep 16, 2020 3:58 pm Don't most healthcare benefits that the VA provides to veterans have a nonzero cost if the veteran chooses to get the care elsewhere? Why should it be free at a grocery store?
VA healthcare has been backlogged and there are expanded options. Don't know why a grocery store per say would be included or excluded, but my understanding is that it's for care when VA system is unavailable.

Veterans' Access to Care through Choice, Accountability, and Transparency Act of 2014
https://en.wikipedia.org/wiki/Veterans% ... ct_of_2014

Veterans to get expanded access to private doctors at VA expense starting Thursday (June 5, 2019 article)
https://www.usatoday.com/story/news/pol ... 345046001/

from the wiki:

Veterans who live over 40 miles away from the nearest VA health clinic or who are unable to get an appointment in a reasonable time frame would be able to receive "choice cards" allowing them to seek treatment from a non-VA facility.
I've not seen evidence that the OP's spouse was trying to use VA benefits at the grocer or even presented insurance info to them. A healthcare service is never free. That is not the default behavior. The question is: who pays? And the OP's spouse appears to have done nothing to communicate to the grocery store pharmacy that it should be anyone other than the OP's spouse. What was the expectation of how the grocery store would be paid? Magic?
Last edited by Northern Flicker on Thu Sep 17, 2020 2:53 pm, edited 1 time in total.
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tibbitts
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Re: Grocery store didn't tell me Shingrix was $160

Post by tibbitts »

interwebopinion wrote: Wed Sep 16, 2020 2:29 pm What concrete proof do you have of such an agreement? No one agrees to being charged 'any price'. That sounds like a price gouging manifesto.
GmanJeff wrote: Wed Sep 16, 2020 2:10 pm You deliberately agreed to any price charged by consciously soliciting and accepting a product and service while choosing not to inquire into cost in advance.
Agreed, as far as I know virtually everyone receiving any medical service agrees to pay any price. The only choice is to not receive the service.

But it wouldn't have mattered if you had asked. The answer would have been "we don't know, ask your insurance." When you ask the insurance you'll be told "it's up to the provider." So you take your chances no matter what you do and pay what you owe. It was fortunate that the OP had to pay $300 and not $30,000.
stocknoob4111
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Re: Grocery store didn't tell me Shingrix was $160

Post by stocknoob4111 »

$160 is super cheap for any kind of medical interaction... my doctor billed insurance $240 for saying "Hi how are you, all well, eating your fruits and veggies? ok good get out of here and good luck".
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JoeRetire
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Re: Grocery store didn't tell me Shingrix was $160

Post by JoeRetire »

LadyIJ wrote: Wed Sep 16, 2020 1:16 pm Just wanted opinions:
My hubby needed his second Shingrix shot. His first was at the VA and free.
Why didn't you go back to the VA?
We went to our local grocery store/pharmacy and they administered the shot (they had a special day where you could get it in your car). We made the appointment a couple of weeks in advance. We filled out the paper work online. So after his shot, they call us at about 9 p.m. and say he owes $160.
You didn't ask the cost? You didn't check with your insurance company if the shot would be covered?
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HueyLD
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Re: Grocery store didn't tell me Shingrix was $160

Post by HueyLD »

It is surprising to me that the pharmacy did not run the claim thru OP’s insurance first.

My pharmacy always does that and lets me know what my copay is, if any.
quantAndHold
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Re: Grocery store didn't tell me Shingrix was $160

Post by quantAndHold »

stocknoob4111 wrote: Wed Sep 16, 2020 6:41 pm $160 is super cheap for any kind of medical interaction... my doctor billed insurance $240 for saying "Hi how are you, all well, eating your fruits and veggies? ok good get out of here and good luck".
This is a $17/hour technician giving a shot, not an office visit with an MD. Pharmacies give shots for free, if you purchase the vaccine from them and $160 is about the going rate for a dose of this particular vaccine.

I do find it odd that they didn’t try to run OP’s insurance first and then tell him the cost. That’s what my pharmacy always does.
Yes, I’m really that pedantic.
diy60
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Re: Grocery store didn't tell me Shingrix was $160

Post by diy60 »

HueyLD wrote: Wed Sep 16, 2020 6:51 pm It is surprising to me that the pharmacy did not run the claim thru OP’s insurance first.

