June 2013 Moms

Where are your DHs/SOs getting their Tdaps?

Trying to figure out how DH will get a Tdap without paying anything out-of-pocket.  Immunizations under his plan are covered 100% (as I believe they probably are for all plans now), but there's a statement in the insurance information about them being "medically necessary."  Would he have to see a physician for a physical and explain he has a baby on the way in order to for it to be considered "medically necessary"?  

FWIW, he has access to a university student health center and will easily be able to get the appointment for the immunization itself...it's the seeing a doctor part that I'm curious for... 

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Re: Where are your DHs/SOs getting their Tdaps?

  • llbta85llbta85
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    My WM's office told me that he should see his PCP.  I would imagine that since its a vaccine that you shouldn't need a reason.  My husband hasn't had a vaccine since he was a child so I would say that he needs a Tetnus booster anyway.  YOu could also go through a Walgreens, Rite Aid etc and submit it for reimbursement.

  • Tdap is concidered a medically necessary whether you see a Dr or not.nonmedically necessary would be like HPV according to some insurances.
  • Ours were covered at local pharmacies.  No need to see a Dr.  Your pharmacist or health center should be able to look up if they are a participating provider and coverage rate.

    If anything, you can call your insurance company and ask where you can go locally to be covered.

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  • I just reminded DH to make his appointment with his DR to go get his shot.

    It should be covered by insurance but even if it isn't he is still getting it.

    I should also add that DH just had his physical a couple weeks ago...I don't know if your DH will need to get one before or at the time of the shot.

     

    ETA: I'll be getting my at my OB next Thrsday and DH will be getting his at his PCP.
    I just saw the "where" in  your title. /facepalm

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  • btsrc5btsrc5
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    My insurance said they would only cover a percentage if we went to a pharmacy because it was considered "out of network."  They said I could make an appointment with my PCP to get a shot, but I didn't want to pay for the visit for just getting the shot.

    We went to the health department (off of Preston/Rose Hill Dr) and got ours.  They were free. 

    Will Student Health give it for free?  If yes, I would go there.  No need to actually see a doctor. 

    I wish our OB would give them in their office.


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  • My DH just went to Target and didn't pay a dime.
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  • DH got it from his PCP.
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  • Check out CVS Minute Clinic if you have one. I just looked online and they offer the Tdap, but not in MA or CT. Figures, I'm in MA.
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  • My husband got his from the allergist.  However, if your husband hasn't received one in the last 10 years, then it should be considered medically necessary regardless of whether or not you're pregnant (especially if he's in contact with college students at a university).

    I would check first with PCP or student health for the prescription.  Does he have immunization records that show if he ever received one.  If he had one in the last 10 years, he doesn't need another (the "every pregnancy" guideline is just for women because it protects the baby, as I understand, until they can get their own). 

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  • BC&LMBC&LM
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    My husband just called his doctor's office and told them he needed it. I am pretty sure they just scheduled him for a quick appointment with the nurse because there wasn't really a reason to see the doctor.
  • My husband accompanied me during my second trimester to one of those walk in clinics on a sunday when I had a horrible head cold/ chest pain.  While he was waiting, he decided to just go ahead and get his Tdap.  It was covered by our insurance except the copay.  

     

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  • CL8badBCL8badB
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    I had to pay for mine at the pharmacy and then my OB administered the shot. My hubby is going to call his primary doctor and see what he says.
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  • BC&LMBC&LM
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    image stackie16:
    My DH was able to go to his primary Dr and get it covered 100.But I am no longer a fan of the Dr, as he told DH if he doesn't have any cough or anything it's not necessary to get the TDap.nbsp; ??nbsp; I wish I was there, this guy seems uneducated, isn't it a preventative shot?nbsp; DH says he doesn't like him either.


    Yeah, that guy has no idea what he is talking about. The TDAP is an immunization, so it's a preventative shot. The only thing I can think is that maybe he got it confused with the TB test, which is called the Mantoux test, but a medical professional should know the difference.
  • jennOKjennOK
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    They give them free of charge at my county health department.
  • My DH got his at the county public health dept. The family practice clinic we go to wouldn't give him the shot without a physical and DH who is in no way medically trained but has a charming quirk that makes him think he knows better then MDs decided he didn't need one so he found out the health department will do vaccines. I think our insurance covered it, or we used flex money.

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  • SympkinSympkin
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    Well my spouse stepped on a nail late last summer so he got the full DTaP from his family physician at the time since it had been a few years since his last tetanus booster.

    I guess that would be considered medically necessary but I really wouldn't recommend going that route.

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  • Ours is offered by the hospital we're giving birth at- they offer it to both parents right after you give birth.
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  • clizhclizh
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    DH actually had his done at the hospital at the same time that they gave me mine, right after M was born.
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  • VASCVASC
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    Okay, thanks all.  Like I said, he will go to his Student Health Services office for the actual shot...I just don't want him showing up there and someone demanding to see a prescription or doctor's orders stating he needs one.  
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  • Mine isn't getting one.  Crying  He had an allergic reaction to the vaccine when he was younger so it's recommended that he not get one again.

    My OB doesn't do them in the office anymore, so I got mine at Target.

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  • Believe it or not- my OB made a chart at her office for my DH and gave it to him when I got mine a few weeks ago. They sent the bill to our insurance and we are all good. Not even a co-pay. 
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