Went to eye doctor a couple of weeks back. Brought in a pair of frames purchased for me as a gift for Christmas.
My Blue Plus plan offers free eye exams, frames, and lenses. Nothing in the plan forbids bringing your own frames, however, I was lied to and told I could not choose covered lenses, a lense that would value in at 40 USD as paid for by insurance.
Instead I was told that in order to fit my frames, I would need polycarbonate, not plastic material. The lens they sold me comes with UV coating and scratch protection. These coatings are specifically NOT covered services. I was told that I could not select the 40 USD uncoated lenses that my insurance would pay for.
My total cost for the lenses came to 220 USD, I had only came prepared to pay 60 USD for an extra scratch protection coating on top of the covered services. I paid 70 of the 220 that day, after I was told they could not bill Blue Plus for the lenses.
Something didn’t seem right, so when I got home I started reading my insurance member manual, again. Nothing even hinted at this supposed caveat that I choose “state-covered” to be eligible for the “covered” lenses.
I called Blue Plus and their reps couldn’t see anything preventing a claim to be filed for then lenses and told me to ask the vision center to run it and at least let them deny it so I could appeal the decision. The vision center tells me they use a different lab for “non-medicaid” lenses and therefore they cannot bill my insurance…
I called my Medical Assistance worker, they told me that I was covered by my plan.
I reached out to my vision center. They told me I was responsible for the payments and that I had agreed to pay them in full before I received my already owned frames back. I told them about my correspondence with my medical worker and my insurance. They offered to discount my fee by the 40 dollars insurance would normally pay for the basic, plastic, uncoated lenses.
I have a good history with this vision center. They have offered my payment plans in the past on things not covered by insurance. For example, in the past I had a contact lense exam where the receptionist waived the exam fee until later in the month when I could come to pay them back.
Why do I feel like something is off here?
submitted by /u/Life_Faithlessness90
[link] [comments]Went to eye doctor a couple of weeks back. Brought in a pair of frames purchased for me as a gift for Christmas. My Blue Plus plan offers free eye exams, frames, and lenses. Nothing in the plan forbids bringing your own frames, however, I was lied to and told I could not choose covered lenses, a lense that would value in at 40 USD as paid for by insurance. Instead I was told that in order to fit my frames, I would need polycarbonate, not plastic material. The lens they sold me comes with UV coating and scratch protection. These coatings are specifically NOT covered services. I was told that I could not select the 40 USD uncoated lenses that my insurance would pay for. My total cost for the lenses came to 220 USD, I had only came prepared to pay 60 USD for an extra scratch protection coating on top of the covered services. I paid 70 of the 220 that day, after I was told they could not bill Blue Plus for the lenses. Something didn’t seem right, so when I got home I started reading my insurance member manual, again. Nothing even hinted at this supposed caveat that I choose “state-covered” to be eligible for the “covered” lenses. I called Blue Plus and their reps couldn’t see anything preventing a claim to be filed for then lenses and told me to ask the vision center to run it and at least let them deny it so I could appeal the decision. The vision center tells me they use a different lab for “non-medicaid” lenses and therefore they cannot bill my insurance… I called my Medical Assistance worker, they told me that I was covered by my plan. I reached out to my vision center. They told me I was responsible for the payments and that I had agreed to pay them in full before I received my already owned frames back. I told them about my correspondence with my medical worker and my insurance. They offered to discount my fee by the 40 dollars insurance would normally pay for the basic, plastic, uncoated lenses. I have a good history with this vision center. They have offered my payment plans in the past on things not covered by insurance. For example, in the past I had a contact lense exam where the receptionist waived the exam fee until later in the month when I could come to pay them back. Why do I feel like something is off here? submitted by /u/Life_Faithlessness90 [link] [comments]Read Morer/HealthInsurance