It came to me that most clients are paying multiples (in upgrades) of what the net insurance reimbursement average is.
Q: If this premise is true, then should insurance underwrite eyewear at all?
Q: What other Medical device/service (if you believe eyewear is) follows this model?
Discussion, please.
Barry
Thought provoking.
Realize, firstly, that vision plans are not indemnification plans...they manage no risk. To wit: every dollar paid out by VSP and Eyemed is collected in employer and employee contributions. Vision plans are not really "insurance" in that regard.
Depending on variables (utilization rate, employer contribution, #of family members covered) vision care may not be a good "buy" for an employee/prospective member.
They do, however, get "basic vision care" with these plans, and a pretty darn good deal on upgrades and additional services and materials.
There's no reason that the employer couldn't give that money directly to the employee and let them shop for the best deal.
As to other devices, one needs to look no further than what Medicare covers as durable medical equipment (DME). I can understand an oxygen tank, but basic post-op specs these days seems a good benefit to cut.
Very good response! I've been a big communicator of your ideas to patients in the chair. Changing doctors because they 'didn't take my insurance' always gets me going. I wish employers would just give the employee x-amount of vision benefits directly and then the patient could go anywhere they please to use it.
I love it when a patient comes in and says: "My insurance made me get my contacts there but they don't fit. So would you please adjust them like you always did when I got them here."
Think of it, an insurance company making someone do something?
It's as bad as "My doctor made me by my contacts and glasses from him?
Chip
Welcome aboard Drwells!
:cheers::cheers::cheers:
There are some Unions in our area that do just this for their members. They give a flat dollar amount like $250 as the allowance towards glasses or contacts. Period. End of story. The members get whatever they want off the regular rack and it's easy for everyone. Love that Union :).Originally Posted by drk
We have one around here like that, except its only $150. Its not bad but we could send it in and get reimbursed from United Health Care. They run the "plan" and it was a nightmare the first 6+ months until we billed people the entire amount and let them send in the invoice. How can you mess up a simple plan like that is beyond me.
I always wondered what would happen to other perks of employment like vision and dental if McCain's health plan actually happened. Doesn't look like we'll ever find out.
It is my pet peeve that so many in the industry call it insurance. Its closer to your company prepaying for socks for all their employees. Then when you go in if you want extra cool socks that have nice red stripes you have to pay extra. Otherwise you just get the small socks that aren't real comfortable, but the company paid for those in full. Just about as stupid, except sock sellers aren't dumb enough to discount 50% or more just to have the option to sell socks to their employees. :p
If we try to answer your original question though. Why do they? Safety? I guess its so the company has some reasonable assurances that their employees are fit to work in a factory, or see the computer screen to get their work done.
How many companies have a safety program and use outside labs and how many have in-house safety optical labs? There is a huge corporation near me where they get the prescription from us and go and have their safety glasses made at the office. Lots of people end up just wearing the safety glasses everywhere.
It also has to do with employers not being able to raise incomes at certain times in our history, so these perks were a way to give people incentives to work at a place. Also, they aren't taxed. Which could be an advantage but really is a wash if you take in to account medical health accounts, or health savings accounts that lots of companies offer. This is similar to what McCain wanted to do with taxing health insurances companies offer. The ironic part is it would have actually taxed the wealthy more than the poor, which should have conservatives up in arms and liberals jumping for joy.
Any other reasons for companies to have vision coverage (stop saying insurance:) )?
Here is a question since we are on the subject. Where exactly do unions get their awesome benefits? I had one guy who is an electrician who ended up buying several hundred dollars worth of glasses since his union covered $350-400 dollars of it.
I'm dumb, but that has to come from their dues doesn't it? So essentially the union is taking their money and then telling them they have to spend $400 of it on glasses every year or they loose it. I don't get it. We give no discount and there are no plans to participate in. Weird.
I am currently trying to find more of these guys. :cheers: I'm keeping my mouth shut..
Barry,
This happens in medical insurance as well. One insurance in our area pays $27 for a medical follow-up visit, no matter how complex. The patients have a $20 copay. The insurance company gets off the hook for $7, It almost saves us money not to file the claim, just collect the copay.
The same insurance company takes it one step further. They require two copays (maximum) on a visit where multiple procedures are performed, so the patient would pay $40 on a visit where we did, say, pachymmetry in addition to the visit. Now they only pay about $8. for pachymmetry, and we collected the extra $20 copay from the patient. Guess what? They deduct $12 from our payment for the procedure...for the priviledge of accepting their insurance. Try to explain that one to an elderly glaucoma patient who wants to know why they have to pay 2 copays per visit.
Basically, insurance companies have no conscience. They are in business to make money, I suppose...like the rest of us. Then people lament how healthcare has become such a BUSINESS.
You answered your own question.
They are perks, just like donuts on Fridays, and foosball in the breakroom.
