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Some may have to pay for H1N1 vaccine in Ohio

By Suzanne Hoholik
The Columbus Dispatch

COLUMBUS, Ohio — Free doesn’t always mean free, and that could be the case with the H1N1 vaccine.

The federal government paid for the nasal spray and shots and is distributing them at no cost to physicians, pharmacies, retail clinics, urgent-care centers, local health departments and federal health centers.

But you could be charged a fee depending on where you get vaccinated for the virus, also known as swine flu.

Local health departments say they won’t charge people, but doctors, urgent-care centers and pharmacies can impose administrative fees.

According to the Centers for Disease Control and Prevention, that fee cannot exceed $19.95 per dose in Ohio.

By comparison, retail pharmacies are charging about $25 for the seasonal flu vaccine.

Right now, only high-risk groups -- pregnant women, people who care for children younger than 6 months old and health-care workers -- can receive the H1N1 vaccine.

Health officials expect that the vaccine will be available for everyone else by December.

Several health-insurance companies have told members that they will cover any fees charged for the H1N1 vaccine.

For example, UnitedHealthcare will pay any fees regardless of the type of health plan you have, with no out-of-pocket costs to customers or employers, said spokeswoman Debora Spano.

Anthem Blue Cross and Blue Shield is waiving the fee for members who have fully insured health plans.

Medical Mutual of Ohio will cover the fee for members whose policies include vaccine coverage, which is about 90 percent of its customers, said Paula Sauer, vice president of care management for the company.

“But there are some employers that did not want to do it,” she said.

Sauer said, for instance, that some employers do not want to rework labor contracts that don’t cover vaccinations just to include paying for the H1N1 vaccine.

The vaccine is free at local health departments.

“We are not charging an administrative fee,” said Jose Rodriguez, spokesman for Columbus Public Health.

Sauer said many employers want to get H1N1 vaccines for their workers, but it isn’t possible.

“The government is covering the costs and totally controlling the distribution,” she said.

The CDC’s guidelines on who can distribute the H1N1 vaccine includes physicians, pharmacies, retail clinics, urgent-care centers, health departments and federal health centers.

To be eligible, providers must sign up with state governments.

“We’re still kind of in a wait-and-see mode,” said Jim Cohn, spokesman for Walgreens drugstores. “We have provider agreements in 49 states, including Ohio, but we don’t know how much supply we’ll be receiving, when or where.”

With all these unknowns, he said, it’s difficult to set an administrative fee.

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