What’s the Purpose of Optical Insurance?
I need to vent a little about my struggles with poor eyesight. It’s not the worst, but it’s bad enough that I can’t just buy glasses from budget retailers like Zenni. Meanwhile, my fiancé recently snagged a pair of low-script glasses for about $70, and I can’t help but feel envious.
I do have some coverage through my insurance, but it’s not great—70% of the usual and customary costs on frames and lenses.
While browsing sites like LensCrafters that accept my insurance, I noticed something frustrating: using my insurance actually made the glasses more expensive! With insurance, I was quoted around $300 a pair, while without it, I could get them for about $180.
I understand that insurance companies are covering part of the costs, and that’s why prices can be higher. But it feels counterproductive. If they’re charging the insurance company $200 while I pay $100, that’s one thing—though it still stings. But if the base price is $180 without insurance, why does going through insurance end up costing me more overall?
I know there are better optical plans out there, but this one comes with my healthcare coverage. It just seems wrong that using my insurance should cost me more out of pocket when dealing with in-network providers.
Interestingly, I’ve discovered that going out of network might be my best bet. An out-of-network provider quoted me $200 for glasses, and after I submit a claim, my insurance will reimburse me $100 for using them. So, in the end, I’m only out $100 for a pair of glasses. Why is this the most advantageous option? I’ve checked with both the out-of-network provider and my insurance, and they confirmed I will get the reimbursement.
I totally get where you’re coming from. It can be really frustrating to feel like your insurance isn’t actually helping you save money when you need it the most. It’s puzzling that insurance would make the process more expensive for you in many cases.
Your experience highlights a common issue with many insurance plans. Often, the rates for in-network providers are inflated precisely because they have deals with the insurance companies. It seems counterintuitive since insurance is supposed to help reduce costs, not increase them. The fact that you’re finding more affordable options out of network is a great example of how complicated the system can be.
Your strategy of finding cheaper out-of-network providers and then submitting a claim for reimbursement sounds like a solid plan! It’s all about figuring out how to work the system to your advantage—it’s unfortunate that you have to, but at least you’re getting the best deal for yourself. Have you looked into any other optical insurance options or plans that might work better for you in the long run?