Health & Medicine

Getting Zostavax isn't as easy as it could be

Readers have reported difficulties finding a clinic that would administer Zostavax, the vaccine aimed at preventing shingles in people 60 and older. In a previous column, I asked readers to relate their experiences trying to run down the shot. That struck a chord, and the mailbox filled up.

Turns out there is a patchwork of procedures in play to get and pay for the shot. Reader experiences run the gamut from smooth sailing to shoal waters. For example:

■ Special storage/administration requirements and billing/coverage ­issues have created barriers for people seeking the vaccination.

■ The Zostavax vaccine must be kept frozen at an average temperature of 5 degrees Fahrenheit and administered within 30 minutes of reconstitution.

■ People who had to pay in full quoted prices as high as $350.

■ Some get the vaccination from their doctor with no problem. The doctor orders the vaccine and gives the shot.

■ Some pharmacies work with doctors to make the shot available. The pharmacy orders Zostavax when you present a prescription. You pick up the vaccine and take it to your doctor, who administers it.

■ Some pharmacies order the vaccine and administer the shot on site.

■ In some instances, you might be asked to pay upfront and file the insurance claim yourself.

■ Readers report that some ­doctors shrugged off giving Zostavax because it was too much trouble.

You see why I used the term patchwork.

Then there's the Zostavax billing issue for Medicare Part D recipients.

The administration fee was billed to Medicare Part B, while the product cost was billed to Medicare Part D.

Thankfully, that changed Jan. 1. Now both can be billed to Medicare Part D.

As demand for Zostavax climbs, expect to see more independent and chain pharmacies stepping up to administer and bill for Zostavax.

Check with your insurance carrier to see whether Zostavax is covered and how much of the cost you have to pay. In some cases, the shot might be covered if your physician signs a ”prior authorization“ form.

Medicare Part D recipients can go online 
(http://medicare.gov/
pdphome.asp) and click on ”Medicare Prescription Drug Plan Finder.“ On the next page, one way to proceed is to click on ”Find & Compare Plans.“ Continue until you get to a box that says ”Enter My Drugs.“ Enter ”Zostavax“ and continue. (An ”Enter My Drugs“ box on the first page would be handy, but hey, it's a bureaucracy.)

For those interested in getting the Zostavax vaccination, the best advice is to call around to area pharmacies and doctors' offices for leads on who might be offering this service. Chances are, there are nearby sources you might not have heard about.

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