Luxottica-Eyemed (scam?)

[ThazinJayne]

Here is an e-mail I received from a friend:


I went into a LensCrafters on Saturday because it was the closest "In-Network" optical provider for EyeMed. A UCSD psychology student ran me through the ancillary optical tests such as peripheral vision, eye pressure, etc. I thinks she was fairly new to operating these instruments, but she had no guidance from a mentor or such. She had a hard time adjusting the instruments properly and was frequently jerking my head around and knocking it against the instruments. She gave six attempts at measuring eye pressure, but ultimately "gave up". Then, she tried to sell me on an "advanced" eye scan that was an extra $39 and provided the same information as a pupil dilation. Then, the psychology student handed me off to the optometrist. He did the usual routine, albeit late, in a manner that was rushed and forcibly friendly, and with a breath reeking of cigarette smoke. He tried to sell me on the advanced eye scan again and I suckered up. I told him I would buy it if he provided me with a copy of the scan on a thumb drive. Apparently, with the regular pupil dilation, pictures are not normally possible, or so I was told. I get a prescription for -0.25, -0.25 in each eye. Nothing much. Now I get to see what this EyeMed "insurance" gets me in terms of lenses, frames, coatings, etc. After the doctor was finished, he physically handed me off to a Lenscrafter sales rep. (Even though I think they are supposed to be separate business entities in CA and that this relationship runs afoul of the intent of the law).


Sales-rep directs me to the "cheapest", full price frames, which start at $100. Minimum price for cheapest lenses was $140. Anti reflective coating = $80 . That's $320 for a pair of glasses. I ask sales rep what's in the anti-reflective coating to make it so expensive. She says, "No one has ever asked me that before". Anyway, "Insurance" gives me $50 off of lenses, $40 off frames, $45 off coating. In such a situation insurance pays $135 and I pay $185 for a pair of glasses. Cool! Luckily, LensCrafters was having a 30% off sale on frame + lens combos. So I am thinking that would be $320 - $72 (30% discount) - $135 (insurance) = $113 . I have never bought glasses before, this seemed expensive, but perhaps reasonable. Then, I tell the sales rep that I have insurance and she says, "oh, you can't combine store discounts with insurance". Think about this. It makes no sense. It made no sense to me whatsoever and I pressed the young, over-dressed sales rep for details. She seemed to recite what a boss might have told her and said the store would make no money if they allowed customers to combine store discounts with insurance. I persisted, saying, "but with the insurance you still get the same amount because insurance + what I pay still equals retail minus 30%." She repeated her same point, emphasizing that they could, "not allow customers to do that". Sure enough, I later found it written in the fine print of their 30% advertisement. It still made absolutely no sense to me. The store would be getting the same amount of money either way. RIGHT?


When I get home, I see what the Internet has to offer in terms of glasses. www.zennioptical.com provides me with a similar looking pair of glasses for ~$20, including shipping from Hong Kong. Apparently, JC Penny, and apparently other retail optical stores send their frames to Hong Kong for lenses anyway, so perhaps it's better to, say, "order directly from the source" by ordering online. There are also a bunch of other low cost online alternatives. I log in to EyeMed online and see if there are any "Out-Of-Network" benefits for frames and lenses which could conceivably cover the marginal cost of glasses ordered on-line. There are none. That seemed pretty curious to me. EyeMed would rather pay $135 for me to buy a pair of retail glasses from LensCrafters than to reimburse me for a $20 set of glasses from Hong Kong. That seems like a horrible way of doing business for EyeMed. Doesn't it?


Well, it seems like a pretty stupid business strategy until you dig around and examine EyeMed's placement in the corporate hierarchy of its parent company, Luxottica. Not only does Luxottica own EyeMed, but it also LensCrafters, Pearle Vision, Sears Optical, Sunglass Hut, Target Optical, BJs Optical, and JC Penny's Optical. Coincidently, these are the only "In-Network" providers in the EyeMed network. So, in essence, Luxottica has no interest in combining insurance with in-store discounts because it ultimately comes out of the parent company's bottom line. Moreover, why would EyeMed provide reimbursement for online optical retailers when doing so would hurt the market share held by Luxottica's optical retail stores? In essence, EyeMed is merely an instrument to protect the market share of the Luxottica family of companies, and it provides little to no substantiative cost amelioration to consumers --- what many would regard as the principal purpose of insurance.


