Eye Doctor $30 to get your Rx? Is this normal?

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kjvmartin
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Eye Doctor $30 to get your Rx? Is this normal?

Post by kjvmartin »

Hello,

My wife has been complaining about her vision for a while, decided to see an MD Ophthalmologist that participates in our HMO. We called and verified a $20 copay for the eye exam. She received her full eye exam, but our VSP vision plan, separate from the HMO, does not cover lenses and frames at this office. She was up front about this and told them she was just there for the exam, but wouldn't be getting any glasses there.

After the exam, and with eyes dilated, she was lead to the "shop" section of the office and they tried to convince her to pick out some frames. She asked for her Rx to go and was told it would be $30 to get a prescription writing. If I had been there, I'd have strongly objected. I've seen a lot of ludicrous medical charges, but to pay a few to get your Rx in writing seems like it should be about illegal.

Is this normal?
123
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by 123 »

The Federal Trade Commission website https://www.consumer.ftc.gov/articles/0 ... act-lenses advises:

"The FTC enforces the Eyeglass Rule and Contact Lens Rule, which give you the right to get a prescription from your eye doctor – whether you ask for it or not – at no extra charge. That allows you to shop around and look for the best deal."

Looks like time to lawyer up and go after them. Maybe they couldn't read the law because they need glasses.
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mouses
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by mouses »

There's an eye exam, and then there's getting a prescription, which is different. In my experience, there is always a charge, about $35, for the prescription. I've never seen a hard sell for the latter however. The glasses section, not to be confused with getting a prescription, is also often a separate business.

I think the second poster is not realizing the quote only applies if the prescription has been determined, and that there is a charge for that.
Last edited by mouses on Tue Nov 07, 2017 5:21 pm, edited 1 time in total.
Leesbro63
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by Leesbro63 »

123 wrote: Tue Nov 07, 2017 5:09 pm The Federal Trade Commission website https://www.consumer.ftc.gov/articles/0 ... act-lenses advises:

"The FTC enforces the Eyeglass Rule and Contact Lens Rule, which give you the right to get a prescription from your eye doctor – whether you ask for it or not – at no extra charge. That allows you to shop around and look for the best deal."

Looks like time to lawyer up and go after them. Maybe they couldn't read the law because they need glasses.
Before I got a lawyer involved, I'd write a letter with the above citation and the threat to contact the FTC and the Optometrist board. I'd send it with a self-addressed-stamped-envelope, giving them 7 days to return the $30, the $6 (or so) to send the letter by certified mail, and the .49 for the return envelope. Why hit them with a sledge hammer when a gentle tap with a mallet might do the trick.
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Toons
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by Toons »

Email this link to them
"The FTC enforces the Eyeglass Rule and Contact Lens Rule, which give you the right to get a prescription from your eye doctor – whether you ask for it or not – at no extra charge. That allows you to shop around and look for the best deal."

Federal Trade Commission :thumbsup

https://www.consumer.ftc.gov/articles/0 ... act-lenses
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investing1012
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by investing1012 »

123 wrote: Tue Nov 07, 2017 5:09 pm The Federal Trade Commission website https://www.consumer.ftc.gov/articles/0 ... act-lenses advises:

"The FTC enforces the Eyeglass Rule and Contact Lens Rule, which give you the right to get a prescription from your eye doctor – whether you ask for it or not – at no extra charge. That allows you to shop around and look for the best deal."

Looks like time to lawyer up and go after them. Maybe they couldn't read the law because they need glasses.
This is foolish advice. A lawyer will cost much more than $35 dollars.
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celia
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by celia »

The $30 could be the (additional) co-pay for an ophthalmologist who isn't a VSP contractor. Usually you go to an optometrist for fitting eyeglasses and an ophthalmologist when there is a medical problem with the eyes (infection, floaters, possible surgery). VSP tends to cover the glasses/contacts part while your medical insurance covers medical needs and surgery.

Find out how much, if anything is covered by your medical insurance and what billing codes were used for the services rendered.
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kjvmartin
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by kjvmartin »

Toons wrote: Tue Nov 07, 2017 5:26 pm Email this link to them
"The FTC enforces the Eyeglass Rule and Contact Lens Rule, which give you the right to get a prescription from your eye doctor – whether you ask for it or not – at no extra charge. That allows you to shop around and look for the best deal."

Federal Trade Commission :thumbsup

https://www.consumer.ftc.gov/articles/0 ... act-lenses
Complaint filed, thanks for the heads up!
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Helo80
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by Helo80 »

kjvmartin wrote: Tue Nov 07, 2017 5:06 pm Hello,

My wife has been complaining about her vision for a while, decided to see an MD Ophthalmologist that participates in our HMO. We called and verified a $20 copay for the eye exam. She received her full eye exam, but our VSP vision plan, separate from the HMO, does not cover lenses and frames at this office. She was up front about this and told them she was just there for the exam, but wouldn't be getting any glasses there.

