RSV vaccince costing some people $300

as a Pfizer shareholder, I thank you.

Just saw this article in the NY Times.

{{ A spokeswoman for the Centers for Medicare & Medicaid Services confirmed in an email to The New York Times that the R.S.V. vaccines should be available free of charge to people with Medicare Part D. If people are told otherwise when they go to get the vaccine, they should call 1-800-MEDICARE for assistance. }}

I think I’ll wait a while on the RSV vaccine and let others do the beta testing. Though, since I’m only paying $1.60/month for my Aetna Part D plan, getting a $300 vaccine for “free” looks tempting.



I’m seeing a lot of “should be” in Medicare. I’ve had several blood tests, ordered by my doctor, where the payments were denied by Novitias. (Novitas is a Medicare Administrative Contractor that processes claims and payments for healthcare providers in 13 states) I have to then go back to my doctor and ask them to resubmit the justification for the test to the provider so the provider can resubmit to Medicare. Makes me think Novitas is incentivized to not approve payment. Why might that be? It will be interesting to see how they handle payment for the RSV.


I’ve been on Medicare for about 2-1/2 years. If the computer at the lab spits out an “Advance Benefit Notification” saying that Medicare may not cover, I just tell them to skip the test, I can always come back when you have the right diagnostic codes if the doctor really needs it. It’s usually either a wrong code or a test that Medicare will pay for only “3 times per year”. So if I come back in a month or two, then it will be covered.

It’s always easier to go back to the lab and do the test when everyone agrees they have the right information, than to correct a screw up and try to get your money back.