debthaven
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Post by debthaven on Jun 25, 2015 21:46:02 GMT -5
We are going to SE Asia this summer, and my sister (who lives in NY/FL) is coming with us. We are in the process of getting the necessary immunizations. DS3, my sister and I have already gotten ours, DH is going on Monday. We went / are going to the nearest local hospital with an immunization / tropical diseases department (they go together here, not sure about in the US). So DH, DS3 and I went to the hospital nearest us, and my sister went to the hospital nearest her. DH, DS3 and I went there in 2009 before our trip to Panama / Costa Rica, so we were more up to date with ours than my sister. DS3 and I went on Wed. We got our (overdue) booster shots for Hepatitis A, and typhoid. 44 euros each = $49 each. DH will be the same. My sister went on Monday. She got a Hep A shot (her first, not a booster), typhoid, and DT (Diptheria-Tetanus). She paid ... $455! Also, they told her she needed 40 days of anti-malarial pills, and sold them to her. (That's NOT included in the $455.) Our doc told us we need 10 days of anti-malarial pills, but did not sell them to us. One of my best friends works at that hospital, she told us who to see, I trust her. I was absolutely floored at the difference in cost! I knew there would be a difference, but I never imagined it would be nearly 10X more expensive for my sister (even though my sister had one more shot than we did). Plus my sister is miffed at me because she hadn't realized she'd need any immunizations or anti-malarial pills when she decided to come with us.
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debthaven
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Post by debthaven on Jun 25, 2015 22:00:55 GMT -5
Sorry I meant to put this in YM OT, please feel free to move.
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resolution
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Post by resolution on Jun 25, 2015 22:02:54 GMT -5
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debthaven
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Post by debthaven on Jun 25, 2015 22:05:39 GMT -5
Resolution, it sounds like things ARE more even here (France).
My sister is not uninsured at all! She is a retired NYC teacher with great insurance.
Travel immunizations are not covered by insurance here either, which is perfectly understandable. My sister's DT shot would have been covered here (although the rest wouldn't have been).
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Ombud
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Post by Ombud on Jun 25, 2015 22:34:27 GMT -5
All services are covered here ... some have copay of $10. Others don't
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debthaven
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Post by debthaven on Jun 25, 2015 22:45:37 GMT -5
All services are covered here ... some have copay of $10. Others don't
Ombud I'm not sure I understand your post. Then why did my sister pay $455 for 3 immunizations while we paid the equivalent of $49 for 2, knowing that her third was very routine (DT)?
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Ombud
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Post by Ombud on Jun 25, 2015 22:55:37 GMT -5
US is weird. I picked mine by coverage. Maybe she picked hers by policy price [mine is $300m single / $800m family coverage -- so it's expensive]
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Tiny
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Post by Tiny on Jun 25, 2015 23:17:11 GMT -5
Thanks. You gave me a reason to go back to my healthcare providers website to check out previous bills as practice. I was alittle overwhelmed by the online info and the deluge of paper that I generated this year.
I got a Tdap? it's tetanus, Diptheria, and pertussis shot that was itemized on the bill as $127 for the drug? and then $47 to administer it. I also had a blood draw and some sort of testing done for a cost of $880 also on that same bill. My out of pocket for the $1054 bill was under $7.00 AND I felt like crap for 3 days after the shot AND got a rash on my arm. That seemed like a pretty good deal - other than the feeling like crap and the rash.
I've got a HDHP. I have paid $1600 out of pocket so far (for about 15K worth of service/tests/exams). Not sure what the shot would have cost out of pocket if I hadn't met the 1300 deductible so quickly.
It sounds like maybe the insurance plan doesn't cover certain kinds of things, like the "going out of the country" shots? I can totally see where a 'good' insurance plan might have some holes. My brother was complaining about the out of pocket cost for a shingles shot(over $150)... he said something along the lines of he'd pay less by going to Walgreens when it was offered than going to get the shot while he was in the doctor's office. he may be totally wrong. He's "old" and doesn't like going to the doctor... but, he's a generally reliable source of information... so I tend to believe him.