After the exam, and with eyes dilated, she was lead to the "shop" section of the office and they tried to convince her to pick out some frames. She asked for her Rx to go and was told it would be $30 to get a prescription writing. If I had been there, I'd have strongly objected. I've seen a lot of ludicrous medical charges, but to pay a few to get your Rx in writing seems like it should be about illegal.

Is this normal?

You should be able to file a complaint with your state's medical board about this practice. Even if you're in the wrong, the board should let you know. The physician knows his/her legal rights, and in my state, I can file a complaint against the physician b/c the receptionist looked at me funny --- obviously the complaint will get nowhere, but the bar is low and the onus is not on you to dissect FTC rules. You paid for a service and seemingly are getting nickled and dimed.
Last edited by Helo80 on Tue Nov 07, 2017 5:34 pm, edited 1 time in total.
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Toons
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by Toons »

kjvmartin wrote: Tue Nov 07, 2017 5:32 pm
Toons wrote: Tue Nov 07, 2017 5:26 pm Email this link to them
"The FTC enforces the Eyeglass Rule and Contact Lens Rule, which give you the right to get a prescription from your eye doctor – whether you ask for it or not – at no extra charge. That allows you to shop around and look for the best deal."

Federal Trade Commission :thumbsup

https://www.consumer.ftc.gov/articles/0 ... act-lenses
Complaint filed, thanks for the heads up!
:thumbsup
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Topic Author
kjvmartin
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by kjvmartin »

celia wrote: Tue Nov 07, 2017 5:31 pm The $30 could be the (additional) co-pay for an ophthalmologist who isn't a VSP contractor. Usually you go to an optometrist for fitting eyeglasses and an ophthalmologist when there is a medical problem with the eyes (infection, floaters, possible surgery). VSP tends to cover the glasses/contacts part while your medical insurance covers medical needs and surgery.

Find out how much, if anything is covered by your medical insurance and what billing codes were used for the services rendered.
The HMO covered the eye exam at our regular copay rate. which is why she went to an eye doctor. She was having trouble with night vision, blurriness.

If glasses were deemed a part of the solution, that was to be a separate transaction through a different insurance company.
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climber2020
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by climber2020 »

kjvmartin wrote: Tue Nov 07, 2017 5:06 pm Hello,

My wife has been complaining about her vision for a while, decided to see an MD Ophthalmologist that participates in our HMO. We called and verified a $20 copay for the eye exam. She received her full eye exam, but our VSP vision plan, separate from the HMO, does not cover lenses and frames at this office. She was up front about this and told them she was just there for the exam, but wouldn't be getting any glasses there.

After the exam, and with eyes dilated, she was lead to the "shop" section of the office and they tried to convince her to pick out some frames. She asked for her Rx to go and was told it would be $30 to get a prescription writing. If I had been there, I'd have strongly objected. I've seen a lot of ludicrous medical charges, but to pay a few to get your Rx in writing seems like it should be about illegal.

Is this normal?
Yes this is normal. Every single ophthalmologist that I'm aware of charges for refractions.

A medical eye exam is different from the vision exam you get at LensCrafters. Refraction fees are not included in a medical eye exam. We absolutely charge for refractions and tell patients up front about the fee. If people don't want to pay the fee, then that's fine; we skip the refraction and do the medical exam only, which is fine by me since refracting someone is by far the most time consuming and tedious part of a complete eye exam and is honestly not worth the 25 bucks relative to the time involved.

The local university eye center charges $40 for refractions. If anything, you're getting a good deal.
123 wrote: Tue Nov 07, 2017 5:09 pm Looks like time to lawyer up and go after them. Maybe they couldn't read the law because they need glasses.
Go ahead. No competent lawyer will take this seriously.
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GerryL
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by GerryL »

kjvmartin wrote: Tue Nov 07, 2017 5:40 pm
celia wrote: Tue Nov 07, 2017 5:31 pm The $30 could be the (additional) co-pay for an ophthalmologist who isn't a VSP contractor. Usually you go to an optometrist for fitting eyeglasses and an ophthalmologist when there is a medical problem with the eyes (infection, floaters, possible surgery). VSP tends to cover the glasses/contacts part while your medical insurance covers medical needs and surgery.

Find out how much, if anything is covered by your medical insurance and what billing codes were used for the services rendered.
The HMO covered the eye exam at our regular copay rate. which is why she went to an eye doctor. She was having trouble with night vision, blurriness.

If glasses were deemed a part of the solution, that was to be a separate transaction through a different insurance company.

So, you're saying she went through the "which is clearer, 1 or 2" routine? I see an optometrist each year to get a routine eye exam and only get glasses when needed. We always do the "1 or 2?" routine. This is covered by VSP. Occasionally I visit an ophthalmologist to address an issue (e.g., dry eye or stress twitching). I think the last time this went through Medicare. They checked the prescription on my current glasses, but I don't recall doing the "1 or 2" routine.
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kjvmartin
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by kjvmartin »

climber2020 wrote: Tue Nov 07, 2017 5:49 pm
kjvmartin wrote: Tue Nov 07, 2017 5:06 pm Hello,

My wife has been complaining about her vision for a while, decided to see an MD Ophthalmologist that participates in our HMO. We called and verified a $20 copay for the eye exam. She received her full eye exam, but our VSP vision plan, separate from the HMO, does not cover lenses and frames at this office. She was up front about this and told them she was just there for the exam, but wouldn't be getting any glasses there.