Want to solve the healthcare "crisis"? It's easy. Before you can purchase a cell phone, you must first purchase health insurance (it's cheaper than most cell plans). Or are cell phones "entitlements" too?:hammer:
I had to tell 2 welfare patients to turn off their cell phones yesterday while we were trying to wait on them. One guy was watching a boxing match. :angry: No, he couldn't afford healthcare, so he was at the hospital getting his free flue shot, and decided to get another pr. of glasses on Medicaid, since the Lions Club bought him a pair last month.
Sorry to vent but it's either here, or someone at work's going to hear it...
Ophthalmic Optician, Society to Advance Opticianry
I hear ya Doctor! You are right about the benefit coming from the Union dues. It depends on the Local for the particular Union how they choose to administer the vision care. And it is essentially use it or lose it, but I try to make sure that everyone I know uses theirs. They are sick of me talking shop, I'm sure. The engineers in our area give the flat allowance. My husband is part of the Teamsters and we get ours thru Davis. I've been asking about a flat amount instead of Davis every time their contract comes up, but it also has to do with the health insurance agreement they make and what that company (ours is BCBS for example) offers for va benefits. And you can imagine the bundling and packages they must offer employers. My clients take all the vision plans out there, and some days I feel like I am giving a seminar to patients about their benefits. And just when ya think you have it down, they go and change something! In my opinion, I'm sure most people would rather just have a fixed amount and put it toward whatever they choose to buy, but I guess that would just make everything too easy for everyone and where's the politics in that?! :p. If I know of any allowance members in your area, I'll send them over!
I love this idea. The day just started but it will be the best thing I've heard all day. My office manager will love it.
Part of the problem is that vision plans are usually thrown in as a package, because ignorant human resources staff don't understand how it all works. Some think eye injuries or diseases wouldn't be covered by medical insurance, others think there would be a revolt if they dropped vision. This might be the perfect economy to try and drop something silly like a vision plan, perhaps they would be more willing to accept the notion.
HOWEVER, I think the most important point in all of this is that many times the companies just don't pay much at all for a huge group of people to have a vision plan, especially if they have high copays and they deduct from the patients paycheck. I think we would be shocked to learn what some of these companies really pay per person for their coverage. The providers seem to take the largest discount (as others have said this is used as a selling point).
Orangezero, my new BF!
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Barry
Don't forget about the Air Jordans, the leather jackets, the $1500+ "grill", etc... I am not trying to be ugly, these have all happened in offices I worked in. The best by far was the woman who brought her 6 kids in for Medicaid glasses, all different last names, who was so excited because she got a $7000 income tax refund and used it for 20 inch wheels and tires for her mid 90's Chevy Cavalier. She was telling her friend all about it from her Sidekick in between emails.
BTW, I'm quitting my job today to live off the state. That way, I will have more time to spend on OptiBoard.
A lack of planning on your part DOES NOT constitute an emergency on mine!
I was just thinking about some of the same stuff today. We take BCBS and people say they have "vision" coverage under BCBS. Which of course is Davis - which we don't accept. Of it could be Eyemed also, which we don't accept. "But you guys accept BCBS, so you have to take it"
Then the patient presents a letter saying that their BCBS medical plan "entitles" them to a 40% discount off their eyewear at their BCBS provider, (or Lux outlet of their choice, of course.)
This is not a prepaid vision plan. This is a discount plan only for people covered under BCBS. I think they (the patient and BCBS) actually expect us to honor this.
But actually my prices are discounted 40% from the LC price - everday. So I guess that's just our U&C.
This really gets to me about BCBS also! And here in NC I just started to notice this about 2 years ago. Nothing on the card tells you the vision is thru Davis or Eyemed. Here we have to take 30% off glasses, which is rediculus and absurd. Also, I haven't seen any fee increases in ten years from these guys (BCBS- I don't take these others). They pay a lousy $96 max for 92004 (new) and $70 for established eye exams WITH refraction. How long can we keep taking this abuse, while the executive make huge salaries?
As long as health insurance in its present form still exists. By the looks of it, it'll be a while. I don't see anyone in Washington having the balls to do anything about it.
Gentle reminder: Uh, excuse me doctor, but you signed up for the abuse when you agreed to take the plan. Without you, the executive making the huge salary ceases to exist...
There's no law saying you have to accept insurance.:o
Ophthalmic Optician, Society to Advance Opticianry
Amen, John...but I agree with Orangezero, let's call it vision coverage, not insurance. Insurance is too *medical* a term!
Barry
Call it "insureance" as it seems to restrict it's benfits to medical and optometric physicians.
Otherwise us independents would be eligable.
Or we could be honest (a off the wall concept I know) and call it a marketing scheme.
Chip
There is a difference between insurance, managed care, and discount plans.
Suspect the main difference is what benefits you the most.
Everyone benefits and loses.
They're just never called what they are. No one comes in sayign they have a MVC plan or they have a discount plan, thy always say insurance and 90% or better are under the impression that the company pays the difference between U and C and what they get charged.
Most of the plans aren't bad if you know how to bill correctly and you know how to purchase correctly, the problem is most offices want to sell an Eyemed patient a Physio 360 with crizal avance in 1.74 because the patient deserves the best. I wish some of these offices owned car dealerships because I deserve a nice Porsche or something more hign end than a saturn. :shiner:
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