After getting a feel for the way the EyeMed, retail optometry world operates, it seems like it is most cost effective to simply abstain from purchasing a vision plan all together, or at least to get one with some very modest "Out-of-network" benefits. But with the cheap price of glasses available online, abstaining from a vision plan probably makes the most sense. These issues with EyeMed vision are compounded by the fact that it is a plan into which a subscriber must pay. In essence, the subscriber is merely paying for the right to buy severely over-priced optical goods. Below, I have pasted my "In-Network" "benefits" for reference. The final remaining interesting feature about how EyeMed operates is how it represents its coverage via its definition of a "Co-Pay". In the Luxottica - EyeMed world, the "Co-Pay" is the amount paid by EyeMed while "% of charge" is the amount paid my the subscriber. You might note that this is the exact opposite of what "Co-Pay" is in the medical insurance world. If this is at all intentional, it is a conspiracy to sucker HR providers and employees into pursuing the apparently attractive benefits of the EyeMed vision plan.
-------------------------------------------------------------------------------------------------------------------------

I wished more patients would do their homework like my friend and see Luxottica = Monopoly!

---

Members don't see this ad.

 

[Mewcakes]

Those prices from eyemed sound more like copays, not how much is covered. I might ask someone to explain your benefits to you again. Eyemed is generally a good insurance.

 

[electron321]

this appears to be the relevant EyeMed pricing scheme which applies to the above-mentioned user's experience. I'm very sure of it.


Co Pay = amount EyeMed pays
% of charge is how much I pay.
Exam
Exam $0
Dilation $0
Eye Exam Refraction $0
Lens
Single Vision $50 Copay
Bi-focal $70 Copay
Tri-focal $105 Copay
Standard Progressive Lens $135 Copay
Premium Progressive Lens 80% of Charge
Other Lens Types 80% of Charge
Premium Progressive Avp 80% of Charge
Frame
Frame 60% of Charge
Lens Options
Standard Polycarbonate $40 Copay
Standard Plastic Scratch Coating $15 Copay
Tint $15 Copay
UV Treatment $15 Copay
Standard Anti-reflective (a/r) Coating $45 Copay
Other Coatings 80% of Charge
Oversized Lenses - Single Vision 80% of Charge
Oversized Lenses - Multi-focal 80% of Charge
Prism 80% of Charge
Other Lens Options 80% of Charge
Contacts
Contact Lens - Conventional 85% of Charge
Contact Lens - Disposable 100% of Charge
Non-Scheduled Items
Non-scheduled Item - Retail 80% of Charge
Laser Vision Correction
LASIK and PRK Procedures 85% of Charge

 

[OD4eyes]

The problem with vision plans such as eyemed, they want the doctor to give free services. I am not sure how familiar you are with insurances, but the reimbursement for services is low, especially when you consider the amount of time and money that is invested in optometry school. An dilated eye exam is valued at 190 in an OMD's office and probably around 100-130 in an OD's office for self paid patients. Eyemed reimburses up to 40, which already includes the patient's copay. For example, if a patient's copay is 10, then they reimburse 30. I see all the EOBs in my office and trust me an OD cannot survive on eyemed patients alone. Eyemed is great for CLE patients but not so great for spectacles patients. Does not sound like you got scam. In terms of your glasses, I have no comment because i do not sell glasses. Eyemed is probably one of the most popular vision plans and don't be surprise if you have to deal with eyemed in your future as an OD. Good luck!

 

[optojake]

Sorry Mewcakes, but Eyemed STINKS for doctors. However, its not the worse. That belongs to Specterrible.

 

[Mewcakes]

Sorry Mewcakes, but Eyemed STINKS for doctors. However, its not the worse. That belongs to Specterrible.

Didn't say it was good for doctors. . But I've sold many a pair of glasses and know that they offer "okay" to "good" coverage for patients. I have also reconciled enough of those reimbursement reports to know they pay beans to their doctor.

And yeah, it sucks that patients always want free services and products. They complain that their glasses are $180, at least half of which is the price of the frame. If an office is sending the glasses out to be done, then there is very little profit after insurance. And then people complain because they say "but my Rx is so little! Why is it so much??". And it's like...why is that supposed to make a difference? There's a frame and there's a lens. Whether you're -0.25 or -3.25, those two components are going to cost the same and you're going to need them both (of course I'm not talking about high index rxs). No one complains about paying for cavities. Why do I have to pay so much? It was only a small cavity! But patients never see it that way...

Ok getting off my soapbox. It smells like troll in here.