After the exam, and with eyes dilated, she was lead to the "shop" section of the office and they tried to convince her to pick out some frames. She asked for her Rx to go and was told it would be $30 to get a prescription writing. If I had been there, I'd have strongly objected. I've seen a lot of ludicrous medical charges, but to pay a few to get your Rx in writing seems like it should be about illegal.

Is this normal?
Yes this is normal. Every single ophthalmologist that I'm aware of charges for refractions.

A medical eye exam is different from the vision exam you get at LensCrafters. Refraction fees are not included in a medical eye exam. We absolutely charge for refractions and tell patients up front about the fee. If people don't want to pay the fee, then that's fine; we skip the refraction and do the medical exam only, which is fine by me since refracting someone is by far the most time consuming and tedious part of a complete eye exam and is honestly not worth the 25 bucks relative to the time involved.

The local university eye center charges $40 for refractions. If anything, you're getting a good deal.
123 wrote: Tue Nov 07, 2017 5:09 pm Looks like time to lawyer up and go after them. Maybe they couldn't read the law because they need glasses.
Go ahead. No competent lawyer will take this seriously.
I understand what you are saying, but here's what I don't understand. The appointment was for an eye exam to get glasses. We were told $20 copay on the phone. The work was then done. She was back in the lobby at checkout and she had the option to pay $20 for the copay or $50 for the copay and Rx. She had an option at the point of sale which wasn't discussed by the doctor or anyone else beforehand. Whatever was done in the exam room was covered by the $20 copay, but the extra $30 let her walk out the door with a piece of paper. Is that a good practice?
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Mlm
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by Mlm »

My Ophthalmologists web site clearly states that he charges $30 for refractions and that the fee is not covered by insurance. I have never had them try to charge me for a written Rx. to take elsewhere.
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by BogleMelon »

I have never paid more than the copay.. Several doctors, not just one. Always get the RX on demand without an issue. That looks fishy and wrong. No doctor should hold the RX from a patient as a hostage!
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NotWhoYouThink
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by NotWhoYouThink »

Could be the office waives the $30 if you buy your glasses at their office, so they charged her once they were convinced that wasn't an option. Not smooth, but plausible. You've filed the complaint, so you'll find out. Let us know. With my doctor, the medical exam (which would have been the reason her eyes were dilated) and the vision exam are billed separately, and my insurance doesn't cover the vision exam with that doctor. Been that way for years.
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climber2020
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by climber2020 »

kjvmartin wrote: Tue Nov 07, 2017 5:55 pm I understand what you are saying, but here's what I don't understand. The appointment was for an eye exam to get glasses. We were told $20 copay on the phone. The work was then done. She was back in the lobby at checkout and she had the option to pay $20 for the copay or $50 for the copay and Rx. She had an option at the point of sale which wasn't discussed by the doctor or anyone else beforehand. Whatever was done in the exam room was covered by the $20 copay, but the extra $30 let her walk out the door with a piece of paper. Is that a good practice?
Improved communication by the office is in order. We have the patient sign a piece of paper at check in that clearly explains the refraction fee so no one can claim ignorance. Sounds like this place doesn't do anything like that.
tibbitts
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by tibbitts »

kjvmartin wrote: Tue Nov 07, 2017 5:06 pm Hello,

My wife has been complaining about her vision for a while, decided to see an MD Ophthalmologist that participates in our HMO. We called and verified a $20 copay for the eye exam. She received her full eye exam, but our VSP vision plan, separate from the HMO, does not cover lenses and frames at this office. She was up front about this and told them she was just there for the exam, but wouldn't be getting any glasses there.

After the exam, and with eyes dilated, she was lead to the "shop" section of the office and they tried to convince her to pick out some frames. She asked for her Rx to go and was told it would be $30 to get a prescription writing. If I had been there, I'd have strongly objected. I've seen a lot of ludicrous medical charges, but to pay a few to get your Rx in writing seems like it should be about illegal.

Is this normal?
I think it's common. What isn't is taking the HMO approach when what you wanted was a basic exam and refraction. I've had a bunch of different vision plans and none included an MD provider. The HMO probably won't compensate the MD for a refraction, only for the eye health/medical exam. You could have gone to a provider in your vision plan for a basic eye exam and refraction, but you chose to go the MD route, and I think you assumed "exam = exam + refraction", but it didn't. So I think it was an usual situation and was just a misunderstanding. I'd consider it an inexpensive lesson, and for what it's worth getting an exam from an MD plus a refraction for $50 is an amazing deal.