My pharmacy always does that and lets me know what my copay is, if any.
That was my thought as well. Spouse and I have each received both Shingrix shots. Each time the pharmacy ran the claim thru the system while we stood at the counter and said, "Mr. or Mrs. DIY60, your cost will be the full amount of $160 for each shot because you haven't reached the annual deductable, will you accept that charge?" I've received numerous shots at the pharmacy and this is how it was always handled. Payment (if any) collected up front.
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cheese_breath
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Re: Grocery store didn't tell me Shingrix was $160

Post by cheese_breath »

Normchad wrote: Wed Sep 16, 2020 3:54 pm
cheese_breath wrote: Wed Sep 16, 2020 3:52 pm I can't count the number of threads I see with people complaining about something because "I didn't know" or "They didn't tell me." What ever happened to the concept of personal responsibility?

Now I step off soapbox.
Personal responsibility should apply to the pharmacist too. He didn’t ask for money. He should own his mistake and stop asking fir money after the fact.
Agree the pharmacist should have told OP's hubby the price, but that doesn't nullify his responsibility in the matter,
The surest way to know the future is when it becomes the past.
tibbitts
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Re: Grocery store didn't tell me Shingrix was $160

Post by tibbitts »

JoeRetire wrote: Wed Sep 16, 2020 6:43 pm You didn't ask the cost? You didn't check with your insurance company if the shot would be covered?
The new standard reply for my insurance is "it's up to the provider and how they code it." But generally the person providing the service isn't coding, and doesn't even work for the same employer as the billing service. I had a blood test last month and that was exactly the the situation. I ended up paying $17 for my annual "free" preventive blood test, which was exactly the same test I've had for years for no cost. I found out on the weekend but keep forgetting to call and see if anyone can explain, but I was fully expecting some kind of charge (despite never having been charged before) and was so relieved that it was only $17 that I've already paid it.
Ready3Retire
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Re: Grocery store didn't tell me Shingrix was $160

Post by Ready3Retire »

Call your insurance company. This happened to me when my wife got her 2nd Shinrix at CVS. Insurance said they only cover if done in a doctor office. I sent a claim in since the doctor did not have the Shingix vaccine and the claim was paid.
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Re: Grocery store didn't tell me Shingrix was $160

Post by iamlucky13 »

cheese_breath wrote: Wed Sep 16, 2020 3:52 pm I can't count the number of threads I see with people complaining about something because "I didn't know" or "They didn't tell me." What ever happened to the concept of personal responsibility?

Now I step off soapbox.
Personal responsibility includes informing a person what you will be charging rather assuming they magically know what the expense will be. This should be especially true when there are complications like a 3rd party who will be paying part or all of the cost. My view is the provider wanted something ($160) in exchange for the shot, but didn't bother to tell the patient.

I am not a lawyer, but I am under the impression that rendering a service for payment is a contractual exchange, even if an informal one. If that is correct then it seems the offer was not accompanied by terms of consideration, and the OP should be able to prevail in court. Of course, what would happen in the meantime while the terms that were never agreed upon are adjudicated in small claims, is the provider will submit the bill to collections and things will get worse, rather than better.

Personally, I would chalk this up as a lesson to always ask, make sure insurance was correctly applied, and begrudgingly pay the bill, because the information asymmetry that exists is only one of a zillion problems with our health care system, and one that is not easy to fight.
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Re: Grocery store didn't tell me Shingrix was $160

Post by RudyS »

egrets wrote: Wed Sep 16, 2020 2:36 pm Medicare.gov says Plan Ds cover Shingrix.
I had mine last December and this February. Medicare Plan D (Humana) did not cover it then. This is not intended to be argumentative, just to point out that things change day to day and company to company.
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Re: Grocery store didn't tell me Shingrix was $160

Post by bikechuck »

LadyIJ wrote: Wed Sep 16, 2020 1:27 pm
RudyS wrote: Wed Sep 16, 2020 1:25 pm Was there no mention of cost in the web site nor in the paperwork you filled out? I had to pay about that amount, but knew up front that Medicare would not cover it, nor my drug coverage. If it wasn;t mentioned, you should argue that.
I am arguing that they should have told me - as I stated above, if they had told us, we would have gone to the VA for free. I don't know if they didn't tell me if we are liable, but might feel kind of like a schmuck if we don't pay up. Maybe they'll negotiate.
You got a bargain. My wife was charged over $300 for just the first shot at her doctor's office. She later learned that she could have paid about what you did had she used her pharmacy instead of her doctor's office. She is upset with her doc for not telling her.
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Re: Grocery store didn't tell me Shingrix was $160