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Post by The Walk of the Penguin Mich on Jun 25, 2015 23:41:55 GMT -5
This is strange....
I got these before one of our trips and paid about $149 for Hep A and Typhoid. I was up to date on DPT. I remember there being some discussion about malaria, but we werent going that far south.
My insurance covers DPT, not the other 2.
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bobosensei
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Post by bobosensei on Jun 25, 2015 23:45:24 GMT -5
Well, this is a good note to me to get caught up on all immunizations before DH gets out of the military.
I wonder if part of the cost difference is because the shots were only necessary because your sister is taking a trip. I never hear people with kids talking about how much immunizations are, and think of all the people who don't have hundreds extra a year for things like this. I wonder if it would have been cheaper for her to go to her primary care physician instead of directly to a hospital. Maybe the cost was for an out of network hospital and provider.
But this is what bothers me about healthcare in the States. You are not charged based on cost, but what they think they need to get out of you to subsidize others or to make a profit.
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Deleted
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Post by Deleted on Jun 26, 2015 0:16:57 GMT -5
This is strange.... I got these before one of our trips and paid about $149 for Hep A and Typhoid. I was up to date on DPT. I remember there being some discussion about malaria, but we werent going that far south. My insurance covers DPT, not the other 2. Same here - DD's immunizations for travel were similar, plus they added a couple other things like for malaria. It was about $130 & not covered by insurance.
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Post by The Walk of the Penguin Mich on Jun 26, 2015 0:46:47 GMT -5
Well, this is a good note to me to get caught up on all immunizations before DH gets out of the military. I wonder if part of the cost difference is because the shots were only necessary because your sister is taking a trip. I never hear people with kids talking about how much immunizations are, and think of all the people who don't have hundreds extra a year for things like this. I wonder if it would have been cheaper for her to go to her primary care physician instead of directly to a hospital. Maybe the cost was for an out of network hospital and provider. But this is what bothers me about healthcare in the States. You are not charged based on cost, but what they think they need to get out of you to subsidize others or to make a profit. Travel immunizations are normally not covered. Regular ones, like DPT are. Unfortunately, you have to go to specific places for more exotic immunizations. A PCP generally office generally doesn't have them in stock. I think I went to tropical medicine at the university for mine. I need to look into where we will need to go for immunizations for Africa....not sure what we will need and not sure where to go locally.
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Deleted
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Post by Deleted on Jun 26, 2015 8:09:33 GMT -5
That's crazy. We have (had?) a business called the Travel and Immunization Clinic nearby and it was run by nurse practitioners. I had insurance but the sticker prices weren't that bad. This was a few years ago, but I suspect it was cheaper since it was pretty simple- all they did was give immunization and write prescriptions.
I'm glad I got my lifetime immunization for hepatitis (only 2 of the 3, I forget which) when it was cheap.
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Wisconsin Beth
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Post by Wisconsin Beth on Jun 26, 2015 9:50:25 GMT -5
My kids immunizations for the standard shots (TDAP, chicken pox, etc.) are free. As is the well child visit when they get them. But neither the kids or DH and I have had to get special shots.
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Post by The Walk of the Penguin Mich on Jun 26, 2015 12:00:06 GMT -5
Also, they told her she needed 40 days of anti-malarial pills, and sold them to her. (That's NOT included in the $455.) Our doc told us we need 10 days of anti-malarial pills, but did not sell them to us.
I was absolutely floored at the difference in cost! I knew there would be a difference, but I never imagined it would be nearly 10X more expensive for my sister (even though my sister had one more shot than we did).
Travel requirements differ between countries, Debt.
