A Tale of Two Students


This is the true story of Jane and Kathy, who are roommates going to Nicaragua for a semester abroad. They were advised to go to a travel clinic prior to departure. Jane is trying to save money and since most travel clinics don’t accept insurance she went to her primary care provider. Kathy came to our travel clinic and got a statement to send in to her insurer for possible reimbursement direct to her.

Jane received a hepatitis A vaccine (cost $95 plus $30 to administer the vaccine) and got prescriptions which she filled at her pharmacy for Lariam for malaria ($204) and oral typhoid vaccine ($65). She paid her $25 copay for the visit and was told they would submit it to her insurance.

Kathy got a hepatitis A vaccine ($85 and we don’t add an administration fee) and oral typhoid vaccine($66) that was packaged in a small Styrofoam cup with ice and a lid to keep it cold until she got home. She filled a prescription for choroquine for malaria ($85) at her pharmacy.

Jane said nobody told her to refrigerate her typhoid vaccine which she had left out. She looked at the small box and there was a sticker that said refrigerate it but she didn’t see it. She called the pharmacy who said the vaccine was no good and they couldn’t take it back or replace it. She would have to call her PCP for a new prescription and have to pay for it again.

She asked Kathy why she had a different malaria prescription. Kathy said she was told this one was less expensive and safer for someone with a history of depression. Jane is taking an antidepressant that she gets filled through her mail order pharmacy. She called the pharmacy again and asked about Lariam and depression and was told said she shouldn’t take the Lariam and to call her PCP. Lariam was not returnable or refundable.

She called her PCP who agreed that Lariam might cause problems for her and that she could have a prescription for choroquine. Her PCP doesn’t usually write prescriptions for malaria prevention.

Jane was not happy. She was out $270. Then she got a statement from her insurer saying that her travel visit and hepatitis A with her PCP was not covered due to her deductable and she owed them $250 less her copay. Her total cost now is up to $605.

Kathy however spent $283 for her visit and $85 for her prescription for a total of $368. Going to a travel clinic first? Less expensive, less aggravating and you get the benefit of expert travel advice.

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