Vision insurance.

[GlennWest]

retired and on Medicare. Medicare doesn't pay much. Went for exam yesterday and getting new lenses. Frames in good shape. Bill was $1176.02. ouch. Medicare paid 200ish. Anyone got Vision insurance and do you think it a good deal.

[Chalkie]

11 minutes ago, GlennWest said:

retired and on Medicare. Medicare doesn't pay much. Went for exam yesterday and getting new lenses. Frames in good shape. Bill was $1176.02. ouch. Medicare paid 200ish. Anyone got Vision insurance and do you think it a good deal.

Yes, I have VSP for both my wife and I. We pay about $50/month which covers us both. For that we get an annual eye exam for $15 copay. We can get a retinal scan for no more than $39 copay. We substantial discounts on the lenses and frames. For example, the last time I went in I got 2 pairs of glasses, both are progressive lenses. One is tinted for sunglasses and the other Transition. Both have anti-glare, polarization and anti-scratch. My total bill was just over $600. To me it is money we spent since we both wear glasses. 

[DanZemke]

1 hour ago, GlennWest said:

retired and on Medicare. Medicare doesn't pay much. Went for exam yesterday and getting new lenses. Frames in good shape. Bill was $1176.02. ouch. Medicare paid 200ish. Anyone got Vision insurance and do you think it a good deal.

$1176.02 for an exam and lenses is MUCH more than I have ever paid.  If you don't suffer from an unusual visual problem, I'd shop around for another provider.   For an exam and lenses, Costco would probably be less than half that price.  Why don't you give them (a local Costco) and ask them what it would cost you to use them next time?

I don't think Vision insurance is a good deal for me.

Edited July 19 by DanZemke
clarity

[Dutch_12078]

1 hour ago, GlennWest said:

retired and on Medicare. Medicare doesn't pay much. Went for exam yesterday and getting new lenses. Frames in good shape. Bill was $1176.02. ouch. Medicare paid 200ish. Anyone got Vision insurance and do you think it a good deal.

My wife and I both have United Healthcare Advantage (Part C) coverage that includes annual eye exams with zero co-pay, and a $250 frames and lenses annual allowance. If we choose to use the $250 towards frames, then single vision, bifocal, trifocal, or Tier 1 (standard) progressive lenses are included. The last time I needed new glasses, my total bill was $225 for upgraded progressive lenses. My wife is currently in between eye surgeries for her glaucoma, so she won't replace her current glasses until everything has stabilized.

[GlennWest]

1 hour ago, DanZemke said:

$1176.02 for an exam and lenses is MUCH more than I have ever paid.  If you don't suffer from an unusual visual problem, I'd shop around for another provider.   For an exam and lenses, Costco would probably be less than half that price.  Why don't you give them (a local Costco) and ask them what it would cost you to use them next time?

I don't think Vision insurance is a good deal for me.

Well there is a prism, progressive and it's the best viewing one, tint, anti scratch coating. , anti glare. They could have been a lot less if I got standard lenses. Also I do have a macular condition. I have never been in a Costco and next time I be in NC rual area. No Costco around there

Edited July 19 by GlennWest

[GlennWest]

1 hour ago, Dutch_12078 said:

My wife and I both have United Healthcare Advantage (Part C) coverage that includes annual eye exams with zero co-pay, and a $250 frames and lenses annual allowance. If we choose to use the $250 towards frames, then single vision, bifocal, trifocal, or Tier 1 (standard) progressive lenses are included. The last time I needed new glasses, my total bill was $225 for upgraded progressive lenses. My wife is currently in between eye surgeries for her glaucoma, so she won't replace her current glasses until everything has stabilized.

All the research I have done on Advantage part c has not been good. 

[DanZemke]

12 minutes ago, GlennWest said:

Well there is a prism, progressive and it's the best viewing one, tint, anti scratch coating. , anti glare. They could have been a lot less if I got standard lenses. Also I do have a macular condition.

I'm just suggesting that you may be able to save significantly by doing a little shopping.   Costco was meant to be just a potential example.

I googled around a bit and learned some things about prism lens.  Thanks!  I also came across this site, which I know nothing about other than what I just on it today.  You may find it interesting.

