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Thread: Help! Healthnet Medicare Advantage not paying on post op glasses OREGON

  1. #1
    Paper Shuffler GOS_Queen's Avatar
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    Redhot Jumper Help! Healthnet Medicare Advantage not paying on post op glasses OREGON

    Apparently in 2018 Healthnet Medicare Advantage merged with Centene. The payor ID and claims address updated as well as subscriber #'s.

    I have had only 2 claims for post op glasses pay in the last 12 months - I keep getting the run around and am getting no where!!!

    Is anyone else in Oregon having these issues?
    "I just love the smell of Optidirt in the morning.

    Smells like------Victory." -- Uncle Fester :p


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    Manuf. Lens Surface Treatments OptiBoard Gold Supporter
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    Redhot Jumper Vision plans offer a line of coverage you can depend on..............................





    Learn more about which Supplemental Coverage works with your plan.

    Contact an agent for details.

    Vision plans offer a line of coverage you can depend on. Coverage includes a provider network of optometrists, ophthalmologists and opticians. And for those with busy schedules, you can even get glasses in about an hour at the nation's leading optical retailer, LensCrafters*.


    source:

    https://www.healthnet.com/portal/shopping/content/iwc/shopping/groups/small/supplemental_coverage/index.action
    Chris Ryser
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    DLO. NA.IC.I.T.PO

    http://optochemicals.com............................. http://arcoatings.com

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    Thanks for sharing such a piece of useful information. Your this kind of Medicare services are more beneficial for us.

  4. #4
    What's up? drk's Avatar
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    In general, nobody anywhere gets Medicare (and I presume private "Medicare") to pay for post-op glasses.

    Nobody I know even bothers.

  5. #5
    My Brain Hurts jpways's Avatar
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    Quote Originally Posted by drk View Post
    In general, nobody anywhere gets Medicare (and I presume private "Medicare") to pay for post-op glasses.

    Nobody I know even bothers.
    I get it paid all the time (I just received 2 payments today, one for a PA resident and one for an OH resident). The additional application and application fee are annoying and having to carry the DME bond generally turns people off, but it's possible.
    Now I will say from my experience in dealing with Medicare Advantage plans (the ones I have gotten payment from are Highmark MA, UPMC MA, Advantra, Aetna Medicare, and AARP MA) the rules differ from plan to plan as to what extras (if any) they pay for but in general they pay for frame and base lenses. Every once in awhile I get a request to prove medical necessity, which stops after I send in the information (which I really should make a packet of the info I send in). Now as for why this particular MA plan does not pay for post cataract eyeglasses I cannot comment on because I have no experience dealing with either of those companies. All I can say is that if I don't have the proper information in boxes 17, 17b, and 19, every insurance company refuses to pay the claim.

  6. #6
    What's up? drk's Avatar
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    Good job.

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