Advice for Eyemed Pediatric Plan Frames

[camaeco]

Hello, our office has been seeing a lot more Eyemed Pediatric Plans with the $0.00 patient co-pay benefit. We are struggling to figure out what frame brands would work best for these plans and count as the covered frame. All of Eyemeds articles about the guidelines for frame choices are so vague it's painful It's proving especially difficult for the kids who are in their teens and don't fit in "kids" frames. Does anyone have any brand suggestions for frames that would be fully covered?

[jpways]

I'm listing the Infocus article that Eyemed gave me regarding costs to avoid listing actual prices.

So, first the definition of "allowable stock", as it was explained to be by someone in Eyemed, it must be qualify in regard to "Inventory requirements for Pediatric Vision Benefits", which gives you minimum stock requirements and acquisition cost requirements. But, under the price found in the "Pediatric Vision Benefits fee schedule", which lists reimbursements. So, under a literal reading of the rules (not confusing acquisition cost with book price) lines that we use would include: Modern Optical's Red, Yellow, and Black price group frames; Windsor Eyewear's Eyecroxx and Italia Mia; and anything from I-Deal Optics that is not the Casino Budget line.

A thing to keep in mind is that the rules only state a minimum stock requirement and that you have to have a group of frames (that include the minimum stock requirement at each size) that you can show any qualifying patient that would be covered in full. We just take that to mean, as long as we were to show an auditor from Eyemed (which thankfully we have never had an in person Eyemend audit) that we include all the frames between the minimum cost requirement and the reimbursement we're fine, that the frames are over 2 (or sometimes 3) sections of our boards (even if it's 80 or more frames) is a moot point.

[drstewart74]

Try I-Deal optics. Cute, inexpensive small frames

[Optipop]

Armani Exchange is a low cost option and not a bad frame, good for teens

[AngeHamm]

It's an exceptionally frustrating plan, because the lens options supplied are all excellent, and the frame options covered are sub-average, with no option for the patient to upgrade frames.

[Optipop]

It's an exceptionally frustrating plan, because the lens options supplied are all excellent, and the frame options covered are sub-average, with no option for the patient to upgrade frames.

Tell me about it!

[Quince]

Try I-Deal optics. Cute, inexpensive small frames

+1

There are plenty of youth sizes as well.