I was looking into this last night for our trip to South Africa. If I was coming from another country other than the US, I would also need yellow fever immunization, along with Hep A and typhoid (my last ones were over 3 years old). So the difference between 10 days of malarial meds vs 40 is very likely a difference in the standards as suggested by the CDC (which governs the US health travel recommendations) vs France's governing body.
About cost, I have to wonder about the cost but know she very likely could have gone elsewhere and gotten it cheaper. The fact that she paid for her DPT makes me suspect that she was dealing with a specialized service, as that *should* have been covered by her insurance.
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CCL
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Post by CCL on Jun 26, 2015 13:12:54 GMT -5
Do they administer any of them at the local health department? Maybe not, but they are usually a bargain for other immunizations. I'm sure ours does the DPT.
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andi9899
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Post by andi9899 on Jun 26, 2015 13:24:34 GMT -5
Does she not have health insurance? Doesn't it usually cover most immunizations 100%?
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kareninwa
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Post by kareninwa on Jun 26, 2015 23:07:01 GMT -5
US is weird. I picked mine by coverage. Maybe she picked hers by policy price [mine is $300m single / $800m family coverage -- so it's expensive] I was thinking that is cheap insurance! I live in WA state, and have had really good plans for years now. I have always had single coverage since I am single with no dependents. My premiums have always been around $500 or more. I have always paid either a small part of the premium or nothing for it, depending on the union contract and/or benefits package at said job. I have had good insurances since 1999, with some months with nothing in 2007 when I was in between jobs. I unfortunately consume a lot of healthcare, so I know just how good of a deal I am getting. KarenInWA
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Post by The Walk of the Penguin Mich on Jun 26, 2015 23:54:56 GMT -5
Does she not have health insurance? Doesn't it usually cover most immunizations 100%? Many times, not those required for travel. My (very good) insurance didnt cover them either).
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Post by Deleted on Jun 27, 2015 0:34:29 GMT -5
Does she not have health insurance? Doesn't it usually cover most immunizations 100%? Not for adults & not travel specific ones. I had to pay for college age daughter meningitis vaccine myself (even though required by college for attendance & she was still dependent on my insurance). Insurance did cover Hep vaccines 100%. No immunizations for me were covered at all (all out of pocket per my insurance then) This was pre-ACA, so I have no idea what is actually covered now! The Walk of the Penguin Mich I will ask my DD if she remembers where she got her shots, she was up north at the time & I think it was one of the Peace Health clinics. If she knows I will PM you. I think because the U students have exchange programs that they have those services in the area. Not sure they exchange with South Africa though, so that might unique!
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milee
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Post by milee on Jun 27, 2015 1:04:10 GMT -5
The prices you quoted appear similar to the pricing from a private travel clinic. Those are just what they sound like - a business that caters to travelers. They offer appointments, clean offices and a consultation with a nurse who can research what's required and what's available out of the options.
If you're patient, willing to do your own research and don't mind some pretty grubby settings, you can usually get all necessary travel immunizations for a fraction of the private travel clinic cost by going to the local public health department immunization clinic.
I've done both (fancy pants travel clinic and public clinic) in AZ, CA and FL. If you're pressed for time, a nervous traveler, unwilling to do some research, or easily grossed out - the private travel clinics are worth the money. I'm at the point now where I know what I need and am past being grossed out by the public health department, so just go there for inexpensive boosters. But each has their place.
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Post by The Walk of the Penguin Mich on Jun 27, 2015 1:05:44 GMT -5
I just did a little googling and it looks like at least 2 of the pharmacies do travel vaccinations. We should be able to get the 2 we need there, I need to do some research about yellow fever though. CDC says not necessary, but it is required by other countries and I want to know why.
Right now, I'm looking at flights to Johannesburg. Right now, Turkish Air is cheapest and there is a layover in Istanbul. I'd like it if we could snag couple days so I could see a friend there. We are probably looking at being gone 3 weeks.
I need to get my butt in gear and start working on this......
