Vent: Eye exam and insurance

[PrincessBelle09]

I just had a comprehensive eye exam and got fitted for new contact lenses. Since being on my own, I have gotten this done one other time. I did not have insurance that included a vision allowance. Without any insurance benefits, the exam and fitting cost around $130. This time, with a $200 vision allowance, it cost me $142 out of pocket. It was at a different office, but both were done at Eye Care Associates.

I called my mom and told her how much it was and she was shocked. She called the same office to see how much it would be for a patient without insurance. They quoted her $188.

What the heck? Did I get screwed?

Side-note: The optometrist's assistant was kind of rude to me. I always have trouble with the glaucoma test (anything going toward my eye, even just a puff of air, freaks me out and I blink like crazy). The last time I got my eyes checked, the woman said that they were not doing the glaucoma test for younger patients because it isn't really necessary. I mentioned this to the assistant today and explained that it usually takes a ridiculous amount of time to perform the test on me and she said, in a really nasty tone of voice, "You're not that young." I'm 21. I think that still counts as pretty young.

 

[DisneyBamaFan]

I stopped buying vision insurance a few years ago. Even with three eyeglass wearers, it costs more than we have ever saved. We just take advantage of sales events for eye exams and new glasses.

 

[Christine]

I just had a comprehensive eye exam and got fitted for new contact lenses. Since being on my own, I have gotten this done one other time. I did not have insurance that included a vision allowance. Without any insurance benefits, the exam and fitting cost around $130. This time, with a $200 vision allowance, it cost me $142 out of pocket. It was at a different office, but both were done at Eye Care Associates.

I called my mom and told her how much it was and she was shocked. She called the same office to see how much it would be for a patient without insurance. They quoted her $188.

What the heck? Did I get screwed?

Side-note: The optometrist's assistant was kind of rude to me. I always have trouble with the glaucoma test (anything going toward my eye, even just a puff of air, freaks me out and I blink like crazy). The last time I got my eyes checked, the woman said that they were not doing the glaucoma test for younger patients because it isn't really necessary. I mentioned this to the assistant today and explained that it usually takes a ridiculous amount of time to perform the test on me and she said, in a really nasty tone of voice, "You're not that young." I'm 21. I think that still counts as pretty young.

Well, I have had a doctor tell me that it is outright fraud for a doctor's office to charge two different rates: one for cash paying customers and one for insurance paying customers.

It is perfectly within their right to offer a discount to ANY customer off of the customary charge, but they should not be charging two different rates. I would call them back myself and ask and then go over your charges with them in detail and see if they added anything on.

I think, at 21, it isn't too early to test for glaucoma. I wasn't aware that it was an older person's disease--maybe it is. I'm sure the risk of it goes up with age, as with anything, but I think younger people can get it.

My doctor's office no longer uses the air puff--they use some blue light that is much more tolerable.

 

[msmayor]

Well, a lot depends on what costs your insurance covers.

In addition, while the "cash cost" may be different, it also may provide for certain discounts that are NOT available if you are using insurance benefits.

For example, LensCrafters often has coupons that offer 50% off frames, but you cannot use the coupon in conjunction with insurance benefits. Depending on your plan and the level of benefits provided, it actually may be cheaper (because of the coupon) to pay out of pocket and not use insurance than to take advantage of the benefits.

 

[PrincessBelle09]

The vision allowance comes with my regular insurance. I'm on a student insurance plan with my university.

As for discounts, what they told my mom was supposedly the "rack rate".

It was just frustrating to expect to have my exam totally covered by new insurance only to be told that the total was $342 and that my insurance would cover $200, leaving $142 to moi.

 

[DisneyBamaFan]

The vision allowance comes with my regular insurance. I'm on a student insurance plan with my university...

Now you know - from now on, ask for prices with and without insurance. I found that I actually paid less if I offered to pay cash. Don't use the insurance unless it actually saves you money.

 

[Handbag Lady]

I would change doctor's offices and find a non-chain the next time you're due for an appointment and ask them to help you with prices ahead of time.

I have an eye doctor that I just love. It is just himself and one other doctor. They have two ladies that run the front office. One of the gals actually sits down and takes about 40 minutes applying my insurance in various ways to help me get the most bang for my buck. The last visit cost me $60 in total and I came out with contacts for a year, transition Ray-Bans for regular glasses and a cool pair of Ray-Ban Rx sunglasses. Granted, I have a Flex-pay account as well to use, but she's SO good at correctly applying the funds I always feel spoiled there.

