Health insurers are required by the ACA to completely cover federally recommended vaccines for members, including flu shots. But while insured members don't pay for the shot out of pocket, their insurers eventually will raise premiums to offset the cost, according to Kaiser Health News.
Compared to most healthcare services, flu shots are inexpensive. However, tens of millions of Americans receive flu shots each year, and expenses add up for insurers. Ultimately, economists say insurers pass expenses to consumers by charging them higher premiums, according to the report.
Complicating matters further, prices for flu shots vary widely among markets and payers. For instance, Kaiser Health News found that among its own employees, an insurer paid $85 for a flu shot at a Sacramento, Calif.-based facility, but about half of that in Long Beach, Calif. Meanwhile, the insurer paid a drugstore in Washington, D.C., $32 for the shot.
Ge Bai, PhD, an accounting and health policy professor at Johns Hopkins University's campus in Washington, D.C., told Kaiser Health News negotiations between insurers and providers, not the true cost of the shot, are at fault for the price variation.
"The patient is immune from the cost, but they are the losers because eventually they pay a higher premium," Dr. Bai said.
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