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> I'm in my mid thirties and asked my pharmacist about it, I can get the shot but my insurance says I'm to old so I have to pay out of pocket for it. Are you s

> I'm in my mid thirties and asked my pharmacist about it, I can get the shot but my insurance says I'm to old so I have to pay out of pocket for it. Are you sure? Also a mid-30s male and my PPO insurance covered it fully last year, no copay, coded as preventative. Call your health insurance and ask about “CPT code 90651”.

ITB 3y ago
Get it
Marsymars 3y ago
In Canada and received it three years ago in my early-30s. Public health didn't cover due to age, and private insurance covered most of it, but remaining cost after deductibles and injection costs was still non-trivial. ($170 across three shots.)
- red-iron-pine 3y ago
  Compared to US medical costs, $170 CAD is a nothingburger. If anything, I'd be more annoyed about the 3-shots and repeated trips, vice a <200 charge; time is money, too.
88913527 3y ago
Such a fascination the various incantations one must give when interfacing with insurance companies to have any hope of achieving whatever your objective might be.
chasely 3y ago
When I was in grad school (mid-20s) I was consulted not to get it. NowI'm pretty sure any adult with insurance can get it through any pharmacy that does vaccines. I think the actuarial tables must have changed or the cost of the vaccine decreased.
ender341341 3y ago
I'll try that, I didn't get it at the time cause life was busy but it has been on my mind. They seem to be expanding the recommendation to wider and wider groups, was told the insurance company pretty much assumed you had HPV over a certain age and wouldn't cover it.
Moto7451 3y ago
Same. Had no problem getting it done at CVS. I saw it selectable when getting some standard boosters and opted into it. I did have to look up the schedule for adults on the CDC website. I was super annoyed as a teen and young adult when they kept opening the window for when you could receive it for a few years younger than me. My understanding is the manufacturers didn’t want to market an STD vaccine so Cervical cancer it was. Never mind men could transmit and harbor it. Guarding all susceptible parties just didn’t work with how they were going to market it.
m-p-3 3y ago
I reached out to mine, not covered :(
firstlink 3y ago
> Call your health insurance and ask about “CPT code 90651”. There's no point to this. Health insurance providers are explicitly exempted from having to be truthful with you about coverage. The better ones will just tell you they don't answer coverage questions at all as a blanket policy; the rest will tell you whatever they think profits them the most.
- giantg2 3y ago
  Most have tools that will tell you if a provider is in network and what a procedure will cost at them. Most have a pre-authorizarion process to confirm coverage as well. Also, if your insurance is through an employer, HR typically has liaisons that can help.
- mock-possum 3y ago
  > Health insurance providers are explicitly exempted from having to be truthful with you about coverage citation needed? What entity rules that they are explicitly exempted?

ITB 3y ago

Get it

Marsymars 3y ago

In Canada and received it three years ago in my early-30s. Public health didn't cover due to age, and private insurance covered most of it, but remaining cost after deductibles and injection costs was still non-trivial. ($170 across three shots.)

red-iron-pine 3y ago
Compared to US medical costs, $170 CAD is a nothingburger. If anything, I'd be more annoyed about the 3-shots and repeated trips, vice a <200 charge; time is money, too.

88913527 3y ago

Such a fascination the various incantations one must give when interfacing with insurance companies to have any hope of achieving whatever your objective might be.

chasely 3y ago

When I was in grad school (mid-20s) I was consulted not to get it. NowI'm pretty sure any adult with insurance can get it through any pharmacy that does vaccines. I think the actuarial tables must have changed or the cost of the vaccine decreased.

ender341341 3y ago

I'll try that, I didn't get it at the time cause life was busy but it has been on my mind. They seem to be expanding the recommendation to wider and wider groups, was told the insurance company pretty much assumed you had HPV over a certain age and wouldn't cover it.

Moto7451 3y ago

Same. Had no problem getting it done at CVS. I saw it selectable when getting some standard boosters and opted into it. I did have to look up the schedule for adults on the CDC website. I was super annoyed as a teen and young adult when they kept opening the window for when you could receive it for a few years younger than me. My understanding is the manufacturers didn’t want to market an STD vaccine so Cervical cancer it was. Never mind men could transmit and harbor it. Guarding all susceptible parties just didn’t work with how they were going to market it.

m-p-3 3y ago

I reached out to mine, not covered :(

firstlink 3y ago

> Call your health insurance and ask about “CPT code 90651”. There's no point to this. Health insurance providers are explicitly exempted from having to be truthful with you about coverage. The better ones will just tell you they don't answer coverage questions at all as a blanket policy; the rest will tell you whatever they think profits them the most.

giantg2 3y ago
Most have tools that will tell you if a provider is in network and what a procedure will cost at them. Most have a pre-authorizarion process to confirm coverage as well. Also, if your insurance is through an employer, HR typically has liaisons that can help.
mock-possum 3y ago
> Health insurance providers are explicitly exempted from having to be truthful with you about coverage citation needed? What entity rules that they are explicitly exempted?