Toddlers: 12 - 24 Months

clicky poll re flu shots & pediatricians

I'm curious (re your LO(s)), not for adults.)

(a note about insurance coverage: unless you are getting your flu shots through a gov't or otherwise funded program that provides them through an outside funding source, not insurance, or some other unusual circumstance, flu shots are not 'free' - if you are insured, your provider is billing insurance for them, or asking you to submit for reimbursement. So if you are insured and can get a flu shot at the pediatrician and they don't ask for payment & tell you you need to submit for reimbursement, the provider is billing insurance to get reimbursed.)

[Poll]

Re: clicky poll re flu shots & pediatricians

  • My vote was for walk in hours where you pay up front & have to submit to insurance on your own.

    There is a caveat to this, if your kid happens to have a well visit during Oct/Nov, they will give a flu shot to him/her and bill insurance with the visit. 

    I find this to be a really weird policy & approach (I already vented about it on 24+ a little LOL) but I was curious to see what the norm was.

  • image groovygrl:
    There is a caveat to this, if your kid happens to have a well visit during Oct/Nov, they will give a flu shot to him/her and bill insurance with the visit
    This is what happened with DD's 15 month well visit earlier this month. It was automatic.
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  • We did it as a part of her 15-month appointment last week.  However, if not for that, would likely have done a walk in and as I have a health savings account, there would be no me paying anything.
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  • I have to call and make an appt and then they bill the insurance, but I am really annoyed because they don't have flu shots yet and don't think they will until the end of Nov.  This happens at this office with vaccines as well.  I am thinking of looking for a new pedi, because this truly annoys me.  Other friends with other local pedi's have been able to get their kids the flu shot this season, so I don't know what my office's problem is
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  • We're SS - flu shots are free through my insurance.  Once the vaccine is available you can walk in during regular business hours and get the shot from the lab area where you go to get blood drawn - they'll do pedis and adults there so DS and I can get the shot at the same time.

    Last year DS got it during one of his regular well-child check-ups with his other vaccines.  This year he's not due for a well-child until December, so I'll take him when I go to get my shot.  Speaking of, I should get on that.

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  • image kj07:

    We're SS - flu shots are free through my insurance.  Once the vaccine is available you can walk in during regular business hours and get the shot from the lab area where you go to get blood drawn - they'll do pedis and adults there so DS and I can get the shot at the same time.

    Last year DS got it during one of his regular well-child check-ups with his other vaccines.  This year he's not due for a well-child until December, so I'll take him when I go to get my shot.  Speaking of, I should get on that.

    Just to clarify, the shots aren't free, they're free to YOU (which is required now with the affordable care act) but the provider can still bill the insurance company for them. So you actually fall in the category of being able to walk in & get it & they bill your insurance.

  • SS -- flu shots are 100% covered on our insurance as part of preventative healthcare, so we would not pay if we showed up to clinic (we never are charged for any services in advance anyway, as we have a consumer choice PPO -- all billing is after the fact based on the plans negotiated rates, and where we are in relation to our deductible and OOP max).  

    We also would not pay if he received it during a well visit, as those are also 100% covered.

    If DS got the shot during a sick visit, we would be billed the appropriate amount for the sick visit after the fact, and still not charged for the shot. 

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  • image amy052006:

    SS -- flu shots are 100% covered on our insurance as part of preventative healthcare, so we would not pay if we showed up to clinic (we never are charged for any services in advance anyway, as we have a consumer choice PPO -- all billing is after the fact based on the plans negotiated rates, and where we are in relation to our deductible and OOP max).  

    We also would not pay if he received it during a well visit, as those are also 100% covered.

    If DS got the shot during a sick visit, we would be billed the appropriate amount for the sick visit after the fact, and still not charged for the shot. 

    So same as the pp, your provider bills insurance, you are not responsible for gathering the reimbursement.  All insurance is supposed to be covering vaccinations so no one "should" be paying for them through their regular provider. I was more curious if the provider is providing them & doing the billing for you or if like my provider, they're outsourcing & forcing the patient to get their own reimbursement.

  • I choose other, for myself and DH they are given at my work. We pay $20 upfront and are reimbursed that money from the insurance company. The insurance company obviously does pay for the shot.

     

    As for DD we can make a pedi appt during the hours they have time. There are no walk in hours, and they will bill the insurance company but we have to pay our $20 co-pay for the appt. For two shots this will obliviously be $40. Last year she got on shot during her 15 month appt, and we choose to take her to a health department clinic for the other dose. The health dept only charges $10 if you can pay. We can afford it so we always pay. My pedi office has been out of a lot of vaccines (ie they never had prevanar 13 and one time they did not have rotovirus for private insurance patients) so we have had to go the health dept a lot. Honestly we prefer those nurses when DD gets shots to the nurse who gives them at the pedis office so we go to the health dept.

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  • There aren't specific walk in hrs.  We can go in anytime during office hours and get it.  They bill insurance.





  • Our clinic does everything. They have special "flu clinics" Tuesday through Friday from 5pm- 8pm and Saturdays from 8am-noon. That is for all of Oct, Nov and the first week or so of Dec. They will bill insurance as a nurse visit for those days.

    You can schedule an appt just for the flu shot. You can also do it as part of a well check. For both they will bill insurance as the doctor visist and shot.

    Since I work for the company, they also give them out free to the employees. Our employee health nurse actually comes to our office to give it to us when we tell her it is a good time.

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  • image kgopel:
    I have to call and make an appt and then they bill the insurance, but I am really annoyed because they don't have flu shots yet and don't think they will until the end of Nov.  This happens at this office with vaccines as well.  I am thinking of looking for a new pedi, because this truly annoys me.  Other friends with other local pedi's have been able to get their kids the flu shot this season, so I don't know what my office's problem is

    That office seems a little fishy to me. Our pedi got the flu shots in the end of July but didn't start offering them as a part of well checks until the last week of August.

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  • You can make an appointment specifically for the shot or you can just get the shot while you're already there for some other reason.  Either way they bill the insurance.
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  • image Elocin:
    image groovygrl:
    There is a caveat to this, if your kid happens to have a well visit during Oct/Nov, they will give a flu shot to him/her and bill insurance with the visit
    This is what happened with DD's 15 month well visit earlier this month. It was automatic.

    I voted "other" because this is what has happened to us last year and will happen again next month.  I bring both kids with me for DD#2's well visit and they give her the shot and, even though its not an appointment for DD#1, they'll give her the mist as well - if I ask them to do it.  They've never had a problem with it.  Otherwise, I would take my older daughter with me to our local pharmacy and have it done along with myself and I pay the $30.

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  • mine always bills insurance first even if I just get the shot, however, since I have had my daughter she has had a well child visit during the flu shot time so it was part of their well child visit and submitted to insurance.
  • The flu shot just happens to line up with their well-baby appointments, so we get it then. Last year it was at 6 months, this year at 18 months. 
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  • Ours was given along with his regular vaccines at a well visit. My insurance was billed and I paid nothing out of pocket as my coverage includes a $0 out of pocket expense for all well visits and all childhood vaccines. If I had done it separately from his regular well visit, I would have made an appointment and it would have been billed the same way since the office codes it as a regular vaccine.
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  • She has her flu shot at the end of a regular check-up... her first year, she had to come back for a nurse appointment for the booster (they need a booster that first time).  Dr's office billed the insurance for both.
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