Skip to comments.Letter from my Eye Doctor
Posted on 01/12/2010 6:49:24 AM PST by ml/nj
I can see that this is only the beginning of the eye-opening changes coming under Obamacare.
Rationing is starting
I've heard it call 'screwing them', 'hustling them', 'f***ing them', 'boning them', and 'scamming them'.
I've never heard it called 'refracting them' before.
Harbinger of the ultimate result of Obamacare.
There are a number of businesses that sell glasses, that is, frames and lenses, that offer a free examination, the refraction, if you buy their glasses. Decline the exam from your doctor, if you need glasses, and wait until Sears, or Pearl Vision, or whatever, has a sale where the exam is included.
They’ve already been fracted once.
Insanity, just plain insanity. Refraction is absolutely required for the optometrist or ophthalmologist to determine the precise correction you need. How can that NOT be a medical service?
We’ve got good private insurance, and this is how they have always handled vision coverage. Nothing new, except that Medicare is apparently now handling these claims like the private firms do.
Well, anybody could have seen THIS coming a mile away...
That said, I’ve never understood why vision problems are not covered as medical expenses.
After all..if I had a hand that WORKED, but did not work WELL, and the doctor could fix it, it would be covered.
Same goes for just about any other organ I can think of. A myopic eye is just another organ that isn’t functioning properly, isnt’ it? What is it about vision problems that cause them not to be covered as legitimate MEDICAL problems?
“Medical” vision coverage, as defined by our current Aetna plan and former Cigna plan, includes eye infections, diseases (glaucoma, retinal detachment, macular degeneration, corneal ulcers, etc.), and general eye health.
Measuring your visual acuity (your need for corrective lenses), known as “refraction,” has always been a separate part of the exam and billed separately by our private insurance.
“There are a number of businesses that sell glasses, that is, frames and lenses, that offer a free examination,..”
...our local Wal-Mart does that....they have an optomitrst on duty and are much cheaper on frames and lenses...however now that I’m getting older I still like to have an experianced MD Opthomologist give me an exam every couple of years...I want to know the medical health of my eyes too...then I go over to WalMart for the glasses...just my two cents FWIW
So soon, so much profit to be made from gullible Medicared seniors, so many scams to be run.
If you have loved ones on an AARP plan, I suggest that you check whether they are being scammed in this way. Me, I moved to a Blue Cross Anthem Medicare Complete plan with $0 premium and prescription coverage.
This is not new: my eye dr has had such a notice posted in the office for a while now.
Refracting has never been a medical service. It is about vision correction. Refractions are performed by optometrists (Doctors of Optometry), who are not medical doctors and are not qualified to treat for cataracts, glaucoma, detached retina, etc. Optometrists do not perform laser surgery. All they do is examone for vision correction. If a medical condition is detected, they refer to an MD.
This is chicken feed. Quit whining.
Does your plan include any coverage for the cost of frames or lenses?
You have to realize Medicare is under tremendous fiscal pressure because of reduced tax revenue and profligate federal spending. CMS (Medicare financing arm) will continue to cut around the edges. Eventually, they will have to cut out the essential services if 0bamacare becomes law. Wherever possible, the government will attempt to pass the blame off to insurance companies and providers.
But consider this. Suppose Medicare covered refraction services but only paid $10. Great. Not necessarily. In this case the provider would have to accept a price lower than the cost to deliver the service. Any non controlled prices would go up to make up the difference. If there is no place to shift the cost, the service will not be rendered or the provider will be forced to stop accepting payment from the insurance company or medical program (Medicare).
The only way to get rational prices is to expose patients to the costs. We could do this with tax exempt high deductible medical savings accounts in the private sector.
The underlined part is what goes away under obamacare ... and because they're cheaper, the Walmart doctors will be third world.
Same with our group insurance. Eye exams have never been covered, yet if you go with a problem (infection, injury to your eye, etc.) it is covered.
This is chicken feed. Quit whining.
I have medical insurance and refraction, or any visit to an optometrist has never been covered. I've had 7 eye-related surgeries over 8 years. All those were covered. Just not refraction, frames or lenses. So, I would not say this is the beginning of Obamacare.
You just pay for it is the cost of glasses. Do you really think you get something for free??? Advertising is an art form. Why should someone provide something for free???
I must not have made myself clear. That is what I was suggesting. Go to your opthamologist, get the medical exam, but decline the “refraction” so you don’t have to pay for it. Go wherever you want to buy the glasses to get “refracted.” My experience has been that the optometrist does a better job of getting my prescription right than the opthamologist.
This has been happening to physicians for years. Medicaid (not Medicare) would bundle a flu shot into an office vist if we gave a flu shot when we were seeing a patinet for a ear infection. Meaning we lost money giving the flu shot. So we had to inconvience our patients and tell them to come back at a different day for their flu shot so we could get payed. The.gov knows how to play the game.
You did not understand my post, and have re-stated the obvious. Of course nothing is free. The POINT IS: you are going to spend money on glasses, and the business is HIGHLY COMPETITIVE. You can get a very reasonable deal on the refraction exam and the glasses. And, packaged that way, the exam is much less expensive that one performed by an opthamologist.
