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WARNING about Tricare for Life coverage and the Shingrix shots Login/Join 
always with a hat or sunscreen
Picture of bald1
posted
Word to the wise military retirees on Tricare For Life!

Got a bill from my doctor today for >$150 for the Shingrix #1 shot.

I'm on Medicare B and Tricare For Life.

Found this utter bullshit which REALLY pisses me off as I had no advance knowledge:

"TFL covers the shingles shot as a medical coverage, not pharmacy coverage. So, the process goes like this:

You get the shingles shot.
You do not have Part D Medicare, so the cost falls to TFL.
TFL covers the shot as a medical cost not covered by Medicare.
When medical costs are not covered by Medicare, TFL deductibles and cost-shares apply.
The deductible is $150 single/$300 family rates, with a $30 cost share for a network primary care doctor.

The bottom line is, you pay for the shot even though it is technically covered.

That explains the medical coverage-side of TFL, however, on the pharmacy side of TFL, you can get the shot at a Tricare network pharmacy. Use the Tricare pharmacy coverage and the shot is covered 100%."

So now I'm trying to find a local Network Pharmacy that gives these to arrange my follow up #2 Shingrix shot.



Certifiable member of the gun toting, septuagenarian, bucket list workin', crazed retiree, bald is beautiful club!
USN (RET), COTEP #192
 
Posts: 11779 | Location: Black Hills of South Dakota | Registered: June 20, 2010Reply With QuoteReport This Post
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Tricare can be tricky. They are supposed to be paying 100 percent for Telehealth but are taking off a copay. They are promising to fix the problem but continue to take off a copay. Medicare can be tricky with vaccines. Still I would pay 150 dollars to avoid Shingles. Thanks for the heads up.
 
Posts: 9343 | Location: Stuck at home | Registered: January 02, 2015Reply With QuoteReport This Post
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Picture of 229DAK
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quote:
So now I'm trying to find a local Network Pharmacy that gives these to arrange my follow up #2 Shingrix shot.
Please let us know what you find out.


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Posts: 7828 | Location: Northern Virginia | Registered: November 04, 2005Reply With QuoteReport This Post
always with a hat or sunscreen
Picture of bald1
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quote:
Originally posted by 229DAK:
quote:
So now I'm trying to find a local Network Pharmacy that gives these to arrange my follow up #2 Shingrix shot.
Please let us know what you find out.


I've found two local pharmacies. :thumbsup:


https://www.tricare.mil/Covere...ered/ShinglesVaccine

Getting Vaccines at TRICARE Network Pharmacies:

You can get the shingles vaccine for free at a participating network pharmacy. You can find a pharmacy by:

Calling 1-877-363-1303
Using the Express Scripts Mobile App
Searching online



Certifiable member of the gun toting, septuagenarian, bucket list workin', crazed retiree, bald is beautiful club!
USN (RET), COTEP #192
 
Posts: 11779 | Location: Black Hills of South Dakota | Registered: June 20, 2010Reply With QuoteReport This Post
Stumbling through where
others have fallen
Picture of REdwin89
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I was told both shots go to your pharmacy. You get the first and they keep the second for you till after the waiting period. Hope that's not true in your case.


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Posts: 2308 | Location: No longer new to Central NY | Registered: March 13, 2004Reply With QuoteReport This Post
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Picture of LimaCharlie
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My wife and I got the Shingrix shots at the Safeway pharmacy for free under Tricare. We each got a 10% off our next shopping trip coupon. Two shots each with a total of four coupons.


U.S. Army, Retired
 
Posts: 3688 | Location: Northwest Oregon | Registered: June 12, 2011Reply With QuoteReport This Post
always with a hat or sunscreen
Picture of bald1
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For those of you who got your Shingrix shots at a pharmacy, did you need a prescription from your internist?

Had to ask as I'm new to this kind of thing (despite my advanced age Big Grin ).



Certifiable member of the gun toting, septuagenarian, bucket list workin', crazed retiree, bald is beautiful club!
USN (RET), COTEP #192
 
Posts: 11779 | Location: Black Hills of South Dakota | Registered: June 20, 2010Reply With QuoteReport This Post
Happily Retired
Picture of Bassamatic
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Sounds like they have a deductible...just like Medicare does.



.....never marry a woman who is mean to your waitress.
 
Posts: 4082 | Location: Lake of the Ozarks, MO. | Registered: September 05, 2005Reply With QuoteReport This Post
Not really from Vienna
Picture of arfmel
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quote:
Originally posted by bald1:
For those of you who got your Shingrix shots at a pharmacy, did you need a prescription from your internist?

Had to ask as I'm new to this kind of thing (despite my advanced age Big Grin ).


I had my Shingrix shots at an independent pharmacy and paid out of pocket, but no prescription was needed. Wife says she got hers at Walgreens snd doesn’t remember needing a prescription, either.







 
Posts: 25309 | Registered: January 30, 2007Reply With QuoteReport This Post
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No prescrition is needed for the vaccine. You may have to complete a questionnaire at the pharmacy.
 
Posts: 9343 | Location: Stuck at home | Registered: January 02, 2015Reply With QuoteReport This Post
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I am on Medicare and Tricare for life also. Last year I got both shingrix shots at the local Walmart pharmacy as my local doctor didn't have it at the time. I have never been billed for any copays in over 12 months. Maybe you can check your local Walmart for the shot. All of this healthcare insurance BS is too f*cking complicated and confusing. No RX was required. Thanks for the heads up as I need a tetanus shot too.
 
Posts: 19 | Location: North Coast, NY  | Registered: October 08, 2012Reply With QuoteReport This Post
I'd rather be hated for who I am than loved for who I am not
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i called my insurance provider today. They cover Shingrex and cologuard if you are fifty or older. wich I am so I am getting my first shot tomorrow
 
Posts: 7255 | Location: Bismarck ND | Registered: February 19, 2003Reply With QuoteReport This Post
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Another Medicare and TriCare for Lifer. We both got two Shingrix shots at the pharmacy in our supermarket (HyVee) and did not pay a thing.

With those two plans (and meds at the nearby military clinic) we rarely pay anything. It's way too complicated for me, Mrs. Sigmund handles that stuff.
 
Posts: 14691 | Location: Eastern Iowa | Registered: May 21, 2000Reply With QuoteReport This Post
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Picture of nmsigshooter
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In 6 months I will be in the same boat. I got the older shingles shot years ago and really don't want the new one. I already have headaches with Tricare Prime, can't wait for TFL. I hate having to deal with the military for anything, its a cluster!
 
Posts: 111 | Location: New Mexico | Registered: October 11, 2020Reply With QuoteReport This Post
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Although I have Tricare for life I got mine at the VA.
 
Posts: 13 | Location: Adamstown Pa | Registered: October 25, 2020Reply With QuoteReport This Post
I'm Fine
Picture of SBrooks
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Blue Cross paid for both my shots with no prescription and minimal copay/out-of-pocket. Just walked into CVS and asked for it...


------------------
SBrooks
 
Posts: 3568 | Location: East Tennessee | Registered: August 21, 2006Reply With QuoteReport This Post
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I got both of my shingles shots at the Youngstown Ohio VA Outpatient center with no cost to me.



Sgt. USMC 1970 - 1973
 
Posts: 406 | Location: Columbiana, Ohio  | Registered: May 04, 2011Reply With QuoteReport This Post
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