I would wait. It is only a few more weeks and you worked really hard to find the solution to your problem.

If your husband has a Medicare Part D drug plan, shingrix is covered.

Medicare Part B covers Flu vaccine.

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

https://www.medicare.gov/drug-coverage-part-d

It is almost open season (starts Oct 15), where your husband can change plans if needed to find one that fits his needs at the best cost.

I hope you get yours worked out.

Most drug stores as well as Costco will mail you your Rx.

Also check GoodRx for a coupon. Depending on where you are located, you might be able to get the cost down to as low as $155.

Hubs gets the flu shot for free. He is shopping around for a new plan . . .

I would wait until your appt at the new dr's office and have it billed through that office based on what you wrote above. However, we have one of those plans like yours, except ours is through the employer, but costs us $$$ and has a $10k deductible. Basically nothing is covered unless it's been a tragic year. I'm typing in so a ding ding doesn't happen to you like has happened to us in the past. Went to Dr X's office for a long awaited appt. Without us being notified, Dr. X was out of the office with a PA filling in. We were surprised, but saw PA. Billing was filed under PA, not Dr X. Everything rejected as out of network and $$$$$. Not that anything would have been covered anyways, but it would have at least been applied to our deductible and that would have helped should the year have turned out to be tragic. When I challenged the claim denial I was informed that it is our responsibility to confirm that the physician on duty, even if within a practice is in network. Expensive lesson as the contracted rate for in network is lower than out of network. We assumed since we went to our regular dr's office for a long scheduled appt, seeing the PA would fine.

That's only about a month so I would take the appointment. I would also ask for a cancellation if one becomes available. Our flu shots are always free under our insurance.

Regarding Medicare, I received a 125+ page book for my dad. I had already decided I need to look at Medicare Advantage for him or a supplemental. I absolutely dread it.

Every state has a Senior Health Information program (SHIP) that will help you navigate the options and how to proceed. It's no cost and is staffed by well trained volunteers - look yours up and contact them for help in deciding what plans you need for your Dad.

Thanks for sharing this, Pinkmountain. I second the GoodRx route, as it was helpful for our family for a prescription that wasn't medically necessary but which the pharmaceutical provider still wanted customers. You may want to consider an independent insurance broker/advisor who may offer initial consultations to maneuver your options.

My family and I have had conventional, employer-covered insurance for years. The ACA has only benefitted us. We haven't noticed any detriments. Just noting this because... well... because.

Tina, when DH was reaching Medicare age, I went to an insurance broker. It doesn't cost anything to sit and listen. He showed me all the types policies available to us living in this county, pointed out some pros and cons. It was very helpful.

We have a Premera supplement for DH, and an additional prescription policy. He really doesn't take any expensive meds but I wanted him to have coverage of course - just in case.

My mother has an advantage plan and it works for her in her larger city. It's more budget friendly and with a vast number of doctors, providers, but there are no advantage plans that we could buy living where we do, even if we wanted one.

No complaints about the choices made, and no angst was involved ;0)

Pink, do you know if your doctor’s office even carries the shingles vaccine? Mine did not and I had to go to a pharmacy.

Pink, double check your Insurance coverage. Your flu shot may (should) also be free.

Thank you more and chessy. Dad is 90 and do has been on Medicare for some time. Is medical situation has changed and I think we need to tweak his coverage. We do have one of those agencies here in my little area (surprise!!). I’ll check it and ship out.

Lascatx, YES! 💓💓💓

We got our Shingrix at no cost. We are both on Medicare (no extra, just the regular coverage) and have insurance through DH's retirement. I thought it was Medicare that paid it, but maybe not.

ETA: Just pulled out the 2021 booklet we received last week. One flu shot per year is covered by Medicare. Also, the pneumonia shot is covered. Part D covers shingles, Tetanus, diptheria, and pertussis vaccines.

That is great to know Cyn!! Dad has had the previous shingles vaccine, but he's had shingles since then too! We need to make sure his health (heart) issues are calmed down enough that he can get the Shingrix. This reminds me to check when he had his last pneumonia shot also.

DH and I went for flu shots today at CVS, and while we were there they offered us the Shingrix so we took that, too. I did not have to make any copayment, so I was a bit surprised.

Ugh, feeling pretty miserable today. DH has no side effects, but I am super achy.

@gsciencechick Tylenol and Advil helped mitigate the side effects for me. I took Tylenol, then 4 hours later Advil, then 4 hours after the Advil another dose of Tylenol, etc.

