Upgrading medicaid patients

**Mizikal** · 06-29-2013, 10:29 PM

I was just wondering what everyone's thoughts were on upgrading medicaid frames and lenses with medicaid patients. The problem I run into with some is if they upgrade the frame or lens they are not covered and also some just cannot afford paying for it hence the medicaid. I find myself not discussing lens options just because I don't want to waste my breath but is it a disservice to them? Should I not treat them like any other patients? 99 times out of 100 they say no but should things like transition or No-glare coating be discussed for that 1 in 100?Just curious.

**anthonyf1509** · 06-30-2013, 08:06 PM

We don't accept Medicaid, but we get a lot of calls and stop ins. Just ask them upfront. Are you willing to consider some products that would greatly enhance your experience, for more money? Or do you prefer blah blah free free?

**opty4062** · 06-30-2013, 09:36 PM

We don't accept it either in the office where I work now. But years ago I worked in an office in a different state that did. At that time (mid 1990s) adding out of pocket options to medicaid glasses wasn't allowed. Maybe it's a state by state thing, or maybe (I'm wondering now...) it was just something we didn't offer as policy at that office.

**Slim** · 07-01-2013, 09:15 AM

here, you cant do anything.... you get what you get. nothing I can do about it. 4 month wait time too. we do offer a $99 package if they need some before xmas...

**Mizikal** · 07-01-2013, 09:49 AM

Originally Posted by Slim

here, you cant do anything.... you get what you get. nothing I can do about it. 4 month wait time too. we do offer a $99 package if they need some before xmas...

Wow a four month turn around on glasses? Is that a March Vision lab?

**Slim** · 07-01-2013, 10:37 AM

no its a prison that makes them for the whole state.

**mervinek** · 07-01-2013, 11:36 AM

Originally Posted by Slim

4 month wait time too. we do offer a $99 package if they need some before xmas...

sounds like Davis. I had several orders that took 2 months

**Slim** · 07-01-2013, 11:45 AM

lol so true, then its not even the right script too...

**Jubilee** · 07-01-2013, 02:49 PM

The rules vary state to state. In the state of Indiana, they can not upgrade the frame. However, they can upgrade the lenses, and the state will cover the base lens cost, then you can charge them for the upgrades.

Many of the offices I have worked with do upgrade a fair amount of their medicaid patients. Indiana will not cover poly on children as a rule, so we offer them poly for $XX and then they get the impact resistant material, along with a warranty on the glasses. The warranty is a huge selling point. While the state will cover lost/broken glasses, it does reset the benefit and requires documentation. With the materials for adults being covered once every five years.. many are willing to pay a bit more to keep that benefit from being reset.

I think more than anything, many of these patients just want to be treated like any other patient. So offer, and if they decline.. don't take it personally. I always tell them I would rather be told no, than to have them come back thinking we didn't have access or I wasn't willing to offer better products.

**David_Garza** · 07-01-2013, 02:54 PM

This thread could just easily be re titled:

Herding Cats

**cocoisland58** · 07-02-2013, 05:09 AM

In Michigan there are several Medicaid plans and they vary as to allowing upgrades. The most basic plan allows none but the other plans allow both lens and frame upgrades. The problem with the frame upgrades is that they only pay about 20.00 on an upgraded frame. Still some people do buy up. Rarely do they upgrade the lenses.

**NCspecs** · 07-02-2013, 01:33 PM

Originally Posted by David_Garza

This thread could just easily be re titled:

Herding Cats

Hah! Yes, indeed.

When I worked in WI there was a program called Title 19- I guess it was medicaid. MY experience is that people wanted the upgrades but were not allowed. They usually wanted colored contacts or designer frames in lieu of the 12 sad little frames in the plastic tray. Many would get a little belligerent with me that they couldn't "pay extra" to get what they want. I usually just said (nicely, because that's how I was raised) that they were recieving a free pair from the goverment but they could buy as many extra pair as they liked. Yeah....no one ever took me up on that offer....

**mdeimler** · 07-02-2013, 01:48 PM

Originally Posted by NCspecs

Hah! Yes, indeed.

When I worked in WI there was a program called Title 19- I guess it was medicaid. MY experience is that people wanted the upgrades but were not allowed. They usually wanted colored contacts or designer frames in lieu of the 12 sad little frames in the plastic tray. Many would get a little belligerent with me that they couldn't "pay extra" to get what they want. I usually just said (nicely, because that's how I was raised) that they were recieving a free pair from the goverment but they could buy as many extra pair as they liked. Yeah....no one ever took me up on that offer....

yea why is is that those who already receive free handouts have the money for the "upgrades ?"

**Slim** · 07-02-2013, 02:08 PM

and iphones that they text on while walking out to the denali on 24's

**Slim** · 07-02-2013, 02:49 PM

oh and two insurances too... we get a lot of people that come in with VSP AND medicaid... that really grinds my gears... hell i dont even have ins and I work my *** off.