If I don't have vision insurance, can I go to my PCP or to an Urgent Care facility for dry eye, in the US (I have medical insurance)?
I have dry eye and I see an Ophthalmologist, who is an MD, and my regular insurance covers the visits. I never use my vision insurance, why should I, the Ophthalmologist does everything the Optometrist does ( including testing for glasses/contacts) but he is a Medical Doctor for the eye and it is covered by insurance as a specialist. I had tear duct plugs inserted in the office on the first visit, sounds painful, but it wasn't. He also recommended dry eye drops (Blink Tears Lubricating), Omega 3 supplements. Because I have rosacea, he recommended I use my Oracea medicine that my dermatologist prescribed because there is a link between rosacea and dry eye. I believe the Omega 3 makes a big difference for me. There are specific Omega 3 supplements for dry eye, and they are all over the counter, as are the Blink Lubricating eye drops. Don't mess with dry eye, it is not only painful, but very destructive to the eye.
Have you heard of this insurance?
I was called by an agent today after filling out an online survey for health insurance quotes. She gave a quote for 119.95 a month which included 30-50 co-pays for doctors, a dental, vision, and prescription coverage. This would be coverage only for my 5 year old daughter. She did not want a social security number and said they do not do medical background checks. She said the name of the company was HealthChoice. She also said I could keep my current doctor because they were a nationwide PPO. This all sounds too good to be true. Has anyone ever heard of this company and if so what reviews do you have about it? Any info is greatly appreciated.
Can you go to the eye doctor if you don't have health insurance?
If you simply want a prescription for glasses, that can be relatively inexpensive. But shop around. You might get a “free” eye exam from a Doctor of Optometry if you buy a pair of the store’s (expensive) glasses. Check prices before having the eye exam!Many lens prescriptions can be filled inexpensively by online stores. The quality of the optics may vary.***A Doctor of Optometry (OD) does not require full medical licence. An Ophthalmologist is a fully licenced Medical Doctor (MD) who did additional studies to specialize in the eye.If you need an MD who specializes in the eye, that is very expensive without health insurance.Good Luck!*** I am a physicist’s daughter. High quality optics are important to the quality of our vision and the strain we put on our eyes.
What is the business model for VSP Insurance? It seems like most people who join VSP would take advantage of the yearly glasses benefit, so how does VSP make money?
VSP owns a company called Marchon. Marchon manufactures for brands like Nike, Calvin Klein, Chloe, Flexon, Valentine, etc.VSP strong arms the eye doctors to purchase the above brands from them by promising to drive patients to those "in network" eye doctors. Patients purchase Marchon products because they are covered by the VSP plan via the in-network doctor. VSP makes money off of those sales.VSP charges premiums and counts on a low utilization rate among its plan members. Only 25% of insured use their benefit each year. Vision benefits do not carry over.VSP charges vision plan management fees to employers.This is how they make money. And a lot of it.A roadmap to a better way:1. Cancel your vision insurance plan--they are a waste of money. Here’s how to get a better value.2. The marketplace would be forced to be more transparent and competitive. The consumer would pay a fair price for eyeglasses, contact lenses, and eye exams (I estimate suggested retail prices would drop 30% to 40% ).3. Put the money that the vision plans are charging, for doing nothing, back into the pockets of the consumers.Disclaimer: I'm the founder of an eyeglass company and this is one of the reasons we started David Kind — to break the system together.
Should I use Kaiser Permanente or Blue Shield for health insurance? Besides cost, what else should I consider?