Incidentally the exam you get as part of the refraction package from your vision plan provider doesn't always include dilation, except at an extra charge.
staythecourse
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by staythecourse »

123 wrote: Tue Nov 07, 2017 5:09 pm The Federal Trade Commission website https://www.consumer.ftc.gov/articles/0 ... act-lenses advises:

"The FTC enforces the Eyeglass Rule and Contact Lens Rule, which give you the right to get a prescription from your eye doctor – whether you ask for it or not – at no extra charge. That allows you to shop around and look for the best deal."

Looks like time to lawyer up and go after them. Maybe they couldn't read the law because they need glasses.
I would recommend calling the doctor's office and tell them the rule which sounds ethical, and legal. If they don't agree tell them you will be notifying the state medical board. If they still don't agree call the state medical board and file a complaint. Personally, I would rather give $30 and legally SINK the MD then have them waive the charge. I'm vindictive that way, but am sure after explaining they will back off. Heck, I would still likely call the state medical board as I am sure this is NOT the first time this has happened in this doctor's office. The ONLY way to make sure folks do the right thing is to have consumers notify the regulatory boards when someone is NOT doing the right thing.

The funniest approach would be calling a lawyer. Finding one who would take the case for damages of a whole $30 is fodder for them joking after you leave their office. it is NOT a movie, lawyers do NOT take casing where a patient has been wronged. They takes cases that generate large $$, which leads to large $$ since they are tried on a contingent basis. OF course, they could just charge you $200- $500 to write a letter to the doctor for $30 charge. Either way, a lawyer route is a complete waste of time.

Good luck.
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2pedals
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by 2pedals »

climber2020 wrote: Tue Nov 07, 2017 5:49 pm
kjvmartin wrote: Tue Nov 07, 2017 5:06 pm Hello,

My wife has been complaining about her vision for a while, decided to see an MD Ophthalmologist that participates in our HMO. We called and verified a $20 copay for the eye exam. She received her full eye exam, but our VSP vision plan, separate from the HMO, does not cover lenses and frames at this office. She was up front about this and told them she was just there for the exam, but wouldn't be getting any glasses there.

After the exam, and with eyes dilated, she was lead to the "shop" section of the office and they tried to convince her to pick out some frames. She asked for her Rx to go and was told it would be $30 to get a prescription writing. If I had been there, I'd have strongly objected. I've seen a lot of ludicrous medical charges, but to pay a few to get your Rx in writing seems like it should be about illegal.

Is this normal?
Yes this is normal. Every single ophthalmologist that I'm aware of charges for refractions.

A medical eye exam is different from the vision exam you get at LensCrafters. Refraction fees are not included in a medical eye exam. We absolutely charge for refractions and tell patients up front about the fee. If people don't want to pay the fee, then that's fine; we skip the refraction and do the medical exam only, which is fine by me since refracting someone is by far the most time consuming and tedious part of a complete eye exam and is honestly not worth the 25 bucks relative to the time involved.

The local university eye center charges $40 for refractions. If anything, you're getting a good deal.
I don't see this as normal, after a medical eye exam the office tries convince her to pick up some frames without a refraction.
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quantAndHold
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by quantAndHold »

I have never, living in two different states over the course of 30 years, been charged for an eyeglasses prescription. Contact lenses, yes. Eyeglasses, no. In fact, every eye doctor I’ve been to, whether opthamalogist or optometrist, has that little FTC quote from above printed on a little placard on the reception counter.
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by tibbitts »

2pedals wrote: Tue Nov 07, 2017 7:01 pm
climber2020 wrote: Tue Nov 07, 2017 5:49 pm
kjvmartin wrote: Tue Nov 07, 2017 5:06 pm Hello,

My wife has been complaining about her vision for a while, decided to see an MD Ophthalmologist that participates in our HMO. We called and verified a $20 copay for the eye exam. She received her full eye exam, but our VSP vision plan, separate from the HMO, does not cover lenses and frames at this office. She was up front about this and told them she was just there for the exam, but wouldn't be getting any glasses there.

After the exam, and with eyes dilated, she was lead to the "shop" section of the office and they tried to convince her to pick out some frames. She asked for her Rx to go and was told it would be $30 to get a prescription writing. If I had been there, I'd have strongly objected. I've seen a lot of ludicrous medical charges, but to pay a few to get your Rx in writing seems like it should be about illegal.

Is this normal?
Yes this is normal. Every single ophthalmologist that I'm aware of charges for refractions.

A medical eye exam is different from the vision exam you get at LensCrafters. Refraction fees are not included in a medical eye exam. We absolutely charge for refractions and tell patients up front about the fee. If people don't want to pay the fee, then that's fine; we skip the refraction and do the medical exam only, which is fine by me since refracting someone is by far the most time consuming and tedious part of a complete eye exam and is honestly not worth the 25 bucks relative to the time involved.

