The annual flu vaccines are free of charge for those insured are not immune to the intricate and contemptuous price cuts plaguing the US healthcare system.
Health insurance companies will pay for the same vaccines depending on how the negotiations with individual healthcare providers are going across the country. In some cases, providers have forced insurers to pay three times the price they would pay to other providers, according to a survey by Kaiser Health News.
The point of sale found that a medical practice in Sacramento, California, received an insurer to pay $ 85 for a flu shot, which they offered to uninsured patients for $ 25.
Although $ 85 may seem like an insignificant amount in the bloated system of the US healthcare system, these prices add up quickly when tens of millions of people receive an A flu shot every year. And while insurers under the Affordable Care Act are required to pay the full cost of all federally-recommended vaccines, including the flu vaccine, the additional costs for insurers are passed on to patients through higher insurance premiums, economists told KHN.
KHN found that the cost of flu vaccines was between $ 25 and $ 85. A physician in Long Beach, California, ordered insurer Cigna to pay $ 47.53 for a shot, while a CVS in downtown Washington, DC, received $ 32 from Cigna for the same shot. A CVS in Maryland, just 1
My insurance ran a bit better than this. In my District of Columbia doctor's office, my insurer Aetna was initially charged a $ 35 fee for my flu shot and Aetna paid them the negotiated rate of $ 24.50.
But that's still a lot above the federally negotiated rates. Centers for Disease Control and Prevention have negotiated a price of just under $ 14 for the same shot. The agency reported private costs of approximately $ 18. Similarly, Centers for Medicare and Medicaid Services will pay $ 18 for the vaccine.
Aetna paid about 35% more than that for my identical shot – and there was no way for me to know that before I got the shot. Hidden negotiated rates make it impossible for patients to look around. And this is not just a problem with flu shots. From diagnostic scans to surgery, there are wild price differences.
"We do not have a functioning healthcare market because of the lack of transparency and opportunities for price discrimination," said Glenn Melnick, health economist at the University of New York Southern California, KHN said. "Prices are patchy and confusing for consumers," he added. "The system is not working on efficient care, and the flu shot is an example of how these problems persist."