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Home Forums BILLERS’ BOARD Medicare/Medicaid

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  • #10797

    We have a client that is needing the Shingrix Vaccine. They have Medicare A and B Primary and Medicaid secondary. No pharmacy benefits.
    From my understanding, since the member has Medicare primary we cannot bill shingrix no matter what the secondary insurance is. Please let me know if I am wrong. I want to be sure we are offering everything we can.
    Thank you!

    #15745

    They will have to pay 100% out of pocket. Medicare A only covers hospital stays and Medicare B only pays Flu/Pneumonia. I doubt Medicaid will reimburse enough to cover cost of vaccine. Sorry

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