The local university eye center charges $40 for refractions. If anything, you're getting a good deal.
I don't see this as normal, after a medical eye exam the office tries convince her to pick up some frames without a refraction.
With a past vision plan I had, I could go to an office with an Ophthalmologist, Optometrist and Optician all in the same facility. The Ophthalmologist was in my health plan but not my vision plan, the Optometrist was in my vision plan but not my health plan, and the Optician... I don't remember if they were in any plan. But it was all the same office. So I think I could have gotten an exam from the Ophthalmologist (for my $50 copay), a refraction (and bonus exam, I guess) from the Optometrist (for free), and ... well I don't know what from the Optician.
dbltrbl
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by dbltrbl »

Most ophthalmologists charge for refraction extra 30-50 dollars. My insurance covers it but my Dr.'s office charges me and reimburses after my insurance pays for it.I think charge was for refraction not writing a sheet of paper.
FamilyMan
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by FamilyMan »

How about call the office, ask for the office manager and ask them about this "charge"? That might clear up a lot of your questions instead of strangers online trying to figure out how your insurance works. Not trying to be harsh but medical billing charges can be difficult to interpret, even for experts in the field.
Katietsu
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by Katietsu »

She went to an opthalmologist for an eye exam because she was having vision complaints. They likely looked for things like cataract, dry eye, glaucoma, etc depending on her age and complaints. As others have said, this appointment, through medical insurance, was for a medical exam. It was not to get a prescription. Getting a prescription is not normally included and paid for under health insurance. The extra fee is for the refraction.

I agree that that there was a problem with communication. It could be that she told them she was just there for the exam. They did the medical exam. The insurance with copay pays for the exam. To an ophthalmologist, an eye exam does not mean a refraction/prescription. This is different than with an optometrist.

Quite frankly, IMO, she should have been charged regardless of where she purchased the glassses. I guess they may waive the refraction fee if you buy glasses there? A couple of ophthalmologists I know have quit doing refraction at all. They have an optometrist in the office. If you want a refraction, you must go to the optometrist for that for a separate fee after you are done with your ophthalmology appointment.
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by idoc »

climber2020 wrote: Tue Nov 07, 2017 5:49 pm
kjvmartin wrote: Tue Nov 07, 2017 5:06 pm Hello,

My wife has been complaining about her vision for a while, decided to see an MD Ophthalmologist that participates in our HMO. We called and verified a $20 copay for the eye exam. She received her full eye exam, but our VSP vision plan, separate from the HMO, does not cover lenses and frames at this office. She was up front about this and told them she was just there for the exam, but wouldn't be getting any glasses there.

After the exam, and with eyes dilated, she was lead to the "shop" section of the office and they tried to convince her to pick out some frames. She asked for her Rx to go and was told it would be $30 to get a prescription writing. If I had been there, I'd have strongly objected. I've seen a lot of ludicrous medical charges, but to pay a few to get your Rx in writing seems like it should be about illegal.

Is this normal?
Yes this is normal. Every single ophthalmologist that I'm aware of charges for refractions.

A medical eye exam is different from the vision exam you get at LensCrafters. Refraction fees are not included in a medical eye exam. We absolutely charge for refractions and tell patients up front about the fee. If people don't want to pay the fee, then that's fine; we skip the refraction and do the medical exam only, which is fine by me since refracting someone is by far the most time consuming and tedious part of a complete eye exam and is honestly not worth the 25 bucks relative to the time involved.

The local university eye center charges $40 for refractions. If anything, you're getting a good deal.
123 wrote: Tue Nov 07, 2017 5:09 pm Looks like time to lawyer up and go after them. Maybe they couldn't read the law because they need glasses.
Go ahead. No competent lawyer will take this seriously.
As stated by climber2020, yes, this is normal: the refraction (the determination of refractive state) is a non-covered service in a medical eye exam. Medicare, which drives coverage by private insurers (likely including your HMO), doesn't cover refractive services because they're excluded by law. In addition, by CMS billing guidelines, if a Medicare patient presents with only a refractive complaint ("I need new glasses"), then the exam also technically is not covered by Medicare, even if disease is detected during the exam.

The fee stated is on par with what is charged by many offices, and is oftentimes higher.

The above cited FTC rule is poorly described on the linked page. The actual text of the rule states:
§456.2 Separation of examination and dispensing.
It is an unfair act or practice for an ophthalmologist or optometrist to:

(a) Fail to provide to the patient one copy of the patient's prescription immediately after the eye examination is completed. Provided: An ophthalmologist or optometrist may refuse to give the patient a copy of the patient's prescription until the patient has paid for the eye examination, but only if that ophthalmologist or optometrist would have required immediate payment from that patient had the examination revealed that no ophthalmic goods were required;

(b) Condition the availability of an eye examination to any person on a requirement that the patient agree to purchase any ophthalmic goods from the ophthalmologist or optometrist;

