Medicare post-op cataract surgery eyeglasses

**Specs** · 10-15-2014, 08:55 PM

This a huge rip-off to the U.S. taxpayer. All of these patients have had Rx changes most of their adult lives. Like everybody else, they pay without government paying for their eyeglasses regardless of income or need. Except Medicaid and there is a financial thresh hold to be met. Now they get Cataract surgery, which results in another Rx change, and usually and hopefully for the better. Still just an Rx change. Why should all of the taxpayers pay for the eyeglasses. The procedure itself is understandable, medical need. The eyeglasses no different than their usual changes. When somebody needs obesity surgery, it very well be medically necessary, but Medicare does not pay for their new clothes because they lost weight. Sorry to those that are Medicare providers, but really? You are just helping increase U.S. debt legally for profit. Just saying as a taxpayer who is tired of the government waste. I'm a Board Certified, Licensed Optician in FL., so I do understand the ramifications of what I say, but it makes sense. These people will still get new lenses, just not at taxpayer expense. THIS SHOULD NOT BE FUNDED.

**wileyguy** · 10-16-2014, 12:57 AM

Medicare only pays for basic frame and lenses.Anything beyond that is at their own expense.Each recipient is entitled to 1 pair per cataract surgery.That's 2 pair lifetime.Many of them are on fixed incomes and last I heard,cataracts are kinda hard to avoid as you get older.
I'm ok paying for that.I'm not ok paying for a new wardrobe for someone that voluntarily ate a shopping cart or 2 too many twinkies.:)

**Specs** · 10-16-2014, 06:43 AM

Aren't most people in this country living on a fixed income. I don't care if its 80% or $50. I don't believe we should pay it.

**becc971** · 10-16-2014, 07:06 AM

really? huge rip off?

really?

**mervinek** · 10-16-2014, 07:25 AM

Just yesterday I had a patient yell at me because that is all that medicare covers. She was ticked off that it wasn't covered in full. You can never make them happy. I wonder what will happen when I'm in need of surgery and Medicare is no more.

**Barry Santini** · 10-16-2014, 08:42 AM

Originally Posted by wileyguy

Medicare only pays for basic frame and lenses.Anything beyond that is at their own expense.Each recipient is entitled to 1 pair per cataract surgery.That's 2 pair lifetime.Many of them are on fixed incomes and last I heard,cataracts are kinda hard to avoid as you get older.
I'm ok paying for that.I'm not ok paying for a new wardrobe for someone that voluntarily ate a shopping cart or 2 too many twinkies.:)

Costco retail is WAY cheaper than medicare's reimbursement. Let them get it at costco. or zenni.

B

**chaoticneutral** · 10-16-2014, 09:19 AM

Thoes are strong feelings Specs. You are absolutely entitled to feel that way. There are lots of government funded programs that should not be available. I lived in Florida for 10 years and if you’ve ever driven through Lake Worth you’ll see what im talking about.

There are 6 of different kinds of poverty. Situational, Generational, Absolute, Relative, Urban and Rural. Suffering from any type of poverty is terrible. I’ve been on the wrong side of the tracks myself. There are people who abuse the system and there are those who use it to get back on their feet in times of trouble. That’s what the program is all about – helping people. We are fortunate to live in a country where that’s available. I don’t need to remind you there are lots of places where basic needs and services are completely unavailable to those that need it.

In this particular case, after cataract surgery, Medicare will cover a portion of the patient’s glasses. If they need a frame, single vision or a lined bifocal, those services will be covered to help them see. Most of the people receiving those benefits are elderly and are truly on a fixed income. This is no excuse. They have worked and payed taxes. A strong word like “entitled” to this benefit is correct for people who, all their lives, contributed to the pot.

Sadly, my generation will be unable to collect social security and Medicare. There may not be a system left for me to apply to when I reach the age of retirement. I will most likely work until I die here at this desk. I feel bad for the patient im working with, my boss who will have to fill out the paper work, the hazmat team that has to clean me up and my wife who will not collect life insurance because we couldn’t afford it. My burial will cremation and a royal 21 flush salute down the toilet. Alas, we hardly knew ye.

If you are going to be mad, perhaps you might direct your energy to something worth being mad at. You could rail at the government amending the use of taxpayer money for transgender operations, the Ebola outbreak or the $385,000 used to study duck schlongs. It’s good to feel passionately about an issue and I hope you find a worthy cause to cavalier.

Thanks for listening.

**Jubilee** · 10-16-2014, 09:22 AM

The practice of paying for post op glasses started before the IOL became common practice. I am not sure how long you have been in the business, but the glasses were medically necessary due to the need for special lenses for aphakia. Powers in the upper teens to 20+ was no uncommon due to the lack of the crystalline lens.

