refraction fee .. say what??

[Karl_K]

So yesterday I went in for a diabetic eye exam.
They told me there was a $30 refraction fee which they said insurance does not cover??
My insurance covers yearly eye exams and glasses every 2 years and I have never ran into this before.
Does that sound legit?
The good news is other than being light $30 and having a migraine yesterday and today from the dilation there is no signs of diabetic eye damage but they wanted to run another test because one eye is a lot worse than the other.
Is this fee legit? I'm thinking of calling my insurance company tomorrow and asking them.

 

[Ibrakeforpossums]

Call, raise a stink, hang their people on the phone. These godless m.f.s come up with something new every week.

 

[pearlsngems]

Well... we're on original Medicare, and it does not pay for refraction (or eyeglasses). I wish it did! DH and I have to pay $55 each for refraction.
So it doesn't really surprise me if your insurance doesn't cover refraction.

 

[PinkAndBlueBling]

Mine was $39 a few weeks ago. Such BS.

 

[missy]

Probably it is legit. The insurance companies have cut payment to many (all?) healthcare professionals. And the reimbursement fees are ridiculous. Blame the health insurance companies and I would not be surprised, if at some time in the (near) future skilled doctors will stop taking any form of insurance. Many of my doctors do not any longer. I mean think about it. You go to school for so many years after college to be beaten down by the health insurance companies who refuse to reimburse parts of your exam? It's ludicrous.


@Karl_K good news about not having any bleeding in the back of your eyes! Focus (haha get the pun) on that.

 

[marymm]

From what I understand, even if your vision insurance doesn't cover it, if you have diabetes your medical insurance may cover it

 

[PinkAndBlueBling]

From what I understand, even if your vision insurance doesn't cover it, if you have diabetes your medical insurance may cover it

I have an eye medical condition that is covered by my medical insurance when I visit the eye doctor. I also have vision coverage. It was a complete pain to find a provider who took both my medical and vision coverage, and even then some didn't understand how it all worked. I've had several arguments with billing departments over them telling me (incorrectly) what my coverage is. When you find a good provider who not only accepts both insurance types, but understands how they work, keep them!

 

[Arcadian]

Thats very odd. My insurance (which is straight up for sh*t) covers this! It won't cover glasses but it will cover that test!

 

[PinkAndBlueBling]

@Karl_K I just received the EOB from the insurance for my eye doctor visit. The fee I paid was part of my deductible. So they did cover it, I just haven't been sick enough this year for them to pay it....

 

[bright&shiny]

I work for an OD. It’s true - refractions are almost always an out of pocket expense now. Most medical insurance companies stopped covering refractions years ago, even with annual visit coverage. Some of United’s plans cover it, but we see fewer and fewer paid. A few contracts (plans) don’t allow a charge to the patients, but most do allow the patient to be charged. Medicare has never covered refractions and does allow for a patient charge.

Vision plans (like VSP or Eyemed) typically offer coverage for refractions (after all, they own the insurance company, the frame manufacturers and lens manufacturers, so they want you to buy glasses). Vision care plans typically can’t be used for medical exams (diabetic, glaucoma, macular, etc) and require a separate visit.

If you have a medical exam, the insurance never covers refraction. They consider it not relevant. Crazy, frustrating, but true.

The insurance companies expect you to have separate visits related to health (medical) conditions and well (vision) exams. They dictate so much of our care….