"Prism lenses are more expensive than other types of prescription eyewear. Temporary prism lens wearers will pay about $250 to $500, while permanent prism lens costs $600 to $1,500. Brand-name eyewear with higher-quality lenses will cost several hundred dollars more."

https://www.accruesavings.com/post/how-much-do-glasses-cost

IMO, insurance is best for covering potential problems that have low odds of happening, but could be financially devastating if they occur.  Combining discounted prices with insurance is usually a marketing technique.

[GlennWest]

14 minutes ago, DanZemke said:

I'm just suggesting that you may be able to save significantly by doing a little shopping.   Costco was meant to be just a potential example.

I googled around a bit and learned some things about prism lens.  Thanks!  I also came across this site, which I know nothing about other than what I just on it today.  You may find it interesting.

"Prism lenses are more expensive than other types of prescription eyewear. Temporary prism lens wearers will pay about $250 to $500, while permanent prism lens costs $600 to $1,500. Brand-name eyewear with higher-quality lenses will cost several hundred dollars more."

https://www.accruesavings.com/post/how-much-do-glasses-cost

IMO, insurance is best for covering potential problems that have low odds of happening, but could be financially devastating if they occur.  Combining discounted prices with insurance is usually a marketing technique.

My macular where the eye focuses is swollen. So my vision is not on same plane with the other normal eye. this is a permanent condition unless I get surgery but vision after surgery is 20/50 normally. I still 20/20 with glasses. I see double since eye sight is not in same plane. the prism corrects this some. Makes it manageable. Also vision size is way greater in that eye some double vision is still there from that. Thru bifocals clear as day. I do appreciate your suggestion. I just have never been in a Costco and know nothing about them. Did find there is one around 80 miles from where I will be. Also just looked at bill and prism in one lense is $40.00 extra

Edited July 19 by GlennWest

[Dutch_12078]

5 hours ago, GlennWest said:

All the research I have done on Advantage part c has not been good. 

Part C doesn't work for everybody, but it's been working well for us since 2008 through multiple health issues in multiple states.

[GlennWest]

Been checking on Advantage plans and from where I be staying it would be a 60 ish mile to get to a doctor in their plan. And in that area it is all country miles. 55 mph also. 

Edited July 20 by GlennWest

[Randyretired]

13 hours ago, GlennWest said:

Been checking on Advantage plans and from where I be staying it would be a 60 ish mile to get to a doctor in their plan. And in that area it is all country miles. 55 mph also. 

We also have been pleased with our advantage plan but not all plans are the same.  Research such as Glenn is doing is vital to determine if there is an advantage plan that meets your needs.  Networks, HMO and PPO and more many advantage plans have not met expectations.  Others such as ours have been outstanding but each area is different.  The details and small print are important.  Additionally changes for next year appear imminent as the pay to insurance companies is changing.

[Chalkie]

21 hours ago, GlennWest said:

Well there is a prism, progressive and it's the best viewing one, tint, anti scratch coating. , anti glare. They could have been a lot less if I got standard lenses. Also I do have a macular condition. I have never been in a Costco and next time I be in NC rual area. No Costco around there

Yes, my wife needs prism due to TIA several years ago. Her last glasses with magnetic sunglasses was about the same price as my two pair because of that.

[GlennWest]

Yes, with all my needs in my lense don't believe I could save a lot somewhere else. But this yearly is costly on retirement. I may get insurance. I would save right much. 

[GlennWest]

I checked several Avantage Plans and none is offered in zip code ,28320, I will be staying in. 

Edited July 20 by GlennWest

[Blues]

On 7/19/2024 at 9:45 AM, GlennWest said:

retired and on Medicare. Medicare doesn't pay much. Went for exam yesterday and getting new lenses. Frames in good shape. Bill was $1176.02. ouch. Medicare paid 200ish.

I'm guessing Medicare for the portion of your bill having to do with your macular problem?  Because traditional Medicare doesn't pay anything toward regular old vision exams (just like it doesn't cover any preventive care).  But it does pay for medical conditions.

Most Advantage plans have vision coverage, but as noted above, there's a limit on the benefit, and I assume you have to stay within a network of providers for the vision benefits.  I don't know how that would coordinate with your eye issues that aren't just normal near-sightedness or whatever. 