I know what you mean about feeling crummy and achy. Keep your eye on the prize! Better a little achy now than shingles later.

I first heard of Shingrix a couple of years ago when a pharmacist friend had just gotten his. I texted him when I was having the side effects with mine. He had zero side effects with either shot! What a lucky duck!

Thanks, bbstx. I just took a Tylenol after breakfast so hopefully that kicks in soon. I'm taking the baby aspirin so i don't want to take Aleve or ibuprofen. had to cancel my Zoom Zumba this morning. Will stay low and enjoy NFL games.

Yeah, starting to come around. Have these two wonderful nurses making me feel better.

To be clear, my issue is not about finding a place to get the shingles shot, nor is it about getting and affording either flu or pneumonia shots. Hubs can get flu and pneumonia free through Medicare. He has the 121 page Medicare coverage booklet, along with supplemental insurance that he purchased from the company his son work for. I have suggested he talk to an insurance broker as he is now shopping around for better supplemental coverage. But honestly, i think better coverage will probably come with a higher price tag, so there ya go. My Dad has excellent supplemental coverage and is paying around 1K per month for it . . . no way around it, on the commercial market, when you are old, you are expensive to insure . . .

As for the cost of the shingles shot, the health department quoted is $160 per shot, with a $30 discount per shot due to hubs prescription discount card. That's still $260 total.

Thanks for the heads up about the insurance billing issues Sea Sea! Hard to say how this is going to play out. As I mentioned, my doctor was MIA all through September due to changing the location of her practice. So I don't know if she offers the shingles shot, but I doubt it. That's one of the reasons I have been searching for a new doctor, another was wanting one closer to home. I thought I had found one, but now that one up and quit. That PA issue worries me, as that was what was offered at the new practice I chose. The office seemed very well organized, but the actual doctor is only there two days a week, the rest of the time you see a PA or nurse practitioner. But my other doctor wasn't easy to get in to see either, so at this point it's kind of a toss up . . . I live in a poor rural area, few good local options. All our local hospitals are hanging by a thread as it is . . .

The information on how my insurance will pay for the shingles shot comes directly from my insurance company. They sent me an e-mail response to my inquiry. They wrote that they would cover 100% but that if I went to a pharmacy I would have to pay and submit a reimbursement form. They didn't say that the pharmacy could bill them, so I don't know. I don't want to wait any longer. The repeal of the Affordable Health Care Act is actively ongoing, who knows how long these regulations that enforce insurance companies paying for preventative vaccinations will stand. They are tenuous at best. Seems like our postal service is also tenuous as far as the reimbursement paperwork too. Russian roulette seems like the new game in town for health care.

Pink, CVS is able to bill my insurance for both the flu and the shingrix. I did not have to make a copay. Maybe give them a call and talk to someone in the pharmacy. I've also used Minute Clinic in the past where they billed.

Your dad pays $1,000.00 a month, $12,000.00 a year for a Medicare supplement? I am shocked. He should definitely call a broker. I am 72 and have had kidney cancer. I pay $37.00 a month to Humana. Hub is 80, has ongoing heart issues and had colon cancer. He pays $42.00 per month. His five meds per month cost $32.00 total out of pocket at Walgreens. Neither of us has a physician copay, and we each have a maximum annual out of pocket of $5,000.00. Neither of us has paid anything for flu, pneumonia, or Shingrix shots over.the years.

Is that the difference.between rural and suburban, red state/blue state, or something else? My goodness, for $12,000 a year it might be worth it to move!

And "they" are in court to repeal the Affordable Care Act? Unbelievable.

I wish you all the good luck in the world for figuring out your situation.

Dad is 88 with the gold standard plan. He pays nothing out of pocket. That's the way he likes it. Maybe he misspoke and pays 1K per year. I dunno, hubs pays $110 per month for his supplemental plan. I can barely keep up with my own plan and my own expenses, (I'm not eligible for Medicare yet) so I'm probably not going to worry too much about other family members. My main focus right now is on finding a new primary care physician and getting my shingles shot . . .these other issues are a side one for me, mostly not under my control. I know what I pay and who I get my insurance from. I've been self insured for over ten years. Has not done me much good as far as saving money on health bills . . . only pay it to save my retirement from the worst case scenario, which so far hasn't happened, but time will tell . . . six more years until I qualify for Medicare and it may be gone by then . . . down with socialism ya know! Or I may be gone by then!