Brain Trust Question

[clockworktomato]

I have what I think is a Really Dumb Question™ but I can't really find the info for it on the relevant websites and I, uh, can't really make any phone calls to ask about it right now as the walls have ears and I *hate* making personal phone calls while at work

Comments

[catonaleash]

Don't worry about it. They'll (the various offices - Doctor and Lenscrafter) will tell you how it works. They deal with insurance plans all the time and can walk you through the process. Most likely at both places they'll go through the insurance company and then bill you for the rest. Make sure to review your bill to determine if you received your full benefit. However, if Lenscrafter wants you to pay upfront and pursue reimbursement on your own, all you have to do is call your HR department. They'll point you to a form (probably online) - you fill it out and submit it with the receipt. Make sure to get a receipt and to retain a copy of the reimbursement form and receipt for your records.

And here's an unsolicited opinion: I suggest you go to an opthamologist rather than an optometrist. Opthamologists are M.D.s and I just feel that it's better to develop an "eye health" relationship with them in case something more drastic is needed down the line.

[catonaleash]

Just re-read your post, and to actually *answer* your questions (sorry about that) - the reimbursement will be easy but how long it takes them to get you a check totally depends on your company. I'm a state emplyee, so I gather dust before I get reimbursed for anything. Private companies probably go much faster.

[clockworktomato]

Thank you!! This is exactly what I needed and I definitely appreciate the reassurance that "it's okay to not know for sure how it works and they won't think you're a moron for it

[coercedbynutmeg]

For the first part, I agree, you pay the copay, they bill the insurance, and if there's a fuckup they'll be hounding you for the sum for the next seven years. :-)

Honestly, I've never had an insurance where I've had eyeglass or contact lens coverage, I've always had to pay out of pocket for those (and honestly, if you wear contacts most of the time, $120/year is only going to cover about half of the bill. My year's supply was $260, because the technology has changed and lenses cost more).
Have you read that annoying book that comes with the policy to tell you about how exactly to do it?

[clockworktomato]

I never actually did the math on the contacts, but you're right -- a six week supply of what I've been wearing is $30, which would be exactly $260 per year. I'm, um...I'm one of those bad people who wears a pair of contacts for longer than I really should, so I hadn't even considered that this technically isn't enough to cover what I should be getting. I guess the presumption is that you get the contacts *and* the glasses, so you don't have to wear the contacts all the time. I need to look into that a bit more. Thanks!

Have you read that annoying book that comes with the policy to tell you about how exactly to do it?Well, yes and no. The only annoying book I got was the provider list, which didn't include details on filing claims, but I got a lot of other information about the website and how to register an online account and that everything else I would need can be found there. So I've been browsing the website and I found claim forms and there's a section for submitting claims online, so it seems that it might just depend on

[coercedbynutmeg]

These little discs on my eyes have been there since July 20, and you're not supposed to wear them for more than 30 days. Oops. I'll probably change them soon though, since if I paid for a year's supply, I'd better WEAR a year's supply. I'm annoyed though, because my former lenses only cost like $180 for a year's supply, but they don't make them anymore.
I suppose you could just order a six-month supply and stretch them out into a year supply, and that would only cost you $10 out-of-pocket. I did that in college because it was too hard to get into the optom twice a year.

I suppose you could call the Lens Crafters and find out too.

*random comment*

[afb]

*envies the both of you* I stopped wearing contacts because my eyes ate them in record time. My one-month lenses were comfortable for about six days, my two-year-plus lenses (rigid ones) were comfortable for six months -- longer if I got them polished.

[faecat]

If I were to have "regular" health insurance, I would be just as noobish. On the two occasions I've had health insurance, it's been through a co-op type group, where the insurance company is part of the medical center, which has all kinds of specialists, including eye doctors, and its own hospital, so it's always been totally painless.

So to make a long story short, I have no idea how it works, but I empathize with the noob-ness.

[clockworktomato]

Hooray for noobies!

There's a Benefits Person here that I could ordinarily direct these questions to, too, but she's on vacation this week. Pfft.

[faecat]

Curses upon people who take inconvenient vacations!

[fishsupreme]

Unless you have a really obscure insurance company, your doctor will probably know what needs to be done with them. Vision plans are normally very straightforward -- a copay and percentage for the office visit, then a fixed allowance ($100 or $150) for glasses and contacts. If yours cost more than that amount, they just pay that amount and you pay the rest.

Normally, the doctor knows about what insurance will pay and will only charge you for the remainder, knowing that if insurance for some reason pays more or less they can always reimburse or bill you later.