 

22 hours ago, GlennWest said:

Been checking on Advantage plans and from where I be staying it would be a 60 ish mile to get to a doctor in their plan. And in that area it is all country miles. 55 mph also. 

2 hours ago, GlennWest said:

I checked several Avantage Plans and none is offered in zip code ,28320, I will be staying in. 

At one point you say the closest doctor (not sure what kind of doctor--eye doc?) would be 60 miles away on an Advantage plan you checked, but then you say there aren't any Advantage plans offered in zip code 28320.  I did a quick check and AARP/UHC, Humana, and Aetna all offer Advantage plans in that zip code. 

As for Costco, I've been to two or three Costco eye doctors.  All of them were optometrists (O.D.--doctor of optometry), not ophthalmologists (M.D. with additional training to specialize in ophthalmology).  If I had actual eyes issues like you, instead of my typical near-sightedness and far-sightednes that can be handled well enough by contact lenses, I wouldn't go to a Costco optometrist, or any optometrist.  I'd stick with ophthalmologists.

And FWIW, optometrists at Costco are independent; I'm guessing they just rent space in the store.  What I can't remember is whether you have to have a Costco membership to get an eye exam from one of their independent optometrists.  I know you have to have a membership to buy glasses in their optical department.  I've had good experiences with buying glasses from them, and they're a lot cheaper than anywhere else.  But I don't know if you would be able to get your particular lenses from them, and even if you could, if the closest one is 80 miles away, I wouldn't bother--that's at least two round trips plus you have to pay a membership fee.

[GlennWest]

There is a good eye doctor in our town, only 2 miles away. But he only do exams. Used him for all my life while I was there. He still practicing too. I checked both Aetna and Humana and site I used stated no plans available. Maybe I should call one. Have to research for closest Costco. Don't ever remember knowing of one until I started traveling.

[GlennWest]

Just checked. Nearest Costco is in Raleigh NC. 3 hour drive one way. 

[lappir]

I've only been on Medicare for a couple years. My first time to the eye Dr. they wanted to submit to Medicare. I had previously just paid for my eye care as I couldn't justify the insurance  costs. It was about a $100 a year for my check up even when I was wearing contacts. 

Fast Forward to this past Friday when I got a message from my eye Dr. that they had tried to send me a bill for what "Medicare" didn't cover. I remarked I'd already paid what the check out person said Medicare wouldn't cover and she agreed I had paid $50, but that was $60 short? I said "When I didn't have insurance, it usually cost me $100 each year." She agreed going back on my account and checking. I said for the future I will decline to use Medicare and pay the money at time of service. 

I've never had anywhere near $1000 in charges for contacts and glasses, but she say's my eyes are still very healthy for my age. 

Rod

[Dutch_12078]

On 7/20/2024 at 5:56 PM, GlennWest said:

I checked several Avantage Plans and none is offered in zip code ,28320, I will be staying in. 

Apparently you didn't check United Healthcare:

https://www.uhc.com/medicare/shop/medicare-advantage-plans.html

[Blues]

4 hours ago, Dutch_12078 said:

Apparently you didn't check United Healthcare:

https://www.uhc.com/medicare/shop/medicare-advantage-plans.html

That's the same as AARP/UHC I mentioned above.

On 7/20/2024 at 8:48 PM, GlennWest said:

I checked both Aetna and Humana and site I used stated no plans available. Maybe I should call one.

I went to all three companies' websites (AARP/UHC, Aetna, and Humana) and entered your zip code of 28320 and all of them offer a variety of Advantage plans. 

But before choosing to switch to an Advantage plan, it's imperative that you understand the difference between traditional Medicare and an Advantage plan, and realize that depending on your health, if you switch to an Advantage plan it's possible you'll never be able to switch back to traditional Medicare because no supplement company will issue you a supplement, and without a supplement, there's no out-of-pocket limit on your financial responsibility for the 20% of Medicare-approved charges that Medicare requires you to pay.

Medicare is incredibly complicated, and the way Advantage plans are marketed doesn't help one bit. 

The simplest approach is to have traditional Medicare and a supplement, but it's also the most expensive approach.  Advantage plans are a lot cheaper and offer extras like vision and dental benefits.  You'd be smart to wonder how they can do that, and if you don't understand how they can do that, then it's not a good idea to choose that to provide your healthcare coverage.

