Vaccine Letter 01

05/31/23

CVS Caremark
1 CVS Dr
Woonsocket, RI 02895
Attn: Karen Lynch, President & CEO

re:  Hepatitus B Vaccine

For your convenience, this letter (including all of the exhibits) is published on the Internet at: mkgappraisal.com/letter2023_01.htm

I received an email dated April 18th, 2023, from Medicare.gov.  The email says:

Thanks to the prescription drug law  that went into effect this year, even more vaccines are free for people with Medicare Part D.  Examples of vaccines now covered under Medicare Part D include:

1. Shingles
2. Tetanus/diphtheria (Td)
3. Tetanus/diphtheria, and pertussis (whooping cough) (Tdap)
4. Hepatitus A
5. Hepatitus B

Sincerely,
The Medicare Team

I received the Hep B vaccine in the form of two injections at my local King Soopers pharmacy.  The first shot on March 12, 2023, and the 2nd shot a month later on April 13th.  In order for me to receive the shots, it was necessary for me to first sign my name to a Vaccine Consent Form , which contained (in small print) the statement:

I authorize Kroger to submit a claim for reimbursement on my behalf to Medicare.  If the claim is denied, I understand that I will be responsible for payment.

Aetna refused to pay.

After receiving your Aetna Formulary Letter dated 3/14/23, I read the instructions.  I then called (800) 414-2386 and spoke with your people.  I tried this six different times.

Aetna is not acting in good faith.

The Joe Biden Executive Order  dated 10/14/22, the Inflation Reduction Act (IRA), and the Medicare.gov email dated 4/18/23, all make a compelling argument that Aetna is required by law to pay my Hep B vaccine fees.  Because of Aetna's stubborn refusal to obey the law, it has been necessary for me to carry a $330 liability on my personal balance sheet.

Karen Lynch, quit stalling.  Pay up, and then send me proof that you did.

If you are unable, or unwilling to send me copies of cancelled checks, or some other proof of payment, then issue a check in the amount of $330 payable to me.  Stop wasting my time.

Philip G Rice
11268 E Linvale Dr
Aurora, CO  80014
dob 04/25/1953

exhibits:

1. Shot 1, 3/12/23 Vaccine Consent Form 
2. Shot 1, Cash Receipt $165
3. Shot 1, Prescription 
4. Aetna Formulary Letter dated 3/14/23
5. My letter to Pharmacy Mgr Gary Pierce dated 3/26/23.
6. Shot 2, 4/13/23 Vaccine Consent Form 
7. Shot 2, Cash Receipt $165
8. Shot 2, Prescription 
9.  Medicare.gov email  dated 4/18/23.

Exhibit Updates
10. Aetna Letter received 6/20/23.  13 pages.
11. Data Breech Letter
    nations benefits to Phil Rice dated 04/27/23.
12. Letter
    Rice to nations benefits dated 6/28/23
13. Letter dated 6/9/23
    Change of Phone Number
14. Letter
    Rice to Sharon Phillips, dated 6/9/23
15. Aetna denial Letter
    to Rice, dated 7/28/23.  Got no response from my prescriber.  Presumably Marc Watkins.
16. Aetna denial Letter
    to Rice, dated 7/28/23.  Part D does not pay for drugs that should be covered by your Medicare Part B.
17. Aetna check to the order of Philip Rice $118.87 dated 7/10/23
18. Aetna July EOB Explanation of Benefits, July 2023, YTD.

-- End of Letter --

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