 

[Ryan_eyeball]

An dilated eye exam is valued at 190 in an OMD's office and probably around 100-130 in an OD's office for self paid patients. Eyemed reimburses up to 40, which already includes the patient's copay. For example, if a patient's copay is 10, then they reimburse 30. I see all the EOBs in my office and trust me an OD cannot survive on eyemed patients alone.

Eyemed paid for exams $40 in 2003, and in 2010 you still get just $40. How much has inflation gone up?

Repeat Vision Plans Stink!!!!

Do not accept these plans into your practice. IMHO Eyemed and Davis are the worst. But Avesis, Spectera, and Superior are a close second.

 

[Ryan_eyeball]

Completely agree!

Eyemed though I'm sure has increased premiums that they charge employers to provide coverage. Its always a win-win situation for Eyemed. Charge employers more, keep eye exam reimbursements flat. There will always be OD's that sign up for this plan, because there are so many OD's out there willing to work for peanuts.

 

[optojake]

Completely agree that vision plans stink!

If optometrists would grow some pride in their profession and quit groveling at the feet of insurance companies, maybe we could grow as a profession. But perhaps I'm just a naive student...or perhaps optometrists need a good dose of naivety if it means they would start taking pride in their profession.

All it takes is for a handful of ODs to say no to vision plans and quit chasing the almighty $.

 

[Ryan_eyeball]

To the original Poster.

you can not discount more than what the vision plan already states. Also you can not combine an instant in store discount with a vision plan. The glasses will almost always be sold for the lower price from whichever method computed.

Another "No-No" is waiving co-pays. This can be hurt you in an audit.

 

[4Eyes]

Then, she tried to sell me on an "advanced" eye scan that was an extra $39 and provided the same information as a pupil dilation.

Sounds like Optomap. I kind of hate it. But it's rather common in a number of practices. Especially, but not limited to, LensCrafters.

Apparently, with the regular pupil dilation, pictures are not normally possible, or so I was told.

You can get photos when dilated, but it would require a camera.... I'm not sure if I understand. It's true that you don't get a permanent record (photos) with a standard dilated exam. But photos are no substitute for a DFE, IMHO.

After the doctor was finished, he physically handed me off to a Lenscrafter sales rep. (Even though I think they are supposed to be separate business entities in CA and that this relationship runs afoul of the intent of the law).

They are separate entities by many state's laws. What I think of this is largely dependent on how things operate at that particular place. A bit of my background: I work in a JC Penney Optical and in a private practice. So I see both worlds, though based on my limited fill-in experiences in other corporate environments, I am tremendously fortunate for my situation at Penney's. Anyway. When I work at Penney's, I have started handing off patients to the opticians and giving the paper Rx to the optician. But that's because 1) a small percentage of patients will take the Rx and walk, and 2) the opticians also collect the exam fee. I'm not trying to make a sale. The opticians hand the Rx over after the exam is paid for. I think it might be different though at LC because one I visited one time had separate people working the Dr side and the optical side. (FTR, I don't personally care whether they buy glasses at JCP or not. Most do, some don't. But I don't see a penny from sales, so even if I were dishonest (which I'm not) I have no incentive to be deceptive. On that note, I am completely forthright if the Rx didn't change much.)

Sales-rep directs me to the "cheapest", full price frames, which start at $100. Minimum price for cheapest lenses was $140. Anti reflective coating = $80 . That's $320 for a pair of glasses. I ask sales rep what's in the anti-reflective coating to make it so expensive. She says, "No one has ever asked me that before".

Depending on where you are, those prices sound pretty average. Person should have had a better reply about the ARC.

Anyway, "Insurance" gives me $50 off of lenses, $40 off frames, $45 off coating.

A bunch of eyemed plans are different, but that's entirely feasible, as electron pointed out.

Then, I tell the sales rep that I have insurance and she says, "oh, you can't combine store discounts with insurance".

It's going to be like that everywhere you go. I can't think of a single exception. The sale doesn't always work out better than insurance, but sometimes it does, depending on what you want on your glasses. If you don't like that, see if you can find a private practice that still takes Eyemed. They don't have sales. =P

Apparently, JC Penny, and apparently other retail optical stores send their frames to Hong Kong for lenses anyway,

I know JC Penney does not send their frames to Hong Kong. There is one lab and it's in the USA. I won't go into the online glasses thing here since that would be beating a dead horse, but I will say...even if Lux/Eyemed does it for their own benefit, there are enough ethical reasons to do it that way too so I don't take issue with it.

