Anybody work for an optometrist?

[Mrs. Bradbury]

I'm quickly losing patience in trying to find out a reasonable dollar amount to expect to pay when using our new vision insurance. I just got off the phone with insurance customer service and with one of the few local providers and I feel like I got half the story.

We have BCBS-GA Blue View vision coverage. We've never had vision coverage in the past. It starts off fairly straightforward - $10 copay for a vision exam. $10 for something called "Vis Lens". $130 allowed for frames each year (Jan-Dec), and 20% off anything over $135. Then it begins to get dicey. For lighter-weight bifocal lenses, there's a $75 copay, then insurance pays the next $120, then we're responsible for anything over that. But we don't know what "that" might be until we're in the thick of it.

Contacts - $55 copay for contact fitting, unless it's "premium", which I was told bifocal may classify as "premium" - then it's just a 10% discount off of whatever the fitting charge is. $130 allowance per year (Jan-Dec) for contacts and it must be used all at once.

More dicey-ness: I couldn't get the chick at the provider to give me even a ballpark figure for what bifocal contacts cost. I specifically asked her, and said I understood different brands have different prices, I was just looking for a range and she said "It just depends" and said it could be discussed further in an appointment. The prospects of that are not looking too good, missy!

So how much do bifocal contacts cost? I know I can order from one of several online companies, but since I don't already wear bifocal contacts I think I need to be fitted through a professional first and afterwards I can order refills from wherever I choose.

Please let me know if this is not the way it's done.

So irritated right now!

 

[Marionnette]

I'm quickly losing patience in trying to find out a reasonable dollar amount to expect to pay when using our new vision insurance. I just got off the phone with insurance customer service and with one of the few local providers and I feel like I got half the story.

We have BCBS-GA Blue View vision coverage. We've never had vision coverage in the past. It starts off fairly straightforward - $10 copay for a vision exam. $10 for something called "Vis Lens". $130 allowed for frames each year (Jan-Dec), and 20% off anything over $135. Then it begins to get dicey. For lighter-weight bifocal lenses, there's a $75 copay, then insurance pays the next $120, then we're responsible for anything over that. But we don't know what "that" might be until we're in the thick of it.

Contacts - $55 copay for contact fitting, unless it's "premium", which I was told bifocal may classify as "premium" - then it's just a 10% discount off of whatever the fitting charge is. $130 allowance per year (Jan-Dec) for contacts and it must be used all at once.

More dicey-ness: I couldn't get the chick at the provider to give me even a ballpark figure for what bifocal contacts cost. I specifically asked her, and said I understood different brands have different prices, I was just looking for a range and she said "It just depends" and said it could be discussed further in an appointment. The prospects of that are not looking too good, missy!

So how much do bifocal contacts cost? I know I can order from one of several online companies, but since I don't already wear bifocal contacts I think I need to be fitted through a professional first and afterwards I can order refills from wherever I choose.

Please let me know if this is not the way it's done.

So irritated right now!

The receptionist will not commit to a dollar figure on those contact lenses because too many people will hear an amount quoted on the phone and expect that to be written in stone somewhere. The truth is that there are so many different types of bifocal lenses and your eye doctor will choose the type that he feels will best suit your vision needs.

But to give you an idea of what my lenses cost, the fitting (which gets done every time my prescription changes) is $45. That does not include the cost of the eye exam. The lenses (Bauch & Lomb Purevision Multifocal) cost $400 for a 6 month supply. My doctor gives me a sample bottle of lens solution whenever I pick up new lenses but I can buy more at CVS or Rite Aid when I need it.

 

[daughtersrus]

I'm quickly losing patience in trying to find out a reasonable dollar amount to expect to pay when using our new vision insurance. I just got off the phone with insurance customer service and with one of the few local providers and I feel like I got half the story.

We have BCBS-GA Blue View vision coverage. We've never had vision coverage in the past. It starts off fairly straightforward - $10 copay for a vision exam. $10 for something called "Vis Lens". $130 allowed for frames each year (Jan-Dec), and 20% off anything over $135. Then it begins to get dicey. For lighter-weight bifocal lenses, there's a $75 copay, then insurance pays the next $120, then we're responsible for anything over that. But we don't know what "that" might be until we're in the thick of it.

Contacts - $55 copay for contact fitting, unless it's "premium", which I was told bifocal may classify as "premium" - then it's just a 10% discount off of whatever the fitting charge is. $130 allowance per year (Jan-Dec) for contacts and it must be used all at once.

More dicey-ness: I couldn't get the chick at the provider to give me even a ballpark figure for what bifocal contacts cost. I specifically asked her, and said I understood different brands have different prices, I was just looking for a range and she said "It just depends" and said it could be discussed further in an appointment. The prospects of that are not looking too good, missy!

So how much do bifocal contacts cost? I know I can order from one of several online companies, but since I don't already wear bifocal contacts I think I need to be fitted through a professional first and afterwards I can order refills from wherever I choose.

Please let me know if this is not the way it's done.

So irritated right now!

I'm not a professional, just a mom with 5 people in our family wearing glasses.

I understand how frustrating it is trying to figure out the plans. We have a similar plan with VSP but our plan is limited to one payment for glasses or contact lenses every 2 years.

For us, we found it least expensive for DD to go to an in-network provider for the contact lens exam and then purchase the contacts from Sam's Club. Even with VSP paying a lower rate for an out of network provider, our out of pocket costs were much less. I think that the cost for a box (not bifocal) from the VSP provider was close to $30 a box and the cost at Sam's Club for the exact same brand was about $15.

