AKB Should my college student son be charged for a flu shot when he has his college's health insurance?

[dailybuck777]

My 20-yr old son has his colleges' student health insurance. (In Ohio, like to keep his privacy so won't mention name) About a week ago, he got a flu shot that the medical provider charged about $120 for. He was charged $60. When I and my younger daughter have gotten flu shots, we were never charged anything. One would think that the govt would be encouraging flu shots and that there wouldn't be a charge for them. Makes no sense to me. Wondering if anyone here has any experience with this. It is an Aetna standard college health insurance plan.

 

[PSULionsDub]

No. Most, if not all, insurance plans cover the shots of vaccines because they are preventive maintenance.

 

[Aardvark86]

My 20-yr old son has his colleges' student health insurance. (In Ohio, like to keep his privacy so won't mention name) About a week ago, he got a flu shot that the medical provider charged about $120 for. He were charged $60. When I and my younger daughter have gotten flu shots, we were never charged anything. One would think that the govt would be encouraging flu shots and that there wouldn't be a charge for them. Makes no sense to me. Wondering if anyone here has any experience with this. It is an Aetna standard college health insurance plan.

A little weird in that most insurance plans will cover at zero copay, and that’s actually a requirement of Aca plans. But I could see a rationale where a college plan is really intended to not be designed for comprehensive preventive services. If your son is covered under your health plan, may want to see if a secondary claim could be filed.

there could also be an in network issue. For example I’m looking at the gw aetna spd and it only covers the flu shot if administered at the gw clinic.

check the school plan spd:

Home | Aetna Student Health

Aetna Student Health offers student health insurance plans to many colleges and universites throughout the country.

www.aetnastudenthealth.com

 

[Plan Ahaed]

Like Aardvark86 said if he's on your plan you should be able to submit as a secondary insurance. You can look up the school and their plan details here: https://www.aetnastudenthealth.com/

I picked a school at random and for immunizations it said if performed at that school's health center (in-network) it was covered 100% but if performed elsewhere (out of network) it was only covered at 60%.

 

[katchthis]

My 20-yr old son has his colleges' student health insurance. (In Ohio, like to keep his privacy so won't mention name) About a week ago, he got a flu shot that the medical provider charged about $120 for. He were charged $60. When I and my younger daughter have gotten flu shots, we were never charged anything. One would think that the govt would be encouraging flu shots and that there wouldn't be a charge for them. Makes no sense to me. Wondering if anyone here has any experience with this. It is an Aetna standard college health insurance plan.

Another possibility, Maybe they billed an E/M code , office visit /exam in with the shot ? What does the insurance payment EOB say ? CVS , although I hate them, are easy vaccine centers. Never had a charge out of CVS for flu, COVID, or Shingrix.

 

[kgilbert78]

Another possibility, Maybe they billed an E/M code , office visit /exam in with the shot ? What does the insurance payment EOB say ? CVS , although I hate them, are easy vaccine centers. Never had a charge out of CVS for flu, COVID, or Shingrix.

Yep--that's a trick the companies use (both insurance and doctor's office) to get more money. I was in the ER a while back and they took me for a test. The test was considered an "office visit" and thus a second copay was required. I've had this happen more than once. The first time I fought it. After that, it wasn't worth my time--the insurance and doctor's office kept playing ping-pong with the bill, even after my company's HR got involved. They are not supposed to do that--but they do it anyway (I think the doctor's office gets more money for an office visit). UGH.

 

[dailybuck777]

A little weird in that most insurance plans will cover at zero copay, and that’s actually a requirement of Aca plans. But I could see a rationale where a college plan is really intended to not be designed for comprehensive preventive services. If your son is covered under your health plan, may want to see if a secondary claim could be filed.

there could also be an in network issue. For example I’m looking at the gw aetna spd and it only covers the flu shot if administered at the gw clinic.

check the school plan spd:

Home | Aetna Student Health

Aetna Student Health offers student health insurance plans to many colleges and universites throughout the country.

www.aetnastudenthealth.com

Never thought about whether it was a comprehensive plan or not. You are required to have health insurance at my son's college. So I assumed that it was comprehensive and it wouldn't make sense if it wasn't. But I will look into it.

 

[dailybuck777]

Like Aardvark86 said if he's on your plan you should be able to submit as a secondary insurance. You can look up the school and their plan details here: https://www.aetnastudenthealth.com/

I picked a school at random and for immunizations it said if performed at that school's health center (in-network) it was covered 100% but if performed elsewhere (out of network) it was only covered at 60%.

Not on my insurance, because I assumed that it was comprehensive. In fact as I am writing this, it almost certainly has to be comprehensive because of the cost. As I said in a previous post, I will check out what the actual coverage is.

 

[dailybuck777]

I couldn't really call the insurance company because the insurance is in my son's name even though I paid for it. My son came home and made the calls and it turns out the bill was a mistake. As I thought, I do have a full-fledged health insurance policy for my son through his college. Aetna said that the shot was for preventive care and there was no copay owed.