In the early days of the West Texas measles, Than Guyen was worried and worried. His four -year -old son was in danger because he received the first of the first dose of the vaccine.
So in mid -March, he took his family to the primary clinic of the Texas University of Texas Medical Branch in Galveston.
At the end of the visit, his son, Anh Hoang, received one shot from four diseases, such as measles, flaws, rubella and chickenpox. He also received a second shot and a flu shot for tetanus, diphtheria, and hundred days. His twin daughters, who had already been vaccinated for measles, had another vaccination.
Nguyen, a post -doctoral researcher in the field of public health and infectious diseases, asked the clinic staff if his family insurance would cover the screening and vaccination. He was convinced that he would do so.
Then the bill came.
Medical procedure
The first measles vaccine was made 1963 License In 1971, it became part of complex measles, flaws and rubella and MMR vaccines. The vaccine for chickenpox today is sometimes combined with what is known as an MMRV vaccine.
The first dose of measles vaccines is generally given between 12 and 15 months, and it takes 1 second between 4 and 6 years old. Experts can recommend children’s vaccines at a young age. More than 750 cases have occurred in Texas, such as the ongoing US measles. According to the Center for Disease Control and Prevention, 95%of the cases occurred in those who were not vaccinated or those who were unknown.
Recommendations that affect management and insurance applications Advisory Committee on vaccination practices. Mid -June, Robert F. Kennedy JR. The Minister of Health and Welfare added a vaccine skeptic to replace the committee. The new panel we met last week is expected to investigate past recommendations, including MMR vaccines.
Last bill
UTMB claimed $ 2,532 for the boy’s visit to the office and claimed three guns. MMRV shots were charged for $ 1,422, and it was charged for $ 161 to manage it.
Claims: Applied range gaps and providers ‘error’
The US health system has a guard rail that allows the recommended vaccine not to be very expensive. They did not help the Nguyen family.
Buy health plan Insurance broker Thaian For Nguyen’s wife and children International Medical GroupIt does not deal with immunity. And at first the family Children’s Vaccine ProgramThe federal funding effort created after measles occurred 30 years ago provides free vaccinations for children who do not have insurance.
So the family was exposed to the impact of the American medical sticker shock without insurance, and the provider set the price. In this case, the UTMB price for the children’s MMRV shots was about $ 1,400, more than five times more than the CDC paid for the private sector.
Nguyen was surprised when the insurance company didn’t pay anything, leaving Bills for three children’s screenings.
He said in a UTMB laboratory that his family’s income was less than $ 57,000 a year. Nguyen’s job provides him with health insurance, but it costs $ 615 a month, and instead, it is $ 1,841 for a one -year policy from Taian. This policy deals with certain types of office visits, emergency room management, hospitalization and chemotherapy, but do not deal with vaccinations or checkups.
Nguyen from Vietnam and his wife lives in the country as a temporary visa while studying. Nguyen said in Vietnam that the total cost of preventive treatment from the clinic in Vietnam will probably not exceed $ 300.
He was concerned about the high price set by the clinic for the vaccine, especially the occurrence of measles.
“It’s crazy,” he said.
Carly Kessler, a spokesman for the International Medical Group, confirmed that KFF Health News did not contain preventive treatment through emails.
After UTMB contacted KFF Health News, Kent Pickering, vice president of clinical contract strategy, surveyed this issue. “This situation would not have happened,” he said in an interview because of the “series of errors.”
Most of the insurance provided in the United States should guarantee a variety of preventive treatment services, including measles vaccines, without copays. Affordable Care Act rules. However, some plans are exempted from rules, including short -term plans or travel insurance. International students at temporary visas do not need to purchase ACA compliance plans for the first five years in the United States.
But what is the cost of vaccine?
Hospitals and other providers can set their own prices for the service to create a price list called Chargemasters. The insurer negotiates a discount on the service he agrees to agree. People who do not have an insurance coverage are usually over the full amount.
Stacie Dusetzina, a health policy professor at Vanderbilt University Medical Center, said, “One of the most disappointing parts of the health care system is that people without health insurance coverage must pay much more than even a health insurance company.
The price may be different, but the CDC is different. Vaccine program price list for children The MMRV vaccine, known as the brand name Proquad, costs about $ 278 in the private sector. According to GOODRX, a prescription cost tracking website, the consumer price of Galveston-Area Pharmacies’ consumer prices range from about $ 285 to $ 326.
UTMB’s pickering did not think that his plan did not deal with the vaccine because the insurance of the Nguyen family was incorrectly entered by the clinic staff at the KFF Health News. If they were, UTMB would have confirmed whether the vaccine program for the Texas child would cover the shot.
The second error was found when the picker investigated the bill. He was updated a few months ago, and the children’s vaccine program’s vaccine prices were listed in the wrong amount, and the price of Nguyen’s son was charged.
Pickering said the price was modified but did not cite the exact value.
Resolution
In addition to contacting the insurer, Nguyen contacted the UTMB’s financial office and asked for a reduction or abandonment of fees.
In mid -May, UTMB sent Nguyen an amendment to his son’s office. The website says that 50%of self -payment discounts are applied, and the website is provided to those who do not have insurance. His total of $ 1,266 was $ 1,266, of which $ 711 was for MMRV vaccination.
Nguyen said, “I expected children to exempt their children’s vaccination costs, especially for MMRV vaccines.
After Pickering had a conversation with KFF Health News, the customer service manager contacted Nguyen to give up the vaccine cost. His new legislation was $ 202.75 for his son’s office, and similar amounts to their daughter’s medical services were similar.
Takeout
A medical claim expert says it is always a good idea to check with an insurer before choosing care, such as a checkup or vaccination.
Others who purchase non -ACA compatibility plans, such as short -term guarantees, often have limitations, so they should carefully review the benefits.
Some services, including vaccinations, may have low cost options.
Galveston County Health District, a vaccination manager of Constance Almendarez, provides free vaccinations through children’s vaccine programs to many people who are not insurance or those who are not insurance, and many public health departments, including Galveston’s S, are not insured through email. He said he provided free vaccinations.
But these programs may be threatened to dismiss federal workers and cancel subsidies for health departments.
Finally, you can request a discount. Medical service providers can offer their own discounts to patients who do not have insurance or have no insurance or charity nursing policies to meet specific income requirements.
This month’s bill is the crowdsourcing survey of KFF Health News and Well+existence of the Washington Post It dissects and explains the medical expenses. The series has helped many patients and readers to reduce medical expenses since 2018, cited in the state, the US Parliament and the White House. Do you have any confusing or ridiculous medical expenses you want to share? Please tell me about it!
