Tuesday, September 09, 2008

Thanks to Shirlee Zerkel, we have info re: coverage for shingles shots

From Sandy Knoesel, September 8, 2008
Subject: RE: question about shingles shot
Dear Mrs. Zerkel:
Thank you for your question about coverage for shingle shots. This immunization is covered under the Aetna and Medical Mutual medical plans. The percentage of coverage is based on how the service is provided. Some providers have the shots available in their offices while other providers require the enrollee to obtain the medication at a retail pharmacy before going to the provider’s office for the injection. For example, if the physician requires that the enrollee obtain the medication, the enrollee could present a prescription at a contracted retail pharmacy and have it processed through Express Scripts. In this scenario, the enrollee would pay $30 for the medication under the Plus Plan and $0 under the Basic Plan because this shot is covered under preventive services. The administration costs for the physician who does the injecting would be covered under the medical plan with benefits determined by the plan in which the individual is enrolled. Enrollees who have questions or need additional assistance should call STRS Ohio toll-free at 1-888-227-7877 and ask for Kathy Crawford or Brenda Foster.
From Shirlee Zerkel, September 4, 2008
Subject: question about shingles shot
Dear Ms. Knoesel:
This question has come up about immunization shots for shingles. Does STRS cover those shots? If so, what % are they covered? SERS covers them.
Sincerely,
Shirlee
Larry KehresMount Union Collge
Division III
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