On 7/20/2024 at 8:52 PM, GlennWest said:

Just checked. Nearest Costco is in Raleigh NC. 3 hour drive one way. 

I'm confused.  Upthread you said there was a Costco 80 miles from where you'll be, and now you're saying the closest one is a 3-hour drive one way? 

[DanZemke]

5 hours ago, Blues said:

I went to all three companies' websites (AARP/UHC, Aetna, and Humana) and entered your zip code of 28320 and all of them offer a variety of Advantage plans.

I think Glenn was talking about an eye glasses plan, not a full-fledged health plan switch.  For example:

https://www.forbes.com/advisor/health-insurance/is-vision-insurance-worth-it/

By the way, a Costco membership is $60 a year and is not needed to make an appointment with one of their affiliated optometrists.  But given your distance from the nearest Costco, I wouldn't be shopping at Costco either.

Edited July 22 by DanZemke
clarity

[Kirk W]

6 hours ago, Blues said:

Advantage plans are a lot cheaper and offer extras like vision and dental benefits.  You'd be smart to wonder how they can do that, and if you don't understand how they can do that, then it's not a good idea to choose that to provide your healthcare coverage.

That is a question that I have had for a long time. Can you explain it or do you know anyone who cah?  I haven't checked recently, but our primary care doctor used to not accept Advantage plans.

Edited July 22 by Kirk W

[Dutch_12078]

6 hours ago, Blues said:

...

The simplest approach is to have traditional Medicare and a supplement, but it's also the most expensive approach.  Advantage plans are a lot cheaper and offer extras like vision and dental benefits.  You'd be smart to wonder how they can do that, and if you don't understand how they can do that, then it's not a good idea to choose that to provide your healthcare coverage.

"Medicare Advantage, or Part C, is a health insurance program funded by two different sources: monthly premiums from beneficiaries and the Centers for Medicare & Medicaid Services. This federal agency runs the Medicare program."

"Private insurance companies manage Advantage plans. Medicare pays them a fixed monthly amount for each beneficiary’s expected healthcare costs."

https://www.medicalnewstoday.com/articles/how-is-medicare-advantage-funded

[GlennWest]

8 hours ago, Blues said:

That's the same as AARP/UHC I mentioned above.

I went to all three companies' websites (AARP/UHC, Aetna, and Humana) and entered your zip code of 28320 and all of them offer a variety of Advantage plans. 

But before choosing to switch to an Advantage plan, it's imperative that you understand the difference between traditional Medicare and an Advantage plan, and realize that depending on your health, if you switch to an Advantage plan it's possible you'll never be able to switch back to traditional Medicare because no supplement company will issue you a supplement, and without a supplement, there's no out-of-pocket limit on your financial responsibility for the 20% of Medicare-approved charges that Medicare requires you to pay.

Medicare is incredibly complicated, and the way Advantage plans are marketed doesn't help one bit. 

The simplest approach is to have traditional Medicare and a supplement, but it's also the most expensive approach.  Advantage plans are a lot cheaper and offer extras like vision and dental benefits.  You'd be smart to wonder how they can do that, and if you don't understand how they can do that, then it's not a good idea to choose that to provide your healthcare coverage.

I'm confused.  Upthread you said there was a Costco 80 miles from where you'll be, and now you're saying the closest one is a 3-hour drive one way? 

Well Wilmington is a big coastal area. Usually one can get anything you want there. That the 80 mile trip. I just figured one would be there. I was surprised nearest was Raleigh. 

[GlennWest]

Some of you seem very knowledgeable about this. I currently have standard Medicare and Mutual of Omaha plan N supplement. My wife has plan F and it is good coverage. She pays very little at visits. It has gone up right much also. I was not offered F when I got mine. N was all I was offered. I am very healthy but I realize that won't last till I die. Sooner or later I will need good coverage. Is there any Advantage plan as good as what I have. Vision insurance for just me is about 300 yearly. Add wife and 600 but she has healthy eyes and no history in her family of eye problems. From what I see Advantage plans is less money with different coverage. Can anyone help me with this choice? Sounds like some of you have done the work already.