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Old 01-28-2016, 09:49 AM
 
210 posts, read 150,873 times
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Quote:
Originally Posted by Scooby Snacks View Post
Incorrect. I have worked in ophthalmology for over a decade. Medicare does indeed pay for new glasses following cataract surgery as well as the IOLs (intraocular lenses, the implants which replace your old cloudy ones). Medicare pays for a basic glasses frame, a single vision, lined bifocal, or lined trifocal lens. If you want a progressive lens or any special coatings, you have to pay extra, but they still pay some on your progressive lens. That is the only time Medicare will pay for glasses. The rest of the time Medicare does not consider glasses medically necessary. I won't even go into how silly I think it is that Medicare doesn't consider prescription glasses medically necessary. They are called PRESCRIPTION for a reason
If you neglect to fill the prescription in a timely fashion, do you still qualify for your Medicare paid pair of glasses/bifocals?
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Old 01-28-2016, 12:16 PM
 
Location: VT; previously MD & NJ
2,202 posts, read 1,345,129 times
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Quote:
Originally Posted by AnnaLee2 View Post
If you neglect to fill the prescription in a timely fashion, do you still qualify for your Medicare paid pair of glasses/bifocals?
You should probably call Medicare on that. Some years back I had a health care provider try to collect the full amount of a bill for my mom. I kept telling them she had Medicare and Medigap. Conversation finally got around to the provider admitting she hadn't sent in the claim soon enough to Medicare so they wouldn't pay, and if Medicare doesn't pay then neither does Medigap. I think the do have time limits. Best to check first.
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Old 01-28-2016, 02:28 PM
 
Location: SW Florida
9,753 posts, read 7,033,290 times
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Quote:
Originally Posted by Vasily View Post
Interesting, I didn't realize this either. From a site on eye care: "The main difference between the two eye-related careers is that an ophthalmologist can handle surgeries and other issues that require more training on the medical side."

Ophthalmologist vs Optometrist - Knowing The Difference

It also sounds like what optometrists can do may vary from state to state.
That's a good article, thanks for sharing it. I'd suppose the scope of the duties included in an optometrist's license would vary from state to state, but here in Florida seems these days many optometrists are providing the primary eye care and medical treatment of eye diseases. They refer to opthalmologists when a patient needs surgery or a lazer type procedure.
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Old 01-28-2016, 03:19 PM
 
Location: Gulf Coast
1,159 posts, read 649,503 times
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Quote:
Originally Posted by jrkliny View Post
Don't hold off. You will appreciate being able to see well.
I know you're right. I don't drive at night any more if I can help it. And I'm also putting on brighter lights inside the house. Dr. told me to judge when to get them off by how good I can see and how annoying it is this way. I'm getting close!
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Old 01-28-2016, 03:46 PM
 
Location: Ponte Vedra Beach FL
14,628 posts, read 17,927,825 times
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Quote:
Originally Posted by jrkliny View Post
I was quoted an additional out of pocket cost of $1500 for each multifocus IOL. Turns out I did not qualify medically because of a previous eye issue. I had the standard fixed IOL implants. That means I have no near vision and need glasses for reading and using a computer or cellphone or camera, etc. In theory implants should be able to correct distant vision so glasses are not needed. I found that claim to be an exaggeration. I found I could substantially improve my distant vision with glasses. I do not need them for driving but they help bring me from about 20:30 to close to 20:20.

So I am back to wearing glasses fulltime. I have bifocals for routine use. I also need separate glasses for using the computer. The reading portion of my bifocals focuses at a distance for reading and not for use of the computer. It also turns out that my glasses cost a small fortune. I tried inexpensive Costco glasses. I replaced the lenses on warranty due to cracking. When they cracked again, I gave up. Even though the glasses had coatings, the glare was horrible. I could barely drive at night due to all of the lens flare. Some of that is due to the implants themselves but that makes additional glare even more dangerous. I solved the problem with Crizal coatings at about double the cost of premium glasses. The costs are not covered by Medicare.
The cost you were quoted for IOLs sounds about to me what my father paid. I am not sure what will be available for us when my husband and I get cataract surgery (we're getting there - living in the Florida sun for a lot of decades doesn't seem to help when it comes to cataracts). If all it means for me is trading my regular glasses (can't see 10 feet in front of me) for reading glasses (which I don't need now) - think I'll pass.

