The start of flu season means lots of ads and public health reminders about the importance of getting a flu shot. Manufacturers are making 170 million to 180 million doses of the flu vaccine this year. And the shot appears to be a lot more accurate than in the past.
If more people are vaccinated, health officials stress, it can lead to greater personal and community protection against the flu.
How accessible and affordable is the vaccine?
As part of WHYY’s crowdsourcing PriceCheck project, we’re asking you — yes you, readers — to share in our searchable database what, if anything, you paid for a flu shot, and what your insurance paid.
It can be anonymous.
Wait, aren’t flu shots free?
As part of the Affordable Care Act, regular flu shots are free, but there may be caveats. Jon Cohen, a reporter for Science magazine, learned this after a dizzying experience stopping at a convenient Rite Aid to get the shot … only to learn that the shot wasn’t free there because that pharmacy was not in his insurance network.
“Well, it’s baffling,” Cohen said. “Pharmacies have giant signs out front that say, ‘Come on in and get your flu shot today!’ And you walk in, and fill out your paper work, and they tell me, ‘Your insurance company doesn’t cover this.'”
The networks and what the shot costs you or your insurance may vary, depending on your plan and where you go. Many pharmacy chains post cash prices. PriceCheck has already found that the cost can range from $14.99 at Costco to $31.99 at Rite Aid.
These pharmacy shots may not be covered under ACA Marketplace plans, and employer plans may only include select locations in their networks. Beyond this, we’re not sure how this dynamic plays out in the Philadelphia region. That’s why we’re asking you.
So, what was your experience? Did you pay anything for a flu shot? Nothing? What did your insurance pay? Visit www.whyy.org/pricecheck and share your story.
Regardless of insurance, if you’re a resident of Philadelphia, the city health department is offering the shot for free at designated locations. Those residents with insurance are asked to bring that information so their insurer can be billed.
What’s in it for me?
Aside from some big chains posting cash prices, this cost information isn’t easily available. Even if a shot is free to you, your insurance is paying something for it, and that’s costing the health system something, said L.J. Tan with the Immunization Action Coalition.
“It’s not free to the payers. That’s why premiums are going up,” Tan said.
Tan wonders whether some providers are dropping out from offering the shot, even if it’s convenient to patients, because of reimbursements. We here at PriceCheck also wonder if some places are charging more than others. How does that affect what an individual might pay and whether one decides to get the shot or not? As it stands, the way insurance and health care work, we just don’t know.
“All of that [reimbursement information for flu shots] is proprietary,” said Tan. “We don’t have data on that, which is what’s so frustrating.”
But you — yes you — when you get your bill or your explanation of benefits, you do have that information. So the idea is, together we can pool our knowledge and learn more.
OK, how do I do this?
It’s easy. Go to our PriceCheck page and under “share your prices” enter the phrase “flu shot” into the procedure column. Below that, note where you went, the total price that was charged, what your insurance paid, and what, if anything, you paid.
The process is anonymous, and you can leave a comment to explain more. Additionally, you have the option to leave an email. It’s private, but it allows us to follow up if we have questions about your experience.
After you’ve entered this information, scroll down to the “find prices” section. Enter “flu shot” into the procedure space and the ZIP code where you’re based. Then, search around and compare what others have entered.