So here’s what’s going on:
I went to see an optometrist for a routine exam and get a new pair of glasses. The optician advised me that scAMBetter insurance would not cover my glasses completely – as in, the transitions probably wouldn’t be covered and a couple options. I reference my Schedule of Benefits and it says I can spend up to $130 on frames, and the lenses were covered 100%, INCLUDING ADDITONAL OPTIONS. Ordered the glasses, ended up paying almost $250 for them. Requested an invoice from my provider and I received an Explanation of Benefits from scAMBetter. EoB says they barely covered half of the cost of the frames, and a fraction of most of the lens options, didn’t cover transitions at all. I contact scAMBetter and they tell me to discuss it with my provider as all the codes submitted were processed correctly.
Has anyone else encountered this? Why do I have to be the mediator between my provider and insurance? Am I screwed out of that money now that I’ve paid it? What would you do?
submitted by /u/jsrvt87
[link] [comments]So here’s what’s going on: I went to see an optometrist for a routine exam and get a new pair of glasses. The optician advised me that scAMBetter insurance would not cover my glasses completely – as in, the transitions probably wouldn’t be covered and a couple options. I reference my Schedule of Benefits and it says I can spend up to $130 on frames, and the lenses were covered 100%, INCLUDING ADDITONAL OPTIONS. Ordered the glasses, ended up paying almost $250 for them. Requested an invoice from my provider and I received an Explanation of Benefits from scAMBetter. EoB says they barely covered half of the cost of the frames, and a fraction of most of the lens options, didn’t cover transitions at all. I contact scAMBetter and they tell me to discuss it with my provider as all the codes submitted were processed correctly. Has anyone else encountered this? Why do I have to be the mediator between my provider and insurance? Am I screwed out of that money now that I’ve paid it? What would you do? submitted by /u/jsrvt87 [link] [comments]Read Morer/HealthInsurance