Granted we have come a long way in being able to correct distance vision in the IOL. The thing to keep in mind if you are a DME provider is they only cover a base frame and lens. You can have the patient sign an ABN, and have them pay for the "deluxe" features of both lens and frame. If you accept any VCP, you can are already familiar with discounting etc. I am sure when we start to really streamline medicare, that this now unnecessary service will be dropped.

**optical24/7** · 10-16-2014, 10:17 AM

"Huge rip-off"? Huge? I'm with becc and cha on this one. There are a lot larger rip-off's of our government's (our) money. If it makes you feel better, I don't file for any of my patients post-op glasses, I absorb the discount I give with no filing.

**Specs** · 10-16-2014, 11:32 AM

Of course there are much larger wastes in government. I want those wastes addressed too. That doesn't make the less expensive wastes ok. I know if you steal a Twinkie from the convenience store. You can get arrested and charged. The thief can't say
"hey I didn't steal a car". That won't fly.

**Robert Martellaro** · 10-16-2014, 11:42 AM

Who needs eyeglasses after cat surgery? The docs have given you the miracle of sight. At the most, unless you're some kind of freaky, hyper-sensitive outlier, all you'll need is OTC readers.

On a more serious note, besides eyeglasses and eye exams, Medicare doesn't cover dental care, dentures, hearing exams, hearing aids, and foot care.

**TEdFitz** · 10-16-2014, 12:59 PM

Way off topic, but no taxes on Hearing Aids in South Carolina. I guess the thinking is along the lines of 'medical device' and not 'fashion statement that just so happens to have eye medicine in it'

**TEdFitz** · 10-16-2014, 01:01 PM

...or 'ear medicine' maybe

**becc971** · 10-16-2014, 01:24 PM

I don't think allowing glasses after surgery is a big enough expense to get upset over. and some of them NEED it. I think it would be nice if the doctor would use their discretion more because a lot of them are certainly not "medically necessary", and they could TELL the patient that instead of going for the cash ... much like the people who know they don't need them, know they can use OTC readers, and still get glasses "because they're free so why not" ...

Part of the issue with medicare and Medicaid is we aren't helping the people who need it. get upset over the crack heads who get avastin shots for nothing because they've done so many drugs they've ruined their eyes. not the 65+ seniors who want some CR-39 lined bi-focals. We should be helping our elder population. hell when i'm 80 I sincerely hope the gov't/the people/my family would help look out for me so I wouldn't HAVE to work anymore. let the old people be man, be more concerned about the 22 year old free loaders who CAN work and choose not to because its easier to get free money and free insurance and free glasses.

plus its so hard to get reimbursement from medicare your tax dollars probably aren't getting allocated to that

**Robert Martellaro** · 10-16-2014, 02:06 PM

Originally Posted by becc971

get upset over the crack heads who get avastin shots for nothing because they've done so many drugs they've ruined their eyes.

Ironically, cocaine was used as a topical anesthetic in eye and nasal surgery.

http://books.google.com/books?id=_Du...urgery&f=false

If you really want to be hard-nosed about drug addiction, round 'em all up and have them ride prison generators.

Or, if just the fact that drug addicts exist at all is too much of a social burden, one could, after a full charge, wire them up to the E-chair for one last ride.

Alternatively, I'm working on a special eyeglass lens filter that will block the images given off by the poor and/or illicit drug users. I think I'll call it OutaSight.

**ioptical72** · 10-16-2014, 02:21 PM

I understand and respect Specs point. However, if we have to debate the relevance of Medicare paying for post op cataract glasses, shouldn't we get into the debate of Medicaid providing glasses for kids? Do you know how many times the parents of the Medicaid child doesn't bat an eyelash over paying the difference of a designer frame versus the more economical frame that Medicaid will pay for? And as they talk to their friend on their smart phone and leave in their brand spanking new vehicle I do have a little resentment brewing. Be grateful for what is provided for you FREE and quit belly aching that your child has to wear generic frames with basic lenses and she/he can't have the designer frame with all the works just because.

**Uncle Fester** · 10-16-2014, 02:37 PM

Here's why it became a benefit.

Originally Posted by Jubilee

The practice of paying for post op glasses started before the IOL became common practice. I am not sure how long you have been in the business, but the glasses were medically necessary due to the need for special lenses for aphakia. Powers in the upper teens to 20+ was not uncommon due to the lack of the crystalline lens.

Demand your local congressman remove it and watch them try to suppress their laughter.

Bottom line- Seniors vote and any politician who tries to change a seniors benefits risks touching the 3rd rail of elected office. It's why congress keeps kicking the can down the road to meaningful reform to prolong entitlements for the future. Maybe we won't get what our parents and grandparents are now getting but still more like 80% of it and it will be sustainable if we change things now.

Everyone knows life in the good old USA was so much better a hundred years ago and as I've said before it's the 19th amendments fault pure and simple.

Skim this lengthy article to see the overall big problem and note the last paragraphs possible solutions to see why a politician won't do it.

http://kff.org/medicare/fact-sheet/m...ng-fact-sheet/