Post by inbox788 »

bikechuck wrote: Wed Sep 16, 2020 9:35 pmYou got a bargain. My wife was charged over $300 for just the first shot at her doctor's office. She later learned that she could have paid about what you did had she used her pharmacy instead of her doctor's office. She is upset with her doc for not telling her.
Was that $300 plus the doctor visit or $300 including the visit? Are doctors allowed to mark up vaccination costs? I assume they're allowed an administration fee, which amounts to a service charge and markup, but that shouldn't be so high. I'd hate for doctors to be incentivized to give out unnecessary treatments to further pad their bills. I thought the whole point of pharmacies was so doctors aren't incentivized to prescribe medications so they can sell more medicines.
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Re: Grocery store didn't tell me Shingrix was $160

Post by cheese_breath »

RudyS wrote: Wed Sep 16, 2020 9:19 pm
egrets wrote: Wed Sep 16, 2020 2:36 pm Medicare.gov says Plan Ds cover Shingrix.
I had mine last December and this February. Medicare Plan D (Humana) did not cover it then. This is not intended to be argumentative, just to point out that things change day to day and company to company.
Remember, different Plan Ds have different formularies. Mine covers it as Tier 3, $47 copay according to the formulary manual.
The surest way to know the future is when it becomes the past.
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Re: Grocery store didn't tell me Shingrix was $160

Post by marcwd »

Northern Flicker wrote: Wed Sep 16, 2020 6:19 pm
inbox788 wrote: Wed Sep 16, 2020 4:43 pm
Northern Flicker wrote: Wed Sep 16, 2020 3:58 pm Don't most healthcare benefits that the VA provides to veterans have a nonzero cost if the veteran chooses to get the care elsewhere? Why should it be free at a grocery store?
VA healthcare has been backlogged and there are expanded options. Don't know why a grocery store per say would be included or excluded, but my understanding is that it's for care when VA system is unavailable.

Veterans' Access to Care through Choice, Accountability, and Transparency Act of 2014
https://en.wikipedia.org/wiki/Veterans% ... ct_of_2014

Veterans to get expanded access to private doctors at VA expense starting Thursday (June 5, 2019 article)
https://www.usatoday.com/story/news/pol ... 345046001/
from the wiki:

Veterans who live over 40 miles away from the nearest VA health clinic or who are unable to get an appointment in a reasonable time frame would be able to receive "choice cards" allowing them to seek treatment from a non-VA facility.
I've not seen evidence that the OP's spouse was trying to use VA benefits at the grocer or even presented insurance info to them. A healthcare service is never free. That is not the default behavior. The question is: who pays? And the OP's spouse appears to have done nothing to communicate to the grocery store pharmacy that it should be anyone other than the OP's spouse. What was the expectation of how the grocery store would be paid? Magic?
Nicely said. The OP is looking to be excused for personal negligence.
Last edited by marcwd on Wed Sep 16, 2020 10:28 pm, edited 1 time in total.
tesuzuki2002
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Re: Grocery store didn't tell me Shingrix was $160

Post by tesuzuki2002 »

sailaway wrote: Wed Sep 16, 2020 1:31 pm Did you ask?
+1
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FrugalInvestor
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Re: Grocery store didn't tell me Shingrix was $160

Post by FrugalInvestor »

sailaway wrote: Wed Sep 16, 2020 1:31 pm Did you ask?
That's always my second question. Do you have what I'm looking for? How much do you charge for it? I can't imagine not asking.
Have a plan, stay the course and simplify, but most importantly....Ignore the Noise!
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Re: Grocery store didn't tell me Shingrix was $160

Post by bikechuck »

inbox788 wrote: Wed Sep 16, 2020 10:09 pm
bikechuck wrote: Wed Sep 16, 2020 9:35 pmYou got a bargain. My wife was charged over $300 for just the first shot at her doctor's office. She later learned that she could have paid about what you did had she used her pharmacy instead of her doctor's office. She is upset with her doc for not telling her.
Was that $300 plus the doctor visit or $300 including the visit? Are doctors allowed to mark up vaccination costs? I assume they're allowed an administration fee, which amounts to a service charge and markup, but that shouldn't be so high. I'd hate for doctors to be incentivized to give out unnecessary treatments to further pad their bills. I thought the whole point of pharmacies was so doctors aren't incentivized to prescribe medications so they can sell more medicines.
It was $300 plus for just the shot.
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Re: Grocery store didn't tell me Shingrix was $160

Post by inbox788 »

bikechuck wrote: Wed Sep 16, 2020 10:31 pmIt was $300 plus for just the shot.
Ouch!
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Re: Grocery store didn't tell me Shingrix was $160