Not only does Luxottica own EyeMed, but it also LensCrafters, Pearle Vision, Sears Optical, Sunglass Hut, Target Optical, BJs Optical, and JC Penny's Optical.

Actually, that's all true except for JC Penney, BJs, and some Sears. Those are US Vision.

In essence, EyeMed is merely an instrument to protect the market share of the Luxottica family of companies, and it provides little to no substantiative cost amelioration to consumers --- what many would regard as the principal purpose of insurance.

From what I've observed, most people are more irritated if/when the sale price comes out cheaper than their insurance. Because it makes them wish they didn't have the insurance. Though without the sale as an option, the insurance would definitely save them money. Some people, it is worth their while. Some people, it isn't. If you don't think it's worth your while, opt out of your vision plan. Depends a lot on where you go, the needs/desires of the patient, and how good the plan is. These can all vary a lot.

The final remaining interesting feature about how EyeMed operates is how it represents its coverage via its definition of a "Co-Pay". In the Luxottica - EyeMed world, the "Co-Pay" is the amount paid by EyeMed while "% of charge" is the amount paid my the subscriber. You might note that this is the exact opposite of what "Co-Pay" is in the medical insurance world.

I don't like Eyemed any more than the next guy, but this doesn't sound right. You get your co-pay. With the same meaning as anywhere in the world. Usually, though, the co-pay is for the basics. And then fancier stuff like AR or premium progressive lenses they don't pay as much. So you pay 80% of charge or whatever on top of your co-pay. Am I missing something? Upgrades are upgrades no matter where you go. They cost more. With medical insurance, a premium IOL costs a lot more than a standard one if you're getting cataract surgery. If you're pregnant, you're going to pay a lot more for one of those fancy 4D ultrasound pictures. Lots and lots of insurances just pay for what they think you need. Not necessarily the nice extras.

 

[IndianaOD]

If you get your glasses online you should expect to pay an optical for everything the cost of the glasses includes at a brick and mortar store or go without.

Internet glasses are cheap because, well, one they are cheap materials. Usually a worker making a dollar an hour or worse. You are taking money out of the local economy and sending it overseas.

You should NOT expect your eye doctor or their optical staff to help you at all with internet glasses without a fee.

At a brick and mortar location the glasses fee includes:
Helping pick the proper frame.
Helping choose the correct lens options for your needs.
Measuring your Pupillary Distance
Measuring the vertical height of the lenses (optical center or seg height)
Applicable warranties on frames and lenses
Verification of prescription (making sure what was made is correct)
Fitting the frame properly to your face
Future adjustments and problem solving

Internet glasses include none of this and is another reason they are cheaper. It is disingenuous to expect anyone to do this for free when you bought your glasses from China.

 

[electron321]

The problem with vision plans such as eyemed, they want the doctor to give free services. I am not sure how familiar you are with insurances, but the reimbursement for services is low, especially when you consider the amount of time and money that is invested in optometry school. An dilated eye exam is valued at 190 in an OMD's office and probably around 100-130 in an OD's office for self paid patients. Eyemed reimburses up to 40, which already includes the patient's copay. For example, if a patient's copay is 10, then they reimburse 30. I see all the EOBs in my office and trust me an OD cannot survive on eyemed patients alone. Eyemed is great for CLE patients but not so great for spectacles patients. Does not sound like you got scam. In terms of your glasses, I have no comment because i do not sell glasses. Eyemed is probably one of the most popular vision plans and don't be surprise if you have to deal with eyemed in your future as an OD. Good luck!

First: The doctor does not give "FREE" services." Usually they are reimbursed ~$59-$69 in the case of "In-Network".

Second: If a doctor is "In-Network" with EyeMed, they agree to this fee schedule. If all doctors refused this fee schedule and acted with some cohesiveness like a union, they would have greater bargaining power. The truth is the business relationships between in-house ophthalmologist and those selling the lenses is not always clear. The ophthalmologist hands off the prescription to a sales representative for a reason --- to close a sale at the same location --- this is because most of the profit for these places are in the lenses and frames. Pulling a patient in for an exam is the "teaser". The Doc makes some minor modification to a prescription and by doing so creates the potential for a sale.

In effect, it's a given that the sale of frames and lenses subsidizes the exam. This is probably why doctors accept these low reimbursement fees from EyeMed in the first place. Those that don't abide by this philosophy are more likely to not be "In-Network" with EyeMed.

