Many people cannot believe that a doctor cannot afford a vaccine, but in actuality, a lot of the doctors who offer the vaccine are losing money by administering the vaccine to patients.
The bottom line is that doctors aren’t being reimbursed sufficiently by insurance companies to cover the costs of stocking and administering the vaccine. The Washington Post reports that some insurance companies are reimbursing doctors only $90 for each of the $120 doses of the vaccine. You have to take into consideration the cost of stocking the vaccine, staffing a nurse to administer the vaccine, syringes, and other related costs.
Doctors may have the option of writing a prescription for the vaccine. The patient would then have it filled at a local pharmacy, bring it back to the doctor's office and have it administered. The problem with this is that many insurance companies do not cover the cost of the vaccine if it is not supplied by a doctor.
What You Can Do If Your Doctor Doesn't Offer the Vaccine
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If your insurance company does not cover the cost of the vaccine or if you are uninsured, ask your doctor to write a prescription for Gardasil. You will have the prescription filled and then take the vaccine back to your doctor to have it administered. Keep in mind that Gardasil has three injections that are administered over the course of six months. Your doctor will write one prescription with two refills for the remaining doses. The current out of pocket expense for Gardasil could be as little as $120 or as much as $200 per dose in the pharmacy.
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If your insurance company covers the cost of vaccine, try to find a doctor in your provider network that does offer it. Your doctor may be able to refer a physician. Keep in mind that you may have to get approval from your insurance company to see another doctor in the network. For adults, check with gynecologists and family practitioners. For young women, try calling pediatricians and family practitoners also.
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Check with your local health department or low cost clinic. Some state programs provide the vaccine at little or no charge. Call your local health department or Planned Parenthood for information.
- If your doctor does not offer the vaccine because of your insurance company's reimbursement policy, write a letter to your insurance company asking them to review their physician reimbursement policy. While you may not see an immediate change in their policy, companies do take customer complaints into consideration.