I have used progressive trifocals for years (the only time I ever take my glasses off from when I wake up to when I go to sleep is when I'm snuggled up with my Kindle - or my husband - a foot away from my nose). My husband has very different progressive trifocals. He loves the coatings on his. My astigmatism/other eye issues are so bad that I have to use my lenses relatively plain - without various coatings that screw them up (for me). Since I wear glasses basically all day - I like Silhouette frames - because they're super duper light. My glasses cost about $650/pair - even with things like AARP or similar discounts. Medicare doesn't cover any of it (neither did our health insurance pre-Medicare).

One thing I don't like about the Costco glasses (never bought any there) is they basically make your glasses from the frames that are there for everyone to try on. They're not "samples". I don't want to pay $20 - much less hundreds of dollars - on a frame that hundreds or thousands of people have been handling/trying on. Also - Costco doesn't handle Silhouette frames. I am in general a big fan of Costco. But not when it comes to glasses.

I really wish my Rx for glasses was easier. I would like to use glasses as a "fashion statement". But - since I'm so hard to fit - and - when I need a new Rx - it often takes me a week or more to get used to it - I like to get a pair that works - and use it as long as possible. Robyn
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Old 01-28-2016, 03:52 PM
 
Location: Ponte Vedra Beach FL
14,628 posts, read 17,927,825 times
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Quote:
Originally Posted by AnnaLee2 View Post
If you neglect to fill the prescription in a timely fashion, do you still qualify for your Medicare paid pair of glasses/bifocals?
Medicare in general doesn't pay anything for glasses at all. Only in a few cases - like when it comes to cataract surgery. Robyn
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Old 01-28-2016, 04:13 PM
 
Location: Ponte Vedra Beach FL
14,628 posts, read 17,927,825 times
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Quote:
Originally Posted by Travelassie View Post
I was surprised when I discovered that diagnosis and treatment of diseases was within the scope of optometrists' license, although not all of them do this...
I don't know about treatment when it comes to optometrists - especially surgical treatment - but we have been extremely happy with a local optometrist who has done our eye screening stuff for well over a decade now. Even though my husband has MS and has had optic neuritis in the past. We have a lot of faith in our optometrist to monitor our eyes - and to tell us when we need an opthalmologist for something like cataracts. If we think he's wrong about something - just in terms of what we're experiencing (hasn't happened yet) - we can set up an appointment with an opthalmologist on our own.

Our optometrist doesn't deal with Medicare. But Medicare doesn't pay for routine eye screenings/refractions. I know there are eye docs who cheat on the Medicare rules - especially in south Florida - where we used to live. But I'm honestly not interested in doctors like that. We pay about $100/year each for routine eye screenings/refractions. Out of pocket. Robyn
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Old 01-29-2016, 06:06 AM
 
Location: SW Florida
9,753 posts, read 7,033,290 times
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Quote:
Originally Posted by Robyn55 View Post
I don't know about treatment when it comes to optometrists - especially surgical treatment - but we have been extremely happy with a local optometrist who has done our eye screening stuff for well over a decade now. Even though my husband has MS and has had optic neuritis in the past. We have a lot of faith in our optometrist to monitor our eyes - and to tell us when we need an opthalmologist for something like cataracts. If we think he's wrong about something - just in terms of what we're experiencing (hasn't happened yet) - we can set up an appointment with an opthalmologist on our own.

Our optometrist doesn't deal with Medicare. But Medicare doesn't pay for routine eye screenings/refractions. I know there are eye docs who cheat on the Medicare rules - especially in south Florida - where we used to live. But I'm honestly not interested in doctors like that. We pay about $100/year each for routine eye screenings/refractions. Out of pocket. Robyn
As I understand it surgery is not within the scope of an optometrist's license, medical treatment seems to be. I have glaucoma, and I see an optomotrist several times a year, she prescribes the eyedrops I use, orders and interprets the tests they do to follow the course of this condition. She's in a group practice with several opthalmologists, though, and I see she will consult with them and refer her patients to them as needed. I had a bout of uveitis a couple years ago that she also diagnosed, and treated. I'm having a couple issues now, that I'm sure will be referred to the opthalmologist I sometimes see there.

She does deal with Medicare and our secondary insurance, her name appears as the practitioner on the explanation of benefit forms we get for the times I see her. Since she also prescribes the medication I take for glaucoma ( and the uveitis I had), her name also shows on the prescription information. No using an opthalmologists name there.
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Old 01-29-2016, 07:27 AM
 
210 posts, read 150,873 times
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Quote:
Originally Posted by Robyn55 View Post
Medicare in general doesn't pay anything for glasses at all. Only in a few cases - like when it comes to cataract surgery. Robyn
Yes, following cataract surgery was under discussion in the post I quoted before my question. I had cataract surgery on one eye about six months ago and never filled the prescription.
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