Third:
In the case of "Out-of-Network" EyeMed reimburses THE PATIENT up to $40. The PATIENT IS LIABLE for the difference. Docs should not lose money in this instance. In EyeMed speak, the traditional meaning of Co-Pay is reversed. Co-Pay is the amount EyeMed pays. Patient pays the rest.

Fourth: EyeMed reimbursement for "In-Network" docs may be low, but keep in mind that EyeMed owns all or near-all "In-Network" providers under corporate umbrella Luxottica.

 

[electron321]

Internet glasses are cheap because, well, one they are cheap materials. Usually a worker making a dollar an hour or worse. You are taking money out of the local economy and sending it overseas.

Materials cannot be substantially different. Plastic is one of the cheapest and most abundantly produced materials on the planet. The same is true with polycarbonate lenses. This is the EXACT SAME material that was used in Nalgene bottles until the BPA scare. Polycarbonate has a higher index of refraction than plastic that's why it is used in so-called "Featherlight" lenses. If the index of refraction is higher, you need less lens to create the same correction. Anyway, point is that both materials are VERY COMMON and VERY CHEAP.

Even if the person making the lens from the online-retailer is paid much less than what their counterpart in the US would be paid, you have to keep in mind that the foreign worker benefits from that job for the sake of themselves and their family just as much as any US worker would. Coincidently, living costs are lower abroad compared to most places in the US. The truth is that the profit margins are lower for online retailers mainly because their throughput is higher and so they can afford to stay in business. Additionally, when you buy from the EyeMed family, you are paying Luxottica's profits and they pay a dividend to investors every year which is derived from the company's profits.

 

[electron321]

Co-Pay is how much EyeMed pays. It is the complete opposite from medical co-pays with which most people are familiar.

The Luxottica umbrella is viewable here: http://www.eyemedvisioncare.com/about/luxottica.html

You can view the corporate hierarchy for yourself:

""Luxottica Group, EyeMed Vision Care's ultimate parent company and recognized leader in the optical industry, is a fully integrated organization involved in the design, manufacture and distribution of high quality frames; retail sales through its company-owned optical retailers; and managed vision care.

As a $3.5 billion company, Luxottica Group represents the following product lines in the optical marketplace:"""

Icons listed are: LensCrafters, Learle Vision, EyeMed Vision Care, Luxottica Retail, Sears Optical, Sunglass Hut, Target Optical, BJ's Optical, JCPEnny optical, and Private Practitioners

Interestingly, on the above-linked page, EyeMed states one of its strengths as its "fully integrated organization involved in the design, manufacture, and distribution of..." . They are saying they own the retail, insurance, design, manufacture. Sounds like a vertical monopoly to me!!!

 

[electron321]

To the original Poster.

you can not discount more than what the vision plan already states. Also you can not combine an instant in store discount with a vision plan. The glasses will almost always be sold for the lower price from whichever method computed.

Another "No-No" is waiving co-pays. This can be hurt you in an audit.

1) I think you're missing the point of the original point which was about WHY you cannot combine insurance with retail because in the case of EyeMed, you're dealing with what best approximates a vertically-integrated monopoly which controls retail, "insurance", design, manufacture, etc . No one was talking about waiving co-pays.

2) Again, lots of confusion concerning "Co-Pays" . In EyeMed speak, "Co-Pay" is what EYEMED PAYS, not the what the patient pays. The patient MAKES UP THE (LARGE) DIFFERENCE . This is very clearly how it reads to me on their reimbursement statement.

3) EyeMed pays a set amount towards each line-item on their policy benefit regardless of what the actual retail price of the item is. In this sense, it should not matter what the retail price of the frame+lenses are, because the seller should be getting the same amount from "insurance" regardless. This is not allowed because for many, if not all, "In-Network" providers, EyeMed "insurance" is owned by the same company selling you your glasses.

 

[IndianaOD]

Materials cannot be substantially different. Plastic is one of the cheapest and most abundantly produced materials on the planet. The same is true with polycarbonate lenses. This is the EXACT SAME material that was used in Nalgene bottles until the BPA scare. Polycarbonate has a higher index of refraction than plastic that's why it is used in so-called "Featherlight" lenses. If the index of refraction is higher, you need less lens to create the same correction. Anyway, point is that both materials are VERY COMMON and VERY CHEAP.