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Ombud
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Post by Ombud on Jun 27, 2015 1:07:18 GMT -5
I think I pay a lot for coverage but very small copays. ♤ MD vists $10 ♡ ER visits $25 ◇ Immunizations / vaccines $0 ♧ Meds $10 each script Urgent care / preventive stuff is free (mammograms, eye exams etal)
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milee
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Post by milee on Jun 27, 2015 1:09:57 GMT -5
The yellow fever vaccine is one I've avoided so far, mainly because it does have some risks so you don't want to take it without understanding what the risks are (both of taking the vaccine and of contracting yellow fever.)
You'll also find that the requirements for various vaccinations not only vary by country, but that the risk levels each country interprets aren't the same. Sometimes it's confusing and you've got to go with not only your knowledge of your personal health and risks but also the types of activities you do on vacation and make your best guess.
Have fun.
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debthaven
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Post by debthaven on Jun 27, 2015 6:01:36 GMT -5
Sorry I wasn't around earlier to respond.
Milee unless she changed her appt, she was going to a local hospital, not a private travel clinic.
I don't know if her insurance will cover the DT, it's possible.
It seems entirely normal to me that the "travel" vaccines aren't covered by insurance, either for her or for us. I was just surprised that it cost her literally 10 times more than it cost us for the same shots.
It's entirely possible that she could have gotten them cheaper, but again, as far as I know she was planning to go to a hospital, not a private clinic.
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973beachbum
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Post by 973beachbum on Jun 27, 2015 10:03:10 GMT -5
The weirdest part to me is that they gave her a TD vaccine and not a Tdap. My DD had a reaction to the pertussis vaccine as a child. It was the older version which was much more prone to giving people reactions than the new one, but it was bad enough that doc's today say it isn't worth the risk for her to take it. So that said we have to make sure she gets the TD vaccine not the Tdap. Sounds easy right? I can't explain how hard it was to get a plain old TD vaccine. No Dr's offices or pharmacies are actually allowed to carry it anymore. Per the new guild lines they are only allowed to carry the Tdap. It was a round in circles trying to find someone who had the TD vaccine. It finally came out that in order for them to get it they had to order it from some special warehouse in Atlanta along with a copy of the Rx and an explanation as to why. We needed it as a requirement from her college but her old TD was over ten years ago so it isn't like it was a bad idea. In the end it ended up only costly $10 but man was that exhausting!
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zibazinski
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Post by zibazinski on Jun 27, 2015 10:07:24 GMT -5
Yup, DH told me that when they went to South Africa, they all had to go to a special place and shots were about $500 apiece. This was more than ten years ago.
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zibazinski
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Post by zibazinski on Jun 27, 2015 10:08:01 GMT -5
Not apiece as in every shot but the shots were about $500 worth for each person. Not covered by insurance at all.
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milee
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Post by milee on Jun 27, 2015 10:32:07 GMT -5
Milee unless she changed her appt, she was going to a local hospital, not a private travel clinic. Very unlikely unless this is a hospital setup very unlike one I've ever seen or consulted for in the SW US or FL. The clinic may be located in the hospital building and may even share a name with the hospital, but it's most likely a separate clinic just housed in the same building. Again, could be private and fancy pants or could be public health dept and housed in the hospital. Hospitals tend to outsource outpatient stuff like that or have separate entities (which the hospital can own all or part of) for things like immunizations.
But maybe NY has a different set up. Just describing what I'm familiar with.
Also, hospitals tend to be the absolutely most expensive facility to get any service in because of the increased facility charges. An X-ray at a hospital will cost you multiple times what that exact same X-ray would cost at a freestanding radiology clinic or a doc office with their own X-ray equipment.
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milee
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Post by milee on Jun 27, 2015 10:32:58 GMT -5
This thread reminds me that my Typhoid immunity is ending next year, so I really need to get going on at least one more interesting vacation before it expires.
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