Kaiser mostly offeres HMOs, so I’m assuming you are comparing Kaiser HMO and Blue Shield PPO. Most of the points below are still valid if your Kaiser option is a PPO.I live in Northern California and was on Blue Shield PPO last year before switching to Kaiser HMO this year, so I can only speak to my personal experience. Additionally, I am generally healthy, so besides the yearly routine checkups, I go to the doctors around once a year.I strongly recommend Kaiser HMO over Blue Shield PPO.Before I talk about why I choose Kaiser, I’ll first go over some downsides of Kaiser:You need a referral to see a specialist, so you can’t just pick a doctor on ZocDoc and waltz in to a heart surgeon’s office. I haven’t found this to be an issue yet since my primary care doctor is pretty competent.Cost wise for the plans I have, Kaiser has a slightly higher copay for non-routine visits (routine checkups are free), but honestly for me it’s the difference of $20 vs $30, so not a big factor.With that out of the way, here’s why I like Kaiser:Centralized, online medical record system (they even have a mobile app!). You can email your doctors to ask them questions, manage all your prescriptions and renew them online, see all your test results with your doctor’s comments, schedule appointments online either for an in person visit or video conferencing or just a call, see your vaccination history, etc. This is literally my dream come true.You can pick up whatever meds they prescribe you in the pharmacy IN THE SAME BUILDING instead of sending your prescription to CVS or Wallgreens, physically driving 10 minutes there and hoping they are open, giving them your insurance information, waiting however long, and realizing that you’ve spent a good chunk of your day picking up prescriptions.There are lots of Kaiser locations in the Bay Area.If you urgently need to see a doctor and your primary care is booked, you can just call Kaiser and they'll schedule you an appointment ASAP with a different doctor.I like my Kaiser doctors a lot more than my previous doctors that i find on ZocDoc.In the past, I’ve had issues with doctors billing me incorrectly because they weren’t able to look up my insurance information, eventually causing me to have to deal with a debt collection agency. When your medical provider and health insurance provider are the same, life is just much easier.
Are any eye exams covered under regular health insurance?
Vision exams are billed two different ways. One being a routine exam and the other being a medical vision exam. Whether an insurance company covers it is based solely on the diagnosis that the provider submits. If the provider submit the claim to your insurance and bills with a diagnosis code that means routine and you have no routine eye coverage than it will be denied. If you took your daughter for fluttering of the eyes than it sounds to me like it should have been submitted as a medical eye exam and should be covered. I would suggest contacting the provider and asking them to resubmit with a medical diagnosis and even a routine diagnosis as the secondary diagnosis. The insurance looks as the primary diagnosis and your claim could be reconsidered. If the provider will not resubmit then you can write a letter of appeal to your insurance company letting them know that your daughter was seen due to fluttering of the eye and not for routine purposes. The insurance company may request the medical records from the provider however it may very well get covered. It is definitely worth trying to get it reprocessed.
I don’t have insurance and I only need a doctor to give me an authorization for a cat scan that I would pay out of pocket, how can I find doctors that would let me see them for authorization without health insurance?
A doctor needs to make at least a limited physical examination in order to determine a diagnosis and reason for a CT scan. The procedure requires a prescription and an applicable, medical necessity ICD-9/10 code.One could go to the nearest Urgent Care Center that is staffed by an MD. It will be more costly by going to a family medicine practitioner or general practitioner. They will probably do a more complex examination.Good luck. Thanks for A2A.
How can I find an eye doctor who accepts Staywell insurance?
I live in Orlando, Florida, and I have recently obtained Staywell through Medicaid. I am 18, and need to go to an eye doctor so I can get glasses or contacts, seeing as the ones I have are three years old and are shattered. I don't know where to get the information that will tell me what eye doctors accept Staywell. Where can I find it, or does anyone know of any local eye doctors who accept Staywell?
Do Walmart Vision Centers accept Medicare plans?
Walmart Vision Centers provide professional medical eye and vision care services. They also sell materials like lenses and frames.Many Walmart doctors of optometry are employees of Walmart and many lease their spaces. I believe there is no single policy prohibiting insurance applications from doctors. In the last several years, more Walmart Vision Center doctors are “accepting” Medicare plans in some form or another. It is important to call each doctor’s office to see what the level of acceptance of coverage.Note: I practiced with National Vision in a Walmart for 16 months.This post is the personal opinion of #Tips4EyeDocs and does not constitute legal, medical or financial advice or a solicitation and is for entertainment value only.
Does Walmart Vision Center accept Medicaid?
You need to call the Walmart Vision Center you plan to visit and your Medicaid MCO (The company on your insurance card) if your state has them. Some Walmart's accept Medicaid, some don't. Vision benefits vary from MCO to MCO. The basic Medicaid benefit *shoud* cover your exam, single vision lenses (ie not bi or tri focals) and a limited number of frame options once every two years for adults. If you have an MCO, some offer richer benefits. I've seen some who will go so far as covering contacts even if they are not medically necessary.