Even if the person making the lens from the online-retailer is paid much less than what their counterpart in the US would be paid, you have to keep in mind that the foreign worker benefits from that job for the sake of themselves and their family just as much as any US worker would. Coincidently, living costs are lower abroad compared to most places in the US. The truth is that the profit margins are lower for online retailers mainly because their throughput is higher and so they can afford to stay in business. Additionally, when you buy from the EyeMed family, you are paying Luxottica's profits and they pay a dividend to investors every year which is derived from the company's profits.

Easy there. There absolutely is a difference. Compare the hinge durability and quality and the material quality of those zenni frames to our Flexon or ProDesign frames. There is no comparison. Just like I had a child patient go through 6 cheap Medicaid frames (similar to zenni quality) in one year. Parents spent money on a Flexon frame this year and they just told me it hasn't had any problems over the past 10 months.

You can say gold is gold, but is it 18k fine gold or 8k full of nickel and crap that will discolor.

 

[electron321]

Easy there. There absolutely is a difference. Compare the hinge durability and quality and the material quality of those zenni frames to our Flexon or ProDesign frames. There is no comparison. Just like I had a child patient go through 6 cheap Medicaid frames (similar to zenni quality) in one year. Parents spent money on a Flexon frame this year and they just told me it hasn't had any problems over the past 10 months.

You can say gold is gold, but is it 18k fine gold or 8k full of nickel and crap that will discolor.

(1) I would just like to point out that I made no comment about the durability of the frames and associated hinges --- just that the properties of the bulk materials "plastic" and "polycarbonate" that constitute 99% of the lens cannot be very functionally different (if at all) between Zenni lenses and those purchased via US retail.

(2) What is "Flexon" made out of? It appears to be sold as a proprietary name, but similar materials are in wide use in industry. You can achieve such "memory" flexibility with a ~50% nickel, ~50% titanium alloy. This can be made by anyone, including frame providers to Zenni optical who might or might not be less scrupulous than US manufacturers about adhering to any possibly relevant patents.

(3) I think we can agree that Zenni carries more frames than most any US retail store. I do not think it is fair to indict all Zenni frames as being low quality merely because they are cheap. They appear to sell frames that are both cheap and expensive. Just like all frames, some turn out better and some turn out worse. Use and bending strain any hinge.

Disclaimer: I have never bought glasses from an online retailer.

 

[optojake]

(1) I would just like to point out that I made no comment about the durability of the frames and associated hinges --- just that the properties of the bulk materials "plastic" and "polycarbonate" that constitute 99% of the lens cannot be very functionally different (if at all) between Zenni lenses and those purchased via US retail.

(2) What is "Flexon" made out of? It appears to be sold as a proprietary name, but similar materials are in wide use in industry. You can achieve such "memory" flexibility with a ~50% nickel, ~50% titanium alloy. This can be made by anyone, including frame providers to Zenni optical who might or might not be less scrupulous than US manufacturers about adhering to any possibly relevant patents.

(3) I think we can agree that Zenni carries more frames than most any US retail store. I do not think it is fair to indict all Zenni frames as being low quality merely because they are cheap. They appear to sell frames that are both cheap and expensive. Just like all frames, some turn out better and some turn out worse. Use and bending strain any hinge.

Disclaimer: I have never bought glasses from an online retailer.

As with most things in life, you get what you pay for. And just how Amazon is cheaper to buy a book from than Barnes and Noble, you have to think about shipping time, cost of shipping, what if the received product is damaged, what if the frames have too large of an A-size and completely swallow your face, what if the frames get bent out of shape during packing, what if the nosepads hurt and you need them replaced what if the patient has an allergic reaction to the frame material? To quote perhaps one of the best movies from the 80's...

"Who ya gonna call?"

Don't come knocking on my office door expecting me to fix your cheap-o frames for free.

 

[KHE]

First: The doctor does not give "FREE" services." Usually they are reimbursed ~$59-$69 in the case of "In-Network".

Second: If a doctor is "In-Network" with EyeMed, they agree to this fee schedule. If all doctors refused this fee schedule and acted with some cohesiveness like a union, they would have greater bargaining power. .

That unfortunately, is called anti-trust and doctors are specifically forbidden from acting with that type of "cohesiveness."

The tragedy is that insurance companies are specifically EXEMPT from anti-trust laws making it a completely UNfree market.

