Shingles, according to the Centers for Disease Control, is “an extremely painful and debilitating rash that can lead to more serious complications.” The signs of Shingles are usually a rash on one side of the body, and you’re vulnerable if you’ve had chickenpox because the virus remains dormant in your body for life and can reappear as Shingles at any time.

Zostavax is the vaccine for Shingles and it is highly recommended for people over age 60. But there seems to be a lot of confusion over how seniors can get the vaccine and what it will cost. I’ve heard that seniors on Medicare, or enrolled in Medicare Advantage plans, have gotten different answers from the same insurance company.

In one case, a husband and wife are both enrolled with the same Medicare Advantage plan. The wife got her vaccine from her primary doctor and paid nothing. When her husband went to his doctor to get the vaccine, he was told he would have to pay $150. The last I heard, the husband was still not satisfied with the answers he was getting from the insurance company.

In most cases Zostavax will come under Part D, but you need to check with your plan to see what the co-payment will be. In many plans Zostavax is a “specialty drug” with a co-pay of 25% or even 33%, depending on the plan. The actual cost of Zostavax should be $150, meaning a Part D co-pay should be between $30 and $50.

However, in most cases you must also pay co-pay to have your doctor administer the shot. And I wouldn’t be surprised if your friends who seek out the Shingles vaccine will have a different payment experience than you.  That’s just the way the crazy system works.

This entry was posted on Thursday, November 5th, 2009 at 4:40 pm and is filed under Health. Tags for this post: Medicare, Medicare Advantage, medicare arizona, medicare tucson, shingles vaccine. You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.