(c) Charge the patient any fee in addition to the ophthalmologist's or optometrist's examination fee as a condition to releasing the prescription to the patient. Provided: An ophthalmologist or optometrist may charge an additional fee for verifying ophthalmic goods dispensed by another seller when the additional fee is imposed at the time the verification is performed;
Their practice did not require your wife to receive her glasses from their optical shop; they released the prescription to her while charging their customary fee, which she paid and subsequently received a copy of her glasses prescription. No law has been broken, no malpractice has occurred. You might at least attempt to submit the bill to your medical insurance or vision plan for reimbursement, but they are unlikely to cover the cost of the refraction. Lesson learned. Please do not attempt to smear this MD's name and career over what is customary practice and billing. Perhaps they should be more clear about the charge for a refraction upfront (like climber2020's practice, we have the patient sign a notice regarding the fee upon check-in, in addition to having posted placard in the waiting area). I might also recommend that you review the full text of the Eyeglass Rule and then consider rescinding your filed complaint to the FTC.
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by HIinvestor »

We have never paid an extra fee to get written prescriptions for contacts of glasses when we got to any optometrist or ophthalmologist, and between the 4 of us, we all need glasses and 3 of us also have worn contacts at various times. Please let us know how the complaint is resolved.
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by Katietsu »

The appointment was for an eye exam to get glasses.
No. If you actually said that, they likely should have told you that is not covered by your medical insurance or the charge for a refraction is XX. I suspect your spouse said she was having trouble with night vision and blurriness and needed an exam. You and wife thought “to get glasses.” What was actually said is that your wife would not be getting glasses there. This is a misunderstanding of the difference between a MD and an OD and medical insurance vs vision plan.
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by an_asker »

kjvmartin wrote: Tue Nov 07, 2017 5:55 pm
climber2020 wrote: Tue Nov 07, 2017 5:49 pm
kjvmartin wrote: Tue Nov 07, 2017 5:06 pm Hello,

My wife has been complaining about her vision for a while, decided to see an MD Ophthalmologist that participates in our HMO. We called and verified a $20 copay for the eye exam. She received her full eye exam, but our VSP vision plan, separate from the HMO, does not cover lenses and frames at this office. She was up front about this and told them she was just there for the exam, but wouldn't be getting any glasses there.

After the exam, and with eyes dilated, she was lead to the "shop" section of the office and they tried to convince her to pick out some frames. She asked for her Rx to go and was told it would be $30 to get a prescription writing. If I had been there, I'd have strongly objected. I've seen a lot of ludicrous medical charges, but to pay a few to get your Rx in writing seems like it should be about illegal.

Is this normal?
Yes this is normal. Every single ophthalmologist that I'm aware of charges for refractions.

A medical eye exam is different from the vision exam you get at LensCrafters. Refraction fees are not included in a medical eye exam. We absolutely charge for refractions and tell patients up front about the fee. If people don't want to pay the fee, then that's fine; we skip the refraction and do the medical exam only, which is fine by me since refracting someone is by far the most time consuming and tedious part of a complete eye exam and is honestly not worth the 25 bucks relative to the time involved.

The local university eye center charges $40 for refractions. If anything, you're getting a good deal.
123 wrote: Tue Nov 07, 2017 5:09 pm Looks like time to lawyer up and go after them. Maybe they couldn't read the law because they need glasses.
Go ahead. No competent lawyer will take this seriously.
I understand what you are saying, but here's what I don't understand. The appointment was for an eye exam to get glasses. We were told $20 copay on the phone. The work was then done. She was back in the lobby at checkout and she had the option to pay $20 for the copay or $50 for the copay and Rx. She had an option at the point of sale which wasn't discussed by the doctor or anyone else beforehand. Whatever was done in the exam room was covered by the $20 copay, but the extra $30 let her walk out the door with a piece of paper. Is that a good practice?
Normally, I am among the doctor bashing gang around here ;-). But on this one ...

I am confused. For an eye exam, you go to an optometrist. For a complaint with the eye, you go to the ophthalmologist. That is my understanding, at least.

From what you wrote, it appears that your wife planned to go there to find out if something is wrong with her eyes, For that, she was quoted $20 as the fees from the ophthalmologist (I first wrote dude, then remembered what happened to me the last time I did that on these forums!).

If she was going there just to get her eyeglass prescription, wouldn;'t they have told her the same thing that they did while she was there, i,e, they don;t take her VSP plan>
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by an_asker »

HIinvestor wrote: Tue Nov 07, 2017 9:27 pm We have never paid an extra fee to get written prescriptions for contacts of glasses when we got to any optometrist or ophthalmologist, and between the 4 of us, we all need glasses and 3 of us also have worn contacts at various times. Please let us know how the complaint is resolved.
Have you gone there for the express purpose of getting a prescription to correct your vision or have you gone complaining of stye in the eye, or pain or soreness, or swelling or .... something else with the eye? That is the crux of the issue here.

Either way, would love to know how it turns out.
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by baconavocado »

kjvmartin wrote: Tue Nov 07, 2017 5:06 pm Hello,

My wife has been complaining about her vision for a while, decided to see an MD Ophthalmologist that participates in our HMO. We called and verified a $20 copay for the eye exam. She received her full eye exam, but our VSP vision plan, separate from the HMO, does not cover lenses and frames at this office. She was up front about this and told them she was just there for the exam, but wouldn't be getting any glasses there.

