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‘Free’ Flu Shots Are Actually Quite Expensive

Getting a free flu vaccine would help protect people from potentially deadly diseases. However, the free service also comes with disadvantages that affect even the wallets of the public. 

Financial experts claimed that health insurers and private health providers have been hiding charges that change the cost of flu shots depending on their negotiations. Companies allegedly use higher premiums to quietly pass expenses to consumers.

In 2017, self-insured employers and insurers paid between $28 and $80 to get the same type of flu vaccine. Experts said the lack of transparency in the U.S. healthcare system allowed the wide discrepancy in costs for the same service, according to Kaiser Health News. People get free flu shots under the Affordable Care Act. The law requires health insurers to cover all federally recommended vaccines.

But as it may seem that people with insurance pay nothing for the shot, they would actually lose money because some insurers pass expenses to consumers through higher premiums. Health insurers’ reimbursements to private health providers also play a role in the hidden costs of free flu vaccine.

“The patient is immune from the cost, but they are the losers because eventually they pay a higher premium,” Ge Bai, an accounting and health policy professor at Johns Hopkins University, said. 

For example, insurance company Cigna paid $32 to CVS for a flu shot in downtown Washington but gave $40 also to CVS in Rockville, Md. The insurer even paid higher to a primary care doctor at MemorialCare in Long Beach to provide flu shots, reaching up to $47.53. 

Cigna also paid $85 for the vaccine from a doctors’ office affiliated with Sutter Health in Sacramento. The company explained that the rates changed due to location the vaccine was taken, number of competing facilities in one area and the size of the health plan.

“It is important to keep in mind that hospitals and pharmacies have different economics, including the cost to administer,”  Cigna said in a statement.

Medicaid, the state-federal health insurance program, also pay for the same flu vaccine at different prices. It pays $15 for a flu shot in Washington, D.C., and $19 to providers in Connecticut.

“We don’t have a functioning health care market because of all this lack of transparency and opportunities for price discrimination,” Glenn Melnick, a health economist at the University of Southern California, said. “Prices are inconsistent and confusing for consumers. The system is not working to provide efficient care, and the flu shot is one example of how these problems persist.”

Flut shot Researchers found that vaccination could reduce the risk of flu by 40 percent to 60 percent even during seasons when the virus is active. Pixabay

 

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