Texas boy needs to protect against measles. The cost of the vaccine is $ 1,400.

In the early days of the beasts in West Texas, Thang Nguyen recognized the increasing number of cases and anxiety. His 4 -year -old son was in danger because he only received the first two doses of the vaccine.

Therefore, in the middle of March, his family took his primary care clinic at the Texas Medical University branch in Galvieston.

By the end of the visit, his son, Anna Huang, received one shot that protects from four diseases – measles, mumps, German measles, and chickenpox. He also got a second shot against Tetanus, Diphtheria and Sheoping Cough, as well as a influenza shot. His twin daughters, who had already obtained measles vaccines, got other fortifications.

Ngawin, a post -PhD fellow at UTMB in public health and infectious diseases, said that he asked the clinic staff about whether his family’s insurance would cover tests and vaccinations. He said he confirmed that he would do so.

Then the bills came.

Medical procedure

The first measles vaccine was Signed in 1963 It became part of the combination of measles, mumps, measles, or MMR, a vaccine in 1971. The vaccine is combined against chickenpox, or foolishness, sometimes to what is known as the MMRV vaccine.

The first dose of the measles vaccine is usually given between 12 and 15 months, with a second between the ages of 4 and 6 years. Experts may recommend vaccinating children of younger ages during the outbreak of the disease – such as the outbreak of the continuous American measles, which led to more than 1,200 cases, 750 of them in Texas. According to the Centers for Disease Control and Prevention, 95 % of cases have occurred in non -fortified people or those who are unknown to the vaccine.

The recommendations that affect the management and insurance coverage are made by Consultative Committee for Irrational Practices. In mid -June, the Minister of Health and Humanitarian Services replaced Robert F. Kennedy Junior Committee, adding skeptics in vaccines. The new painting that Last weekIt is expected to check the previous recommendations, including the MMR vaccine.

The final bill

UTMB submitted $ 2,532 to visit the boy’s office and three shots. The MMRV shot on its own was $ 1422, in addition to $ 161 to manage it.

The problem of bills: coverage gaps and “errors” of the supplier

There are degrees in the American health system aimed at preventing the recommended vaccines from being expensive. They did not help the Naguin family.

Their health plan, purchased from Insurance broker Tiaan The wife and children of Naguin and manage her International Medical GroupIt does not cover the vaccinations. Initially, the family assistance was not provided under Childpoint programFederally funded effort, created after measles outbreaks more than 30 years ago, which provides free immunization for non -insured and unbelievable children.

Therefore, the family was shocked by posters to American medical care without insurance, as service providers set prices. In this case, the price of the MMRV for the child’s MMRV bullets was about 1400 dollars, or more than five times what the Center for Disease Control in the private sector says.

Ngwin was surprised when the insurance company did not pay anything, leaving bills for the examinations of his three children, which were close to $ 5,000.

He said that the family’s income, from his job in UTMB laboratories, was less than $ 57,000 per year. The Noguyen job provides health insurance for him, but he set out at $ 615 a month, as he would also cost his family coverage, and instead he bought one year policy of Taian, which total $ 1841. Policy covers certain types of office visits, emergency room care, hospitalization, chemotherapy, but not fortification or tests.

Ngawin and his wife, from Vietnam, live in the country with temporary visas while completing his studies. In Vietnam, Ngawin said, the total cost of the preventive care his family received at the clinic may not exceed $ 300.

He was concerned about the high prices set by the clinic for vaccines, especially during the outbreak of measles.

“He is crazy,” he said.

Carly Kisler, a spokeswoman for the International Medical Group, confirmed in an e -mail to KFF Health News that the family plan does not cover preventive care, including vaccinations.

After calling UTMB by KFF Health News, the deputy head of the clinical contracting strategies, Kent Pickering, looked at the matter. “This situation should not happen,” he said in an interview.

Most of the insurance provided in the United States, without accessories, must cover a variety of preventive care services – including measles vaccine – below Rules in the law of sponsorship at reasonable prices. But some plans are exempt from these rules, including short -term plans or travel insurance. International students on temporary visas do not have to purchase a plan compatible with ACA during the first five years in the country.

But what about the cost of vaccines?

Hospitals and other service providers may specify their own prices for services, creating price lists called Chargersters. Insurance companies negotiate service discounts that they agree to cover. People who do not have insurance coverage are generally on the hook for the full amount.

“Among the most frustrated parts of our health care system is that people who do not have health insurance coverage should pay more than the health insurance company that will pay,” said Stase Dossitina, professor of health policy at the University of Vanderbelt University.

While prices can vary, the Center for Disease Control Children’s program price vaccines The MMRV vaccine – also known as the PROQUAD brand – shows about $ 278 in the private sector. Consumer prices for Proquad in pharmacies in the GALVESTON region range from about $ 285 to $ 326, according to the described cost tracking site.

“Initially, the NGUYEN family insurance was incorrectly entered by the clinic staff, so they did not pick up that his plan did not cover the vaccines. If they have, it is possible that UTMB will explain if the Texas Children’s vaccines program will cover the cost of the shots, which only receives the small management fees for the program.

Another mistake was revealed when Beckering looked at the bill. He said that Chargemaster from UTMB was updated a few months ago, and vaccine prices were listed for those who do not receive footage through the pediatric vaccine program in incorrectly, which led to the imposition of fees on the son of Naguan.

Beckering said the prices had been corrected, although he refused to cite the fine numbers.

decision

In addition to contacting the insurance company, NGUYEN Communicate with the financial offices at UTMB, and request a reduction or relinquishment of fees.

In mid -May, UTMB sent a revised invoice to visit his son’s office. I have applied 50 % self -discount, whose website says it is presented to those who are not believers. The revised collection reached $ 1,266, and it was $ 711 of MMRV.

“I expected them to give up the cost of vaccination to my children or at least reduce it, especially for the mmrv vaccine,” Ngawin said, noting that his family will remain linked in an attempt to pay their bills.

After Beckering spoke with KFF Health News, a customer service representative communicates with NGUYEN, giving up the cost of vaccines. His new bill was $ 202.75 to visit his son’s office, as well as smaller amounts similar to the care of his medical daughters.

Ready -made meals

Medical billing experts say it is always good to check your insurance company before optional treatments such as checks or vaccines to find out what is covered and the debtor is for you.

International students and others who buy plans not compatible with ACA, Like short -term coverageIts benefits should be reviewed carefully, because there are often restrictions.

For some services, including vaccinations, there may be low -cost options.

Konstan Almenders, director of fortification in Galfston Province in Galfston Province, said in an email that many public health departments, including Galfston, offer free vaccines through the pediatric vaccine program for those who are eligible, including people who do not have insurance or insurance that does not cover vaccines, said Constance Almenders, Director of Evangelization in Galfston Province in Galfston Province.

But those programs It is likely to be threatened When the Trump administration is demobilizing federal workers and moving to cancel the grants to health departments.

Finally, you can request a discount. Medical service providers may provide self -payment discounts for unintended or unbelievable patients, or charitable care policies for those who meet the specific income requirements.

The bill of law is a collective investigation before KFF Health News and Washington Post+ An dissection and explanation of medical bills. Since 2018, this series has helped many patients and readers reduce their medical bills, and it has been martyred in the states of the state, in the American Capitol, and in the White House. Do you have a confusing or interesting medical bill you want to share? Tell us about that!