After the exam, and with eyes dilated, she was lead to the "shop" section of the office and they tried to convince her to pick out some frames. She asked for her Rx to go and was told it would be $30 to get a prescription writing. If I had been there, I'd have strongly objected. I've seen a lot of ludicrous medical charges, but to pay a few to get your Rx in writing seems like it should be about illegal.

Is this normal?
My comment is slightly off-topic (BTW, I agree with almost everyone here that you should not have been charged extra for the eyeglass Rx). My story emphasizes the point that VSP optometrists make their money by selling glasses, not by doing exams, and I think they're highly motivated to sell you a new Rx every year or every time you get an exam.

Last year I was having symptoms similar to your wife, blurred vision, trouble with bright lights while driving at night. I had just had new glasses with a stronger Rx about 12 months prior, but since it was the end of the year and I had not used my VSP benefit, I decided to go in and have my vision checked again. The optometrist did a thorough exam (dilation, etc.) and said I needed to up the power in one eye (e.g., new glasses). I got the new glasses and in less than 6 months I was having the same symptoms again. This time I made an appointment with the optometrist at my HMO. They immediately diagnosed a cataract in one eye and set me up for surgery. Could this cataract have gone from undetectable to blurring my vision within six months? Seems unlikely to me, especially since I just had a new Rx in the last year. I'm cancelling my VSP insurance and I'm going to get my eye exams and glasses at my HMO from now on.
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by climber2020 »

baconavocado wrote: Tue Nov 07, 2017 9:55 pm Could this cataract have gone from undetectable to blurring my vision within six months? Seems unlikely to me, especially since I just had a new Rx in the last year. I'm cancelling my VSP insurance and I'm going to get my eye exams and glasses at my HMO from now on.
Cataracts can reach a stage where over a very short time they can rapidly change your eyeglass prescription (google myopic shift).

Posterior subcapsular cataracts can even noticeably alter your vision overnight. I've seen patients who were fine when going to bed, and they wake up the next morning blurry.
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by nisiprius »

climber2020 wrote: Tue Nov 07, 2017 5:49 pm...Yes this is normal. Every single ophthalmologist that I'm aware of charges for refractions...
I don't think you read the original post. The refraction had already been done. The $30 charge was assessed in the optical shop as the cost of giving her the prescription that the shop already had. That's what she was told it was for.

In my state, every eye doctor charges you for a refraction, and frequently sends your Rx to the associated optical dispensary... and encourages you to get your glasses made there by never suggesting that there's an alternative. But not one of them has ever attempted to assess a charge for giving you your own copy. Not ever.
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by HueyLD »

nisiprius wrote: Wed Nov 08, 2017 5:18 am
climber2020 wrote: Tue Nov 07, 2017 5:49 pm...Yes this is normal. Every single ophthalmologist that I'm aware of charges for refractions...
I don't think you read the original post. The refraction had already been done. The $30 charge was assessed in the optical shop as the cost of giving her the prescription that the shop already had. That's what she was told it was for.

In my state, every eye doctor charges you for a refraction, and frequently sends your Rx to the associated optical dispensary... and encourages you to get your glasses made there by never suggesting that there's an alternative. But not one of them has ever attempted to assess a charge for giving you your own copy. Not ever.
+1 here.

I dislike arm twisting by doctor's office. A family member went to eye doctor's office for routine exam that included refraction not covered by medical insurance. So, the office visit included the regular copay plus the cost of refraction.

After the visit, he was told to go wait in another line to get his glasses prescription. The whole purpose of forcing patients to get their prescription at the associated optical shop was nothing but "revenue enhancement."

He didn't want to wait another hour for his prescription, so he asked the receptionist to mail it to his home address. Well, the receptionist printed the prescription right on the spot. I guess they didn't want to spend the money mailing it.
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by climber2020 »

nisiprius wrote: Wed Nov 08, 2017 5:18 am
climber2020 wrote: Tue Nov 07, 2017 5:49 pm...Yes this is normal. Every single ophthalmologist that I'm aware of charges for refractions...
I don't think you read the original post. The refraction had already been done. The $30 charge was assessed in the optical shop as the cost of giving her the prescription that the shop already had. That's what she was told it was for.

In my state, every eye doctor charges you for a refraction, and frequently sends your Rx to the associated optical dispensary... and encourages you to get your glasses made there by never suggesting that there's an alternative. But not one of them has ever attempted to assess a charge for giving you your own copy. Not ever.
Yeah - she should have been told about the fee setup at check in. I can see how this can result in problems.

I always make it a point to tell patients that they can buy their glasses anywhere they want to; in many ways, I actually prefer when patients get their glasses elsewhere because 1) it's a time consuming process that takes up a lot of our technicians' time, especially if the glasses didn't turn out right the first time (much easier to just say "go back to Costco and they'll fix them for free"), and 2) for ophthalmologists, the optical shop typically isn't a major source of revenue since most patients don't specifically go to an MD to buy their glasses. Our office would run more smoothly if the optical shop wasn't even there, but oh well.
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by Herekittykitty »

The OP may have already done this, but if not, I do not see any downside in writing a letter to the ophthalmologist with a brief outline of what occurred and asking for assistance and obtaining the prescription or if the wife already has paid the money for it, of being reimbursed the money.