Maybe it would be best for you to go to the provider, get the exam and try a pair of contacts. Then if they are working well, check around and see what the cost difference would be to get them with your in network benefits vs getting them out of network.

You don't need a Sam's card to use the optical dept. Other places may be cheaper so call around.

 

[Mrs. Bradbury]

The receptionist will not commit to a dollar figure on those contact lenses because too many people will hear an amount quoted on the phone and expect that to be written in stone somewhere.

We live in a small town and the receptionist knows me/my family (her dad taught me driver's ed.) I was very clear that I was just looking for a range of prices, and I felt like she was reading from a script. Maybe she was within earshot of her boss.

But to give you an idea of what my lenses cost, the fitting (which gets done every time my prescription changes) is $45. That does not include the cost of the eye exam. The lenses (Bauch & Lomb Purevision Multifocal) cost $400 for a 6 month supply.

Thank you so much for sharing how much yours costs - yowza! Talk about sticker shock! However, it's not surprising they are expensive and I really dislike wearing glasses, so I guess I need to gather up my pennies and bite the bullet.

I'm not a professional, just a mom with 5 people in our family wearing glasses.

That makes you a professional as far as I'm concerned!

For us, we found it least expensive for DD to go to an in-network provider for the contact lens exam and then purchase the contacts from Sam's Club. You don't need a Sam's card to use the optical dept. Other places may be cheaper so call around.

Oooh good point! We don't have a Sam's membership anymore and I didn't know I didn't need one for the optical dept. Thanks for the idea, I will definitely consider in & out of network sources.

Thanks to both of you for the advice!

 

[Jennabeth]

I would your insurance to see if they cover a certain amount if you go out of network. I thought it was better if I used someone who "took" my insurance, but then I realized their prices were double (sometimes triple) what I paid at Walmart (which I really dislike shopping at). I ended up paying a couple hundred dollars out of pocket when I went to a "we take your insurance private optical center".

I sat down and figured what I would have paid if I went to Walmart and got reimbursed and I saved quite a lot. I now go there for my exam and fitting, then buy my contacts from Walgreen online (they often email me 15% - 25% off codes, free shipping) and get reimbursed from my insurance company. It's a little more work, but save me quite a bit.

To give you an idea, when we bought my daughters glass from someone that took my insurance, we paid $100 out of pocket for her glasses with the cheapest frames. When we went to Walmart, I paid $23 out of pocket (after insurance reimbursement) for her glasses with almost the most expensive frames (better quality than the "we take your insurance private optical center" ones). This year I got an exam, fitting and 3 boxes of contacts for $60 OOP, it would have cost me $118 for the same thing at the "we take your insurance private optical center".

 

[Jennabeth]

I would your insurance to see if they cover a certain amount if you go out of network. I thought it was better if I used someone who "took" my insurance, but then I realized their prices were double (sometimes triple) what I paid at Walmart (which I really dislike shopping at). I ended up paying a more out of pocket when I went to a "we take your insurance private optical center".

I sat down and figured what I would have paid if I went to Walmart and got reimbursed and I saved quite a lot. I now go there for my exam and fitting, then buy my contacts from Walgreen online (they often email me 15% - 25% off codes, free shipping) and get reimbursed from my insurance company. It's a little more work, but save me quite a bit.

To give you an idea, when we bought my daughters glass from someone that took my insurance, we paid $100 out of pocket for her glasses with the cheapest frames. When we went to Walmart, I paid $23 out of pocket (after insurance reimbursement) for her glasses with almost the most expensive frames (better quality than the "we take your insurance private optical center" ones). This year I got an exam, fitting and 3 boxes of contacts for $60 OOP, it would have cost me $118 for the same thing at the "we take your insurance private optical center".

 

[cmjaffe]

My DH had a decent optical plan two years ago... with his premiums we got an annual eye exam which also included a contact lense fitting for free and then had the basic lenses (light weight) and a limited frame selection. If we wanted a premium frame from the insurance inventory it would cost a bit more (but not a huge amount). If we went to the "designer labels" of frames that weren't part of the insurance plan we'd get a low allotment for the frame, so we'd just stay with the insurance area.
Now DH has a new plan with VSP... a $15 copay for eye exam from a provider, $15 copay for lense and frame (up to $130 allowance). If we go out of network we have a $85 allowance for frame and lense. So we go to provider for eye exam ($15). When it comes to selecting the actual glasses we have a hard time finding anything "decent" in the $130 range. After spending long time I finally just grab anything... then she looks at my prescription... "well, you want thin lenses.... it's going to be about $85 more... so the glasses that were supposed to be $15 are now going to be close to $100 AND I'm not that thrilled w/choice. My 14 yo daughter doesn't like anything there so I get her exam there ($15) and then take her to Costco and get her glasses that she would like better... Those costs $110 total (I think... not that high) with poly carbonate lenses etc. We'll get $85 back so total out of pocket is $25... not bad since if got them through insurance's place it would had been something she hated and would still cost us $15.
DS wears contact lenses. If we went through insurance for exam for contacts it would have been very expensive now and we didn't know what brand of lenses the doctor would prescribe. So he just had exam for glasses and I'll take him to Costco for the contact fitting (ok another expense) but I know that they doctor there will try many different lenses to fit him and would try to stay with something that would be within our budget. The optician's exam is $130 which in this area is reasonable but as far as other national Costco's go is a bit high (I've seen them in the $90-110 range) but convenience counts these days w/gas prices. Anyone can get the eye exam there, I don't believe you have to be a Costco member for this service.
And all of this reminds me that we need to submit Elizabeth's eye glass bill for payment since it's almost the end of March.
Good luck, and sorry for the novel.