By Beth Spain
The Affordable Care Act implemented by the Obama administration has taken effect as a first-line defense against this year’s influenza battle, according to articles from HealthCare.gov. Under the act, patients with private health insurance or Medicare will not be charged a co-payment, co-insurance or be required to meet deductibles toward preventative services.
“It’s all about accessibility, getting people the care they need,” said Cindy Fisher, pharmacy manager at Kroger on West University Parkway.
Fisher said preventing disease and providing everyone with an opportunity to get vaccinated eliminates health costs later and is a major goal behind the act.
In Fisher’s 11 years of working for Kroger Pharmacy, she said Medicare has always paid for flu vaccinations. The new policy would mainly affect people with private health insurance.
The policy does not require private insurers to pay for services performed by facilities out of the company’s network.
Furthermore, Fisher said patients still have to pay for vaccinations at pharmacies because preventative care is billed through medical benefits, not prescription benefits.
Fisher said Blue Cross Blue Shield is the only private healthcare provider she knows that is giving credentials to pharmacies to bill medical benefits.
However, Fisher said for the past four years some of her customers have asked for receipts so their healthcare providers can reimburse them.
Last flu season, Paul Mayer, director of Union’s Health Services, said Union received many of its vaccines from the Jackson-Madison County Health Department in coordination with the Department of Health and Human Services.
Mayer said budget restraints might not allow such donations this season, and he is not aware of any provisions, including universities, under the act. Vaccines at Union are $15, and clinics opened Sept. 22 in Harvey Hall.
This fall, Mayer has 400 flu vaccines with 800 more on the way. Kroger on West University Parkway has 1,000 regular flu shots and over 400 high-dose flu shots.
This year’s flu shot contains three inactivated strands: H1N1, H3N2 and influenza B. The shot takes two weeks before protection can begin and will last for one year, according to the Centers for Disease Control and Prevention.
The act covers all young adults on their parents’ insurance until age 26, regardless of marital status. Young adults do not have to be full-time students to receive coverage. More information about young adult coverage under this act can be found at http://www.hhs.gov/ociio/regulations/adult_child_fact_sheet.html.
The policies within the Affordable Care Act apply for numerous preventative services, including screening and counseling for alcohol misuse, diet counseling for adults at high-risk for chronic diseases, and several vaccinations, such as Tetanus, Hepatitis A and Hepatitis B.
