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Istvan  
#1 Posted : Saturday, September 11, 2021 11:21:52 AM(UTC)

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An annual flu shot is a basic preventative service covered at no cost under GEHA plans as administered through CVS.

Yet when I went to get one, with an appointment, at a CVS pharmacy in Arlington VA--CVS/Carmark is GEHA's pharmacy benefits manager--I was told it was not covered. The pharmacy manager called GEHA and was told it was not covered. I went to my car and called GEHA. GEHA transferred my call to CVS/CareMark which assured me that it was a covered service. They called the CVS Pharmacy were I was and arranged for it to happen. All of this took about an hour.

My issue is that, with an appointment, it should not take an hour with several denials to obtain a basic covered service at a designated provider. The system created by CVS and the health care system in general is so complicated that CVS's employees can not navigate it. Or that CVS has failed to train their employees adequately as to how to operate it.

Alternatively, Flu shots may be a money loser for CVS leading CVS to erect a number of road blocks so as to minimize the number of shots that they actually have to give.

Don't really know. BUT, something is clearly wrong! Particularly considering that this occurred in Arlington VA which is home to thousands of current and retired Federal employees and GEHA is one of the largest FEHB plans.
GSBS  
#2 Posted : Saturday, September 11, 2021 11:28:10 AM(UTC)
GSBS

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Originally Posted by: Istvan Go to Quoted Post
An annual flu shot is a basic preventative service covered at no cost under GEHA plans as administered through CVS.

Yet when I went to get one, with an appointment, at a CVS pharmacy in Arlington VA--CVS/Carmark is GEHA's pharmacy benefits manager--I was told it was not covered. The pharmacy manager called GEHA and was told it was not covered. I went to my car and called GEHA. GEHA transferred my call to CVS/CareMark which assured me that it was a covered service. They called the CVS Pharmacy were I was and arranged for it to happen. All of this took about an hour.

My issue is that, with an appointment, it should not take an hour with several denials to obtain a basic covered service at a designated provider. The system created by CVS and the health care system in general is so complicated that CVS's employees can not navigate it. Or that CVS has failed to train their employees adequately as to how to operate it.

Alternatively, Flu shots may be a money loser for CVS leading CVS to erect a number of road blocks so as to minimize the number of shots that they actually have to give.

Don't really know. BUT, something is clearly wrong! Particularly considering that this occurred in Arlington VA which is home to thousands of current and retired Federal employees and GEHA is one of the largest FEHB plans.


CVS has $5 waiting for you!
https://www.cvs.com/immu...AvD_BwE&gclsrc=aw.ds

Did you know that all FEHB health plans cover flu shots at no cost to their members? Many plans offer flu shots for children and adults at convenient locations like retail pharmacies.
GWPDA  
#3 Posted : Tuesday, September 14, 2021 5:28:17 PM(UTC)
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CVS insists that my GEHA coverage means that my health insurance is "government issue", "just the same as Medicare and Medicaid." Government Employee Health Association to them means that it's government. They argued and argued and refused and refused. As a result, I transferred my one local prescription which is covered by a pharmacy discount card to the Safeway pharmacy. CVS in person doesn't grasp how GeeHaaaaa! works. (Speaking from the Borderlands where GeeHAAAAAAAAAAA! is how we instruct our horses.) Safeway cheerfuly vaccinated me for my second pneumonia dose, shingrix, old people 'flu shot and something else that I've forgotten, all on my GEHA account. City of Tucson vaccinated me for free for COVID.
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