Friday, March 1, 2019

SOL1: What I Learned About Medical Insurance Today

            I’m 76, using Medicare. My new doctor wants me to get another pneumonia vaccine even though I had one with my old doctor some years ago.
            I went to my usual independent pharmacy today to see if I could get it there. The pharmacist said that the cost would be $279. She said that my Part D insurance doesn’t cover that vaccine, and this pharmacy doesn’t have a contract that covers the vaccine under Part B. However, I could try going to a chain pharmacy and see if their contract under Part B would cover it.
            This is the first time I’ve had any problem with coverage. Why should it make a difference what pharmacy I get the vaccine at? Why do the chains have a contract with Medicare Part B for coverage for this vaccine, but not this independent pharmacy?
            My pharmacy has the best customer service. They call if I’ve forgotten to get refills for my regular medications. They keep track of when prescriptions expire and will call my doctor to get new ones. My local chain pharmacy has never done any of this.
            What about yours? Do you have an independent pharmacy near you? Does your local chain pharmacy provide good service?
I’m participating in the 12th annual Slice of Life Challenge over at Two Writing Teachers. This is day 1 of the 31-day challenge.  It’s not too late to make space for daily writing in a community that is encouraging, enthusiastic, and eager to read what you have to slice about.  Join in!


  1. Ugh, the whole insurance business is such a big frustrating game! I feel for you. We had to say goodbye to our regular local pharmacists twice. It's headache and a half. Hope it all gets straightened out sooner than later. We're at a big chain again since we moved and it's meh. Customer service is great on certain days and awful on others. They robo call every single day and we don't get THAT many drugs. The app is nice for easy refills without calling though... Great first slice!

  2. Insurance seems designed to drive us mad, don't you think? This is truly crazy-making. I will say, however, that the Duane Reade pharmacists -- both at my old pharmacy before I moved and at my new one near my job -- have been wonderful. They call me to double check things and update me on their efforts to work with my doctors and my insurance whenever there are problems. They're really good. I don't know if that would be true for all Duane Reades ... or if it would carry over to Walgreens, since Walgreens owns Duane Reade now, but it might be worth a try? I'd suggest talking right off the bat with the actual pharmacist, not with one of the techs. The pharmacists seem to pride themselves on having a relationship with customers, almost like an extension of your GP. So maybe start with her or him.

  3. Insurance is the worst. The call center hours are terrible. And they are never open on the weekends. HELLO! I work. Hope you get things figured out. And welcome back.