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Thread: Insurance

  1. #1
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    Insurance

    Hello Optiboarders,

    In India there is no insurance for eyewear. The customer needs to pay for it themselves. Of course there are some corporates that reimburse their employees on a yearly basis for purchase of eye wear.

    How does insurance work in your country?
    Do you think it increases or harms your business?
    Was it forced upon by some Government law or did the Optician want for it to be implemented?
    Does the customer have to pay a premium( meaning a yearly/monthly charge) to the insurance company?
    Is it only available in the USA?

    I'm just asking to understand how this works.

    Benny

  2. #2
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    There are many points of view on this question. Some embrace optical insurance, some despise it. I am somewhere in the middle.

    On the positive side, optical insurance drives consumer demand...to some degree. It can increase your practice volume.

    On the negative:
    1. They make you work harder for less money.
    2. They force you to give discounts on uncovered services and materials.
    3. They force you to use their materials and labs.
    4. Some plans have opened their own retail locations which undercut your business.
    5. Some plans are so vertically integrated that they control manufacturing, wholesale distribution, retail distribution, laboratory services and "insurance/benefits" marketing. In the US, we call this a monopoly.

    It was not forced by government, it developed from entrepreneurship or greed....depending on your point of view. Capitalism at it's best, I guess. It is largely an American phenomenon.

    Most optical plans are provided by employers as part of a benefits package. Lately though, some optical plans are trying to sell their plans directly to consumers.
    Many optical plans are not insurance at all, but simply a discount plan.

  3. #3
    O.D. Almost Retired
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    On those points:

    1. They don't MAKE you work harder for less money. They send additional patients your way which if your staff cannot handle you should hire more or get more efficient. Additional revenue from these additional patients are always additional to your bottom line, unless your fees are too low relative to your costs.

    2. True, but usually 20-30%, which is very tolerable for most, again, unless the pricing is too low to start with. If they are, then they are working too hard to make a living already.

    3. Some plans do, some don't

    4. True, but so far few and far between. One opened up 4 miles from my office about a week ago. I've never been busier.

    5. Partly true, but since participation is voluntary by both patients and providers, it's hardly as evil as it sounds.

    I agree that the optical industry worldwide is driven largely by profit motives, and capitalism pretty much reigns here in the USA and around the world.

  4. #4
    Compulsive Truthteller OptiBoard Gold Supporter Uncle Fester's Avatar
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    Quote Originally Posted by beejay View Post
    Hello Optiboarders,

    In India there is no insurance for eye wear. It is not really insurance. It is "managed care". The customer needs to pay for it themselves. Of course there are some corporates that reimburse their employees on a yearly basis for purchase of eye wear. The patient still pays for it but the insurance company takes a piece of the pie for putting you on their panel of recommended doctors and sends exams your way.

    How does insurance work in your country? You increase all your prices so you can discount them for the "insurance".
    Do you think it increases or harms your business? It adds a layer of paperwork and makes you less independent as you now have to answer to the insurance.
    Was it forced upon by some Government law or did the Optician want for it to be implemented? Corporations saw a way to increase profits and dividends.
    Does the customer have to pay a premium( meaning a yearly/monthly charge) to the insurance company? Maybe. There are hundreds if not thousands of plans that are offered. Some business' pay it as a benefit to their employees.
    Is it only available in the USA? Mostly USA and Canada.

    I'm just asking to understand how this works.

    Benny
    Insurance companies selling eye wear benefits will complicate the way you were used to doing business.
    Last edited by Uncle Fester; 11-20-2015 at 12:38 PM.

  5. #5
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    Thanks for the inputs.

  6. #6
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    Quote Originally Posted by Uncle Fester View Post
    Insurance companies selling eye wear benefits will complicate the way you were used to doing business.
    That is true, especially if Indian providers are not using computers much in their offices. I would be surprised if that were true, given how much computer savvy people come from India. But if they are going to the stock room, pulling lenses, finishing them while the patient waits... Yes, it would add a whole other process (CLAIMS) to their world, unless the Insurance provider keeps it very simple. If on the other hand, providers are already thoroughly computerized, including EHRs (electronic health records), it should be easy for them.

  7. #7
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    Bumping up an old thread.

    Can someone point me to the largest insurance company for eye wear plans in America? Thanks in advance.

    Benny

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    Quote Originally Posted by beejay View Post
    Bumping up an old thread.

    Can someone point me to the largest insurance company for eye wear plans in America? Thanks in advance.

    Benny
    The largest PROVIDER of eye wear plans in the US is probably VSP. A close second would be EyeMed. There are a lot of INSURANCE COMPANIES that sell plans from both of those providers, and I don't know which one of those would be the largest.

  9. #9
    Compulsive Truthteller OptiBoard Gold Supporter Uncle Fester's Avatar
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    I'd have said Medicare followed by Dept of Defense, followed by Federal (Gov't employees') Insurance.
    Medicare provides one pair of basic glasses after cataract surgery.
    DOD provides military eye wear of course. Maybe someone close to a base can explain dress eye wear benefits. If It's like private insurance there are many, many options.

    Dr. Stacey has the private providers.

    Now why do you really want to know how it works beejay?

  10. #10
    OptiBoard Professional
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    Thanks for the input Dr. Stacy and Uncle Fester...

    I just want to know more about this as its new to me..

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