 

[PBEA]

Materials cannot be substantially different. Plastic is one of the cheapest and most abundantly produced materials on the planet. The same is true with polycarbonate lenses. This is the EXACT SAME material that was used in Nalgene bottles until the BPA scare. Polycarbonate has a higher index of refraction than plastic that's why it is used in so-called "Featherlight" lenses. If the index of refraction is higher, you need less lens to create the same correction. Anyway, point is that both materials are VERY COMMON and VERY CHEAP.

Even if the person making the lens from the online-retailer is paid much less than what their counterpart in the US would be paid, you have to keep in mind that the foreign worker benefits from that job for the sake of themselves and their family just as much as any US worker would. Coincidently, living costs are lower abroad compared to most places in the US. The truth is that the profit margins are lower for online retailers mainly because their throughput is higher and so they can afford to stay in business. Additionally, when you buy from the EyeMed family, you are paying Luxottica's profits and they pay a dividend to investors every year which is derived from the company's profits.

the comments about plastic frames being of similiar characteristics is pretty naive. Why not put your money where your mouth is and buy a $10 plastic frame from zenni, and then purchase a warranteed flexon frame (about $200-300+). They aren't even close. Many people I see have done this, and it really is no contest. As for lenses, there are plenty of ways to cut corners in manufacturing materials (just looking at chinese steel, everybody knows it is crap), one very important area is the surfacing of lenses, in which the asphericity, base curve, etc are very important in reducing peripheral aberration (ever try looking through a fishbowl?). There are even rumours that in some cases they are casting some of their lenses from acrylic!! Not allowed in the US.

With regard to eyemed, yes they are totally vertically integrated. They own the docs in the box, and sell their own wares via there "insurance". I don't like it, and I don't accept those plans, but so far nobody has done anything about it. Often people eventually realize that they don't save much and maybe switch plans or pay out of pocket. Many ODs frown on the close relationship that the mall has when employing ODs, and I think the spectacle Rx you were given (-0.25!!!!) is just further evidence of the pressure the corporation is exerting on the OD. Call it job security, if the OD doesn't play ball (and sell stuff) he/she is out on the street.

 

[4Eyes]

I think the spectacle Rx you were given (-0.25!!!!) is just further evidence of the pressure the corporation is exerting on the OD. Call it job security, if the OD doesn't play ball (and sell stuff) he/she is out on the street.

Somewhat off-topic, but I have had a couple of patients who reallyreallyreally want their -0.25 OU Rx filled. I'm like...really? Okay, if you really want to spend money on it.... But they've had it for years and can't stand not having it. *shrug* I hope no one sees one of my Rxs floating around and thinks I was trying to pull a fast one. At any rate, yeh, this person shouldn't have been led to believe that they NEEEED glasses. But if the person was complaining of blur, and they were trial framed and thought, OHH I MUST HAVE THISSSSS, then that's his/her decision. That certainly doesn't seem to be the case in this particular instance though. (I almost glossed over the fact that you were referencing the case at hand and not just making a blanket statement, so these last few sentences are kind of tacked-on.)

 

[PBEA]

Somewhat off-topic, but I have had a couple of patients who reallyreallyreally want their -0.25 OU Rx filled. I'm like...really? Okay, if you really want to spend money on it.... But they've had it for years and can't stand not having it. *shrug* I hope no one sees one of my Rxs floating around and thinks I was trying to pull a fast one. At any rate, yeh, this person shouldn't have been led to believe that they NEEEED glasses. But if the person was complaining of blur, and they were trial framed and thought, OHH I MUST HAVE THISSSSS, then that's his/her decision. That certainly doesn't seem to be the case in this particular instance though. (I almost glossed over the fact that you were referencing the case at hand and not just making a blanket statement, so these last few sentences are kind of tacked-on.)

I once had an "optician" mother bring her child in. The kid was about 6 or 7 and he had a small amount of astig. I told her that her kid did not need glasses and she freaked out. She demanded the rx, which I refused, stating it was unecessary. At the time I was leasing space in wallyworld and the "optician" complained to the wally optical store, who in turn gave me an earful about not giving the Rx. I believe there is a small amount of harm providing placebo or otherwise unecessary spectacles to children (mainly from a psychological standpoint). As an adult, however, I agree, if they just want the cosmesis of wearing plano glasses, and they fully understand that is the sole purpose of said spectacle, then I say have at it. I do think that a large majority of these low power specs that are suggested/prescribed/offered are done so under the guise of need, or that they provide significant improvement. They don't, and to suggest otherwise is unethical. Typically the prescribing doc will use clever wording like: "To see your best you would use this", or "This will make your vision better", or "you can use this to see 20/20." It is nonsense.

