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A few weeks ago, I was talking to my wife while I was at work, and she mentioned that she had gone to Target, and had decided to get a flu shot.  We'd never done this before so I was a little curious about how everything went down.

Typically, we get our flu shots in one of two ways:

  • Doctors Office – As part of a checkup, they will usually offer a flu shot during the season.  Our insurance coverage provides 100% payment for routine checkups and immunizations, as long as it's done through a participating provider, so we have never had any out of pocket costs.
  • Work – The employer I work for actually brings in a couple of nurses for a day, and you can get your flu shot for free.  I've done this before, though if I happen to have a checkup scheduled, I'll usually have it done there to avoid lines and such.

The plan by my wife raised a few red flags, specifically with regards to the cost and payment.  She told me that Target had taken her insurance card, and said they accepted that coverage, and didn't charge her anything.  On top of it, my wife got 2 pharmacy rewards points, which is a program that if you fill prescriptions at a Target pharmacy, you get a 5% off shopping pass good for one day only after you have accumulated 5 points.  Since we already get 5% by using our Red Card, this stacks, and you get 10% off.  Not bad.

The issue is that I know that our insurance plan likely doesn't accept Target.  I have no idea why, but they do not consider anything outside of a doctor's office or hospital as an in-network provider.  This means that we cannot go to any urgent care facility or any ‘in pharmacy' wellness clinic.  This has always struck me as backwards, because if it's off hours and I have a non-emergency need to see a doctor, I'd be happy with going to an urgent care facility, but instead they either say that you should wait or you should go to an emergency room, which is going to have a much higher billed rate.

In any case, I called my provider and asked if the flu shot would be covered at Target, and they confirmed that it wouldn't be.  I called Target back and asked about our account, expecting to have a balance.  They pulled it up, and said…it was paid.  We had no balance.

So, I logged into our insurance plans website, where you manage all claims and information about your coverage.  You can see backward two years.  There was nothing there pertaining to my wife getting a flu shot.

I figured that maybe it had somehow gotten billed to the prescription plan.  We have one insurance card that provides information on both, so I logged into our prescription plan's website.  There was nothing there either.

Those are the only two places that would have possibly received a claim for this, and neither is showing a claim filed.  It's been over a month, so I know it would have processed by now.  Yet somehow Target is satisfied that they've been reimbursed for the shot.

If it were to somehow show up, I think the cost would be $28 to us, so it wouldn't be a huge amount.  I'd of course be mildly annoyed that we had to pay for something out of pocket that could have been covered elsewhere, but at this point, since no one will fess up as to who actually pays for it, I'm not going to say anything.  Shhhhhh……

Who do you think paid for my wife's flu shot?  Have you ever had someone report payment in full though you weren't sure it was paid?