Do you have copay for synagis shot (If Synagis is covered)

armo

So last month we get a surprise bill from pedi's office, who suddenly decided to code the synagis shot as a therapeutic intervention and so we have to pay a $20 copay per girl.  We were just going in monthly exclusively for this, and were initially told it's not an office visit so no copay.  Insurance says pedi is allowed to bill us this way, though there is another way they could bill it that wouldn't result in the copay.

I'm kinda annoyed that they are switching on us, and backbilling us for this winter now!  Just curious what you all have to do, and if i should make a stink about it . 

 Otherwise, I love this pedi office and don't want to be known as a bad apple, but if they are just trying to make money then don't make it off me.

lstaylor73

Yes, we did have to pay a copay when we were allowed to have the shot for the boys.  But that just adds to our medical deductions for taxes.  I would make a stink about it if it goes back to 2008 and you've already submitted your taxes if that would have put you over the limit for the deductions. Otherwise you might just have to suck it up for now and just insist they bill you more timely in the future.

MrsJRT

We did not have a copay, but we have a home health nurse that comes out each month to give DS the shot. I would probably question it, though, b/c if you do not see the pedi while you are there, then it should be coded as a "nurse only" type visit.  I would think if you insurance covers the shot, then you shouldn't pay a copay since it's not a physician visit.  I could be wrong, though, but it wouldn't hurt to ask.  Good luck!

KellyMichelle

We had to pay 20% of each shot.

TriciaJoy

No.. but we get ours at a special well-baby clinic that only does the Synagis shots.

That being said, we have Robbie's vaccines split up, and we don't have to pay a copay for the 2nd set because it's billed as a "nurse visit" (we don't see the doctor) and there's no copay for that.

ijack

We have an office visit copay. I probably wouldn't make a fuss about it, because $20 seems like a lot less than any kind of deductible

NotJustAnAuntie

We don't have a co-pay because it's considered a "well baby" visit and we only see an NP, not a doctor.

gymrat

Yes, we have a copay it's $300-500 per dose until we meet the deductible. I have twins and my son is big enough to receive two doses per month. $20 would be a dream for me.

lauraanddave

Yes, we have a co-pay and then an office visit pay.  A nurse administers the shot, but then our pedi always stops in to see us, say hi, and check DD real quick.

jlc071903

YES, but our ins sucks...to be honest,  I'm suprised we didn't have to meet our deductible for 2009 for the girls to get their shots...I thought for sure we'd be screwed that way...b/c the shots are so expensive.

Kalki

We pay $20/child every shot.

Susan_KW

old insurance:

synagis given in the office, we paid $15 copay

new insurance:

synagis given at home by nurse: no copay

synagis given at pedi office, $15 copay

Tammy06

Be glad that is all you pay, with our new insurance under my husbands, we pay 20 per baby for a copay, had to meet deductable, 1000, then pay 10 percent each baby. Ends up Jan, Feb, Mar only shots are running us 2500!

Mrs.JBW

The months that we were lucky to have a well baby visit, we didn't have a co-pay.  But the months that we didn't have an appoitment OR the synagis timing wasn't right, we had a $15 office visit.  We were so lucky to have 100% of the shots covered by insurance.  My ped office charged $15 to fill out the daycare forms!