 

[aarlan]

.

 

[aarlan]

I believe there is a small amount of harm providing placebo or otherwise unecessary spectacles to children (mainly from a psychological standpoint).

Old fashioned thinking here...We have at least one youngster every 2 months or so that INSIST on getting the latest spongebob frame or other character despite having NO refractive error...they just browbeat their parents into submission until they get the same cool frame their friends at school are wearing..., or the tweens like that retro buddy holly look that all the young actors and musicians wear now. Glasses are not as 'psychologically harmful' as you may believe. There is far less of a stigma related to eyewear now than 20-30 yrs ago.

Also, even with a slightest rxs, the rule of thumb should be to Trial frame it and give the pt the option. I've seen some folks with a -0.25 that felt that it made all the difference in the world for them. Don't assume that you know their preferences better than they do. Recently had a 30 y/o that came in wearing 0.50 sph dist... I also thought had been duped by a prev OD. I couldn't imagine that a pt with plenty of accomodative reserve and no convergence anomalies could possibly benefit from this Rx. I even hinted at that fact. By the end of the exam, and countless attempts to try to trip him up to see if he could even spot the diff Plano sph OU vs 0.50 sph at dist, he pegged the 0.50 sph every time. He insists they make a big difference for distance. Trialed them, pt likes them, so I rx'd them.

Don't assume you're doing the pt a favor by "saving their money" for the minor scripts. Trial it, write it out, and let them decide if it is worth it. Don't refuse to write it...that's just silly.

 

[PBEA]

Old fashioned thinking here...We have at least one youngster every 2 months or so that INSIST on getting the latest spongebob frame or other character despite having NO refractive error...they just browbeat their parents into submission until they get the same cool frame their friends at school are wearing..., or the tweens like that retro buddy holly look that all the young actors and musicians wear now. Glasses are not as 'psychologically harmful' as you may believe. There is far less of a stigma related to eyewear now than 20-30 yrs ago.

Also, even with a slightest rxs, the rule of thumb should be to Trial frame it and give the pt the option. I've seen some folks with a -0.25 that felt that it made all the difference in the world for them. Don't assume that you know their preferences better than they do. Recently had a 30 y/o that came in wearing 0.50 sph dist... I also thought had been duped by a prev OD. I couldn't imagine that a pt with plenty of accomodative reserve and no convergence anomalies could possibly benefit from this Rx. I even hinted at that fact. By the end of the exam, and countless attempts to try to trip him up to see if he could even spot the diff Plano sph OU vs 0.50 sph at dist, he pegged the 0.50 sph every time. He insists they make a big difference for distance. Trialed them, pt likes them, so I rx'd them.

Don't assume you're doing the pt a favor by "saving their money" for the minor scripts. Trial it, write it out, and let them decide if it is worth it. Don't refuse to write it...that's just silly.

no

 

[KHE]

Materials cannot be substantially different. Plastic is one of the cheapest and most abundantly produced materials on the planet. The same is true with polycarbonate lenses. This is the EXACT SAME material that was used in Nalgene bottles until the BPA scare.

This is a common misconception.

Materials CAN be substantially different. It's like the difference between a $3000 NIKON camera lens and a $15 disposable camera at CVS. They both have glass lenses, right? Why is one $3000?

This does not automatically mean that every private OD carries ultra high end stuff. Many, if not most use run of the mill products. But for truly high end lenses, there is a substantial difference.

And it's not just the material itself. It's the way it's manufactured, what coatings are used, and how those coatings are applied. That all factors into it.

 

[Mewcakes]

And it's not just the material itself. It's the way it's manufactured, what coatings are used, and how those coatings are applied. That all factors into it.

Agreed. And let's not even get started on progressives.

 

[Meibomian SxN]

This is a common misconception.

Materials CAN be substantially different. It's like the difference between a $3000 NIKON camera lens and a $15 disposable camera at CVS. They both have glass lenses, right? Why is one $3000?

This does not automatically mean that every private OD carries ultra high end stuff. Many, if not most use run of the mill products. But for truly high end lenses, there is a substantial difference.

And it's not just the material itself. It's the way it's manufactured, what coatings are used, and how those coatings are applied. That all factors into it.

Also don't forget being compensated for the staff explaining each coating, what it does and how it will benefit their way of life! God forbid we should get compensated for sharing our knowledge and expertise!

 

[msulli06]

-