Comments on: Avoiding unnecessary medical procedures that aren’t covered by insurance

By: Karen

Karen — Fri, 15 Oct 2010 00:22:03 +0000

Mickey – If you can convince your insurance company to waive it, I’d love to know how you did it. In my experience, if you call to dispute, the insurance company will likely refer you back to the provider, who will insist that you agreed to the procedure and the charge will stand. If you didn’t consent to the procedure, you might have some luck disputing it. Unfortunately, though, since there’s no governing body to turn to, if the insurance company and doctor’s office won’t reverse the charge, then you’re likely out of luck.

By: MickeyButler

MickeyButler — Thu, 14 Oct 2010 22:23:57 +0000

I recently went for an eye exam to get a new eyeglass prescription. The opthomologist, who was new to me, took a photo of my eye, but didn’t discuss it. I now find it’s only partially covered. My routine exam to get a prescription was billed at $500. Any suggestions as to how to dispute the copay I was asked for which came to $64.00

By: Jill

Jill — Mon, 19 Jan 2009 04:08:40 +0000

I am in agreement on this whole contact lens fitting. It is quite a bit of crap. I too had an eye exam on saturday, and was charged for the fitting, but I wasn’t even given a new pair of lenses to “fit.” Luckily my fitting was less expensive–$30 at Pearle Vision. I think I had the retina scan procedure you’re describing, about a year ago (the photo of the back of your eye basically?). I opted out of it this time because it was pretty pricey.

By: Karen

Karen — Sun, 18 Jan 2009 15:29:17 +0000

Thanks for the advice! I definitely did some research before showing up at the office. That’s how I knew that the exam was covered, but the contacts wouldn’t be.

I don’t plan to buy my contacts at the office, because I can get a better deal at Costco. But Costco isn’t in my insurance network, so I opted to get my exam done with a doctor who was. Unfortunately, I can’t get my prescription without the fitting.

Does Costco charge for a fitting if you get your exam and prescription from them? If not, then I’ll pay the $50 in the future. Even paying for the exam out of network is a better deal than being covered for the exam but paying $63 for the fitting!

By: Funny about Money

Funny about Money — Sun, 18 Jan 2009 03:31:24 +0000

Be aware that some of these people don't know what's covered. It's commonplace for doctors' front office personnel to tell you the practice is in your insurance company's network, when surprise! It's not. I'm still going around and around with one of my now-very-former doctors, whose office, after trying to charge me $80 for a flu shot that my insurance refused to cover, is trying to charge me for an insurance copay even though they lied ... uhm ... were mistaken in saying they were in network. BTW, Kacie's got something. My contact lens provider produces perfectly fine contact lenses when handed a prescription from an optometrist or an ophthamologist. No "fitting" is involved. You can get an eye exam & prescription from Costco for $50. I believe you can order contact lenses online, with a prescription. Funny about Money’s last blog post..Win 6 months of the W. St. J.

By: Andrea

Andrea — Sun, 18 Jan 2009 02:00:34 +0000

I definitely agree that it’s important to be a good consumer of healthcare and to understand what your insurance covers. However, I would add that being a good consumer of healthcare includes being responsible with all of your healthcare choices, even the ones the insurance company is paying for. Just because something is covered, doesn’t mean you should do it if it isn’t necessary. High medical costs incurred by insurance companies ultimately leads to higher premiums and affects us all. Just my two cents.

By: Kacie

Kacie — Sun, 18 Jan 2009 01:43:49 +0000

I think “contact lens fitting” is a total scam. Maybe there’s more to it than they’re letting on, but it really seems like the dr. just asks if they feel ok.