Artist(Band): ZZ Top
When you wake up in the morning and the light is hurt your head
The first thing you do when you get up out of bed
Is hit that streets a-runnin’ and try to beat the masses
And go get yourself some cheap sunglasses
Oh yeah, oh yeah, oh yeah
Spied a little thing and I followed her all night
In a funky fine levis and her sweater’s kind of tight
She had a west coast strut that was as sweet as molases
But what really knocked me out was her cheap sunglasses
Oh yeah, oh yeah, oh yeah
Now go out and get yourself some big black frames
With the glass so dark thay won’t even know your name
And the choice is up to you cause they come in two classes:
Rhinestone shades or cheap sunglasses
Oh yeah, oh yeah, oh yeah
Refraction has been a separate billed portion of the ophthalmologist’s medical exam for several years...This is one example of the “rationing” that has slipped in gradually with little or no fanfare...however one thing to realize, before opting out of your ophthalmologist refracting your vision, realize that most ophthalmologists are not in the business to sell eyeglasses..just medical evaluation and total eye care and if you don’t need eyeglasses, you don’t need them..BUT an eyeglass retail business offering “free exam” they ultimately want to sell you expensive eye glasses...Being in ophthalmology, I have seen many patients come into the office with glasses bought at a retail establishment perhaps with the “free exam” The lenses are plano ( plain glass or very very minimal correction) and thus the patient probably really didn’t require them...also, who is doing the refraction???? Just something to keep in mind....
Has a nice ring, huh?
Nothing new. Trips to the optometrist for vision exams (refraction) have generally never been covered by insurance. Maybe a few of those union-negotiated Cadillac plans cover it but, in my experience w/ a handful of employer provided plans, I’ve never had a refraction covered by insurance.
I am curious about your experience w/ health plans that do/did cover refraction. Do fill us in.
We discovered them last year, and the product is top quality and unbelievably priced.....Just Saturday I got a pair of progressive bifocals with bendable titanium frames and the 'Transitions' (darkem-lightem) feature - $72.00.
Give a study to Zenni Optical - online. Top quality, unbelievable prices. Just be sure and get your 'pupillary distance' from an eyecare person.
Personally, I feel outright fract.
Medicare is already rationing.
I know an elderly woman scheduled for knee transplant and Medicare denied a bone density test scheduled before the surgery because she was ‘too old’. The surgeon won’t do the surgery without the bone density test to determine the health of the underlying bone.
She is in shock about the government denying her coverage. I told her to get used to it and you are welcome for voting for Obama.
FWIW, I am on Medicare, saw my eye Dr. in Dec and he charged $20 for this.
And so it begins.
See you all at carousel!
I suppose having ones blood pressure checked isn't a "medical service" either.
We will never have rational prices without patient exposure. What we have now with Medical programs and 3rd party insurances is government fiat pricing, the hallmark of a command economy.
I have some Aetna plan through my wife's employer and our thousands of dollars taken out of her paycheck.
But this isn't about insurance, I don't think. The doctor is using Medicare as an excuse to begin charging for something that has ALWAYS been included in EVERY eye exam I've ever had. It is as if your GP were to start charging you to check your blood pressure.
My mother, who is on medicare, recently had an eye exam and she had to pay $20. Now I know why.
I’ve been refracted a thousand times.......
The medical insurance only pays for medical issues related to the eyes, not for vision correction. The separate plan for vision insurance (which is optional, you can buy it or opt out) pays for an exam and a reasonable allowance for glasses (frames and lenses) or contacts once per year.
We have always bought the vision plan because the entire family is myopic and all wear glasses and contacts, so it saves us money.
The medical plan pays for eye infections, etc., and for a yearly check on the mole on my cornea. But if I want them to do a refraction and give me an Rx for glasses/contacts while I’m in the chair, it’s a separate charge, filed on a different plan.
Always has been that way.
But an important medical service like Viagra is covered.
Age 65 is approaching for me and I have checked with a number of private insurers to purchase a primary health plan of our own and none of them want to be our primary insurer.
Congress passed a law and Bill Clinton signed it making it mandatory for Medicare to be the primary insurer and private policies secondary.
I am able and quite willing to pay for a private plan as primary insurer and yet the Government won't let me.
What's a responsible person to do?
Assuming 0bamacare becomes a reality, the most practical solution for the individual near term will be off shore. Of course, this will not be practical for office visits and minor procedures, but it could become a real option for expensive procedures especially if waiting times increase as in the UK and Canada. Centers of excellence will arise in places like the Caymans, Costa Rica if 0bamacare really takes root. Indeed, many seniors enjoy retiring offshore because of tax advantages and lower costs of living.
The other approach is to act at the state level by contesting and destroying this legislation on a constitutional basis.
I live on the Mexican border here in Southern Texas and already know of a number of Americans using some of the medical assets across the border. These providers have started and grown their businesses primarily for the north of the border patient and dollar. The problem of course is the rampant crime and security in Mexican border towns for both US and Mexican citizens.
The good news is that at my age, what ever takes place, it will only affect me for a relatively short period of time. My biggest concerns are for my children and grand children.
It costs $30 to fill a tank of gas for your car...I honestly don’t know why people can’t pay for their own damn eye examinations. Why must Medicare pay for every single thing? If someone comes up with a good explanation for me, I’ll apologize and admit I was wrong.
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