Post by TravelGeek »

Gill wrote: Wed Sep 16, 2020 1:44 pm $160 after insurance is about the going rate. I paid that for both shots.
Gill
My insurance paid around $170 for each shots, for me and my wife. No copay. A parting gift from my former employer.
DaftInvestor wrote: Wed Sep 16, 2020 2:11 pm I just paid $350 for a COVID-19 test ($250 charge by med center; $100 charge by lab; took 2 minutes for nurse in parking lot to swab me). I paid a $40 insurance co-pay. I only bring this up because $160 - if that is the total - sounds cheap to me.
Interesting. My insurance (HDHP) paid for the test without copay.
MathWizard wrote: Wed Sep 16, 2020 2:46 pm Flu shots at the grocery store are $35 to $65.

They are free at the Dr's office.

We'll wait a week and get them for free.
Every grocery store here is having big advertising signs for free flu shots (fine print: with insurance). We get ours at the drug store pharmacy, also for free (with insurance). Insurance pays $35 for it.
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JoeRetire
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Re: Grocery store didn't tell me Shingrix was $160

Post by JoeRetire »

tibbitts wrote: Wed Sep 16, 2020 8:24 pm
JoeRetire wrote: Wed Sep 16, 2020 6:43 pm You didn't ask the cost? You didn't check with your insurance company if the shot would be covered?
The new standard reply for my insurance is "it's up to the provider and how they code it." But generally the person providing the service isn't coding, and doesn't even work for the same employer as the billing service. I had a blood test last month and that was exactly the the situation. I ended up paying $17 for my annual "free" preventive blood test, which was exactly the same test I've had for years for no cost. I found out on the weekend but keep forgetting to call and see if anyone can explain, but I was fully expecting some kind of charge (despite never having been charged before) and was so relieved that it was only $17 that I've already paid it.
You need a new insurance company. It's their job to inform you what is covered, what is not, what your out of pocket expense will be, and what to tell the provider in order to have it coded correctly.
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Re: Grocery store didn't tell me Shingrix was $160

Post by Doom&Gloom »

I don't recall what mine cost at the pharmacy, but I do remember being told in advance and also remember thinking at the time that the cost doesn't really matter very much as I want it almost regardless of price. Almost.

Pharmacy should have informed OP in advance. Since they didn't, OP should have asked. In all matters healthcare related, one must be an informed consumer.
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Re: Grocery store didn't tell me Shingrix was $160

Post by cashmoney »

LadyIJ wrote: Wed Sep 16, 2020 1:16 pm Just wanted opinions:
My hubby needed his second Shingrix shot. His first was at the VA and free. We went to our local grocery store/pharmacy and they administered the shot (they had a special day where you could get it in your car). We made the appointment a couple of weeks in advance. We filled out the paper work online. So after his shot, they call us at about 9 p.m. and say he owes $160.

Now I'm not saying we WON'T pay it, but that's quite a rub - I think they should have told us in the two weeks or even that day, not afterwards. Normally I wouldn't think twice, but we've been getting hit hard by every house repair that you can think of since COVID, and I would have waited until we had to go back to the VA.

Thoughts anyone?

Thanks for indulging me.


If you are on Medicare Shingrix is an outpatient drug thus covered under the part D plan usually under a tier 3 copayment.Many part D plans will have a deductible for tier 3 or higher drugs.The cost of administering the shot is usually free though.

https://www.medicare.gov/coverage/shingles-shots

Shingles shots
Medicare Part A (Hospital Insurance) or Medicare Part B (Medical Insurance)

doesn't cover the shingles shot.

Generally, Medicare prescription drug plans (Part D) cover all commercially available vaccines (like the shingles shot) needed to prevent illness. Contact your Medicare drug plan for more information about coverage.
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Re: Grocery store didn't tell me Shingrix was $160

Post by Faith20879 »

LadyIJ wrote: Wed Sep 16, 2020 1:16 pm Just wanted opinions:
... I think they should have told us in the two weeks or even that day, not afterwards.
I can certainly relate. DH just got his first shot a week ago. CVS had his ins. info and said "today's shot is free (covered). ". Now that was before he informed us that there is a 2nd shot involved. When everything was done, he mentioned the booster within 6 months. We just assumed that will be free too. From your experience, we may have assumed wrong.

If when we go back and indeed be asked to pay 160 for the booster shot, I probably will not feel too bad because you have prepared me. If I had not read it here, I would probably feel like you for a few days then pay and move on.
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