May 16, 2011 at 3:28 pm #2001BonbonParticipant
and, unfortunately, you guys are it!
I’m trying to get a new pair of glasses. Medicare pays for one pair of glasses after you’ve had catarac surgery, which I just did. I went on the internet to find a provider and Walmart was the only one there. Keep in mind, I live in a huge metropolitan area, there are 52 providers in the phone book but none of them accept Medicare.
So I got to WallyWorld and they tell me they don’t take it. So I call Medicare (add a minimum of 15 minutes each time I call) and they give me Lens Crafters’ number, nope, they don’t either. I call again, get a place in Boca Raton (which is a good 1 1/2 drive from me) or Hollywood which is also about 45 minutes. Call them, nope, not them either.
Now I’m really steamed. Call them again this a.m. and get another place in Boca. Call, nope, they provide "glass eyes" not "eyeglasses." Called the other one, he said he can only sell me glasses if I’m his patient. (My eye doc doesn’t sell glasses.) So now I’m back to square one. I tried to get approval to go somewhere else and then get reimbursed…nope, they don’t do that. I’m told I "may get reimbursed but there are no guarantees!
Sorry, I’m done now. Gotta go over to WalMart and buy some new glasses. Not only do I need new ones, I stepped on my old pair and broke the frame all to pieces so all I have is an extremely old pair that I can’t see a thing out of. Grrr…May 16, 2011 at 3:40 pm #23740annieoParticipant
I just came back from an "insurance information" session at my husband’s work. I think the eye insurance lady made me more confused that I already am about insurance in general. What it boils down to is that the eye insurance owns most of the optical companies that supply frames so you can go to one of their companies. And more good news, it’s only a 10% increase on your dental and 1.5% on medical. And your deductible has tripled. Whoopee! Sorry about your glasses Bonbon. Good luck.May 16, 2011 at 4:51 pm #23748trixiebeldenParticipant
i think that because the medicate repayments are so low, fewer and fewer providers accept medicare patients. i know where i live (also large city, population 200,000, and near even larger cities), i had heard there is only 1 dentist accepting medicare (i don’t know how dental and medicare go together, in this instance it was a special needs kid who was needing something done), and he was considering stopping.
i keep seeing commericals for america’s best, supposedly $70ish for eye exam and 2 pairs of glasses– i don’t really believe that, though i haven’t checked it out yet.May 16, 2011 at 10:31 pm #23754DeeLanParticipant
If I’m not mistaken Medicare will pay no matter what doc you go to. The difference between a doc that accepts Medicare and one who doesn’t is the difference and what you end up paying.
If a bill is $400 and Medicare only approves $200 then they pay the doc $160 and you owe $40. Plus the doc has to bill Medicare. If the doc doesn’t accept Medicare then Medicare still pays the doc $160 but you’re responsible for the $40 + the $200 that Medicare didn’t approve.
Don and I are both On SS and have Humana. We get up to $290 a year toward glasses. I go to an opthamologist near my house due to having glaucoma and he gave me a new script in January. Went to the optical shop in the town we use to live in (25 miles) He’s in our insurance and I called to see what it would cost for progressive, transition lenses with anti-reflective coating. $245. I was keeping my old frames since I LOVE them. Before I picked up my glasses I get the EOB from the insurance. He billed them over $300. There were charges for $100 for frames and the lenses and coatings were way over what he quoted me. When I picked them up I couldn’t see and he kept telling me I needed to get use to them. I’ve had progressives for 10-15 years I went to my doc and he checked the lenses and they were no where near the prescription he wrote. Go back to the optical shop and he blames my doc but agrees to re-do the lenses and proceeds to tell me I’m costing him money. That’s when I pulled out the EOB and told him he got more than he was entitled so he’s doing OK. Pick those up and still can’t see. Back to eye doc and the script still doesn’t match what’s written PLUS the seg height which is the distance from the bottom of the lens to the center where I’m suppose to look through for distance is not right. If the glasses are sideways on my face I can see distance fine but can’t read or drive with them normally. He wants to fix them again and I tell him NO, refund the money to the insurance or I’m reporting you for insurance fraud.
Called everyplace in the area and found a few that accept my insurance. One place accepts it but only at their location in Georgia, I’m in Alabama. Go to another place and the difference between insurance and cost should be $20. They tell me I owe $52. I have to pay sales tax on the entire bill. I’ve NEVER paid sales tax on prescription eyeglasses before. They tell me the insurance company charges them sales tax. I know that’s a lie. Walk out and call insurance company and it is a lie. Finally found someone in the insurance that doesn’t charge sales tax and suppose to have my glasses this week. Just hope I can see out of them.May 17, 2011 at 10:02 am #23755BonbonParticipant
here in Florida and I called them and they said they can’t help me. But they cautioned me very strongly to NOT get them, pay for them myself and then submit the bill to Medicare because I’ll never get paid. Ya can’t win. I’m just about to go someplace and just pay for them myself. I guess that’s what they’re hoping for.
Deelan, would you please email me? I have a personal question I’d like to ask you privately. email@example.com Thanks.
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