 

[tvguy]

Before I had eye insurance, my glasses and frames (progressive lenses) cost me $300 to $400.
After eye insurance, my glasses and frames cost me $300 to $400, but there is a big production in the dispensing opticains office about how my insurance is paying this and that, and how these glasses would have cost me $800 without insurnance.
But my vision insurance costs only $10 a month for the family, and the eye exams are now free, instead of $150 (times 4 in our family), so it makes the insurance worth it.

 

[PrincessBelle09]

I would change doctor's offices and find a non-chain the next time you're due for an appointment and ask them to help you with prices ahead of time.

I have an eye doctor that I just love. It is just himself and one other doctor. They have two ladies that run the front office. One of the gals actually sits down and takes about 40 minutes applying my insurance in various ways to help me get the most bang for my buck. The last visit cost me $60 in total and I came out with contacts for a year, transition Ray-Bans for regular glasses and a cool pair of Ray-Ban Rx sunglasses. Granted, I have a Flex-pay account as well to use, but she's SO good at correctly applying the funds I always feel spoiled there.

WOW! I need to look into private practices next year.

 

[a1tinkfans]

I have insurance and do not use it for my glasses. It is cheaper without the insurance, and yes, they charge differently.
I go to a local optometrist that is under my plan for the exam, (free) take the script and then get my glasses elsewhere. I buy my contacts thru Bj's so much less expensive.
Vision plans are notorious for not covering enough.....

 

[msmayor]

The vision allowance comes with my regular insurance. I'm on a student insurance plan with my university.

As for discounts, what they told my mom was supposedly the "rack rate".

It was just frustrating to expect to have my exam totally covered by new insurance only to be told that the total was $342 and that my insurance would cover $200, leaving $142 to moi.

Understandable...but were your expectations based on the actual benefits your insurance provides or just an assumption? Too often people just think that because they have insurance, things are 'covered' and it won't cost them.


The good thing here is you have learned an important lesson about knowing and understanding your benefits before obtaining the service. And remember to check on and understand your benefits every single time you change insurance carriers. ALL policies are different, and even the 'same' policy can have varying benefit levels depending on what an employer/plan sponsor is willing to contract for. Never assume, for example, that all Blue Cross or Cigna insurance plans are the same. They aren't.

 

[Tink888]

It's not just the eye doctors that charge differently (or maybe I should say discount differently). We got a bill once for a trip my son had to the ER. They made an error and billed as if we were uninsured and we received a huge portion of the bill discounted since we were uninsured. That caught the error, but needless to say I'd have had to pay much less out of pocket had I been uninsured.

 

[Agri]

One thing I haven't seen anyone mention is that being measured for contacts adds to the cost of your eye exam. Its not an automatic part of an eye exam, so unless your mother asked specifically for that as well, her quote would be lower. Both of the eye doctors I have been to - and the pricing I checked into at Wal-Mart - charge extra for measuring for contacts. This is also something that insurance typically won't cover - they'll cover an exam for glasses, but contacts aren't a necessity and therefore, not covered.

Glaucoma isn't an old person's disease. It occurs more frequently in people over the age of fifty, but that does not at all mean that at age 21 you are not at risk. Family history plays a huge part as well as other risk factors. At my age of 28, I have now developed strong indicators that I will have glaucoma within the next few years and I do not consider myself 'old', either. My paternal grandmother developed it when she was in her late 30s, if I recall correctly. You can lose a significant portion of your vision before you even realize it, which is why testing is very important. Once you lose part of your field of vision, you cannot get it back, but with early detection, the progress of the disease can be slowed or even arrested.

On a similar note, my best friend from high school was diagnosed with a form of macular degeneration when he was 25, which is also far more common in older people.

Yes, the puff of air is annoying - I'm the same way - but I'd rather deal with a puff of air than going blind.

 

[RangerPooh]

Not having vision insurance for a while I usually shop around for the best price on contact/glasses exams. I recenlty had an exam and paid $90 for both the glasses and contact exam. I've paid less at other places, but am not complaining. From past experience I have learned that private practices charge more than the vision centers at Costco, Walmart, and Shopko. Did you consider shopping around prior to going with this company?