Good Medicine, Bad Information: Survey of Drugstores Finds Misinformation about Flu Shot Coverage

Drugstore customers seeking flu shots this winter may be paying too much because of bad information at the pharmacy counter, according to a new study by watchdog group Change to Win Retail Initiatives (CtW). The group surveyed 50 Walgreens locations in Los Angeles and New York City and found that the nation’s largest private provider of flu shots gave inaccurate information about insurance coverage 48 percent of the time. These errors could be causing customers to unnecessarily pay out of pocket for covered vaccinations or causing some shoppers to not get a shot at all.

Walgreens is the largest private provider of flu shots in the country, and flu shots are important for public health. On average there are 200,000 hospitalizations for flu-related complications each year, and out-of-pocket costs are one common reason people give for not getting vaccinated.

“It is truly shocking that Walgreens cannot consistently give accurate information about flu shot coverage,” said Nell Geiser, Associate Director of Change to Win Retail Initiatives. “Flu shots are important for keeping ourselves and our families healthy, and this study shows that it’s also important for consumers to be educated about their insurance coverage to avoid unnecessary out-of-pocket expenses when getting vaccinated.”

In some instances, Walgreens employees told CtW researchers that the shots were covered when they were not, and in others, the company said an insurance plan would not cover flu shots when it was valid. Walgreens representatives refused to run an insurance card to verify whether a flu shot was covered in 40 percent of visits. In these instances, Walgreens gave incorrect information more than half of the time.

CtW is offering tips for consumers so they don’t get stuck paying too much at the pharmacy such as:

  • Check with your insurance provider before getting a flu shot so you are armed with correct information.
  • Make sure the pharmacist runs both medical and pharmacy insurance cards if your health plan has separate providers.
  • Ask for a refund if you’ve been wrongly charged.

Last year, Walgreens entered into a settlement with New York Attorney General Eric Schneiderman for misleading thousands of New York state employees about their flu shot coverage. A recent LA Times column notes that drugstores profit from this misinformation because they receive roughly $30 from individuals out of pocket and less from insurance reimbursements.

In Los Angeles, Walgreens provided wrong information about insurance coverage for flu shots 56 percent of the time, and in New York, 40 percent.

CtW researchers confirmed coverage with insurance providers and tested 8 plans across both markets by visiting Walgreens stores, presenting insurance cards and asking pharmacy staff to check whether flu shots were covered. The CDC recommends that everyone over the age of 6 months be vaccinated against the flu.