I would write it as if the assumption were that there were communication issues that were not intentional on the part of the office staff and that the wife therefore relied on information that was either incorrect or confusing. As far as the letter goes, I would stick with that, and make no comments implying ill will on anyone's part, but would make it helpful in that it will bring to light the "communication issues," in case the ophthalmologist does not know (assume he doesn't for the purpose of the letter) and in addition requesting either the prescription be issued free of charge, or if the fee has already been paid, request reimbursement.

Either you will get what you want, or you will not. If you do, I would be appreciative. If not, I would just let it go because your time and grief is worth more than that.
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by Rupert »

I see an optometrist and an opthalmologist in the same large practice. I see the M.D. only when I'm having vision problems (maybe every 5 years or so) and otherwise see the optometrist (yearly). On the rare occasion I see the M.D., he usually does a refraction just to save me another trip to the office that year. The office bills my health insurance for the medical exam and my vision plan (also VSP) for the refraction. I've never had a problem. Seems to me the problem here was that your wife saw a doctor who was not in your vision plan's network, right?
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by susa »

kjvmartin wrote: (1) .. She received her full eye exam
(2) ...After the exam, and with eyes dilated
So, at least one or perhaps two professionals were engaged in service, spent time to perform a full examination and used at least some time and materials in their service. They are not unpaid charity volunteers.

Your wife did NOT simply walk in and stand behind a desk an utter the words "... may I have a copy of my PREVIOUS Rx... "

I don't know about your time, or how valuable you consider it to be but if I have a mechanic "...come and take a look at this wheel.." and he actually comes and examines at least for 60 seconds my tire and wheel, I feel obligated to compensate him for time and materials. If I simply yell across a shop floor "...do I need to increase the tire pressure.." and he yells back a response, then perhaps it's free.
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by NotWhoYouThink »

The other problem is that we are hearing from the OP, but it was his wife that was at the doctor. We don't know what she signed when. Maybe OP has the whole story with all the details, maybe not.
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by susa »

Rupert wrote: I see an optometrist and an opthalmologist in the same large practice... Seems to me the problem here was that your wife saw a doctor who was not in your vision plan's network, right?
To add to your fine analysis, the fine point that both optometric physicians (OD) and ophthalmologist (MD) are licensed doctors with at least 4 years of graduate school plus state licensing requirements. The MD completed also a residency program and may perform surgeries. Both write prescriptions for medicines and recommend patients according to each specialty.
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by rkhusky »

I go to an ophthalmologist for all eye exams. A technician performs the refraction test, which costs about $30 and which I pay out of pocket. I don't pay extra to get the prescription printed. A technician and the ophthalmologist both perform additional tests, which insurance covers. I also pay out of pocket for a separate contacts exam, which is usually about $45. I don't pay extra to get the prescription printed. I do not get my glasses or contacts from the in-office optical shop, although they do one extra measurement that is added to my glasses prescription.
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by JPH »

My wife's ophthalmologist includes a refraction in every annual exam. The refraction is not covered by insurance as part of the medical exam, but he would like to know how well she can see. If the refraction determines that she could benefit from a new prescription, then one is written and she is charged $30. If she says she does not want new glasses, then the prescription is not written, and the $30 is waived. If she later changes her mind and wants the prescription, then she pays the $30 and is given the prescription.
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by an_asker »

baconavocado wrote: Tue Nov 07, 2017 9:55 pm [...]My story emphasizes the point that VSP optometrists make their money by selling glasses, not by doing exams, and I think they're highly motivated to sell you a new Rx every year or every time you get an exam.

Last year I was having symptoms similar to your wife, blurred vision, trouble with bright lights while driving at night. I had just had new glasses with a stronger Rx about 12 months prior, but since it was the end of the year and I had not used my VSP benefit, I decided to go in and have my vision checked again. The optometrist did a thorough exam (dilation, etc.) and said I needed to up the power in one eye (e.g., new glasses). I got the new glasses and in less than 6 months I was having the same symptoms again. This time I made an appointment with the optometrist at my HMO. They immediately diagnosed a cataract in one eye and set me up for surgery. Could this cataract have gone from undetectable to blurring my vision within six months? Seems unlikely to me, especially since I just had a new Rx in the last year. I'm cancelling my VSP insurance and I'm going to get my eye exams and glasses at my HMO from now on.
I learned that lesson very early in the game. We had VSP just for one year! :oops:
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by an_asker »

climber2020 wrote: Tue Nov 07, 2017 10:34 pm
baconavocado wrote: Tue Nov 07, 2017 9:55 pm Could this cataract have gone from undetectable to blurring my vision within six months? Seems unlikely to me, especially since I just had a new Rx in the last year. I'm cancelling my VSP insurance and I'm going to get my eye exams and glasses at my HMO from now on.
Cataracts can reach a stage where over a very short time they can rapidly change your eyeglass prescription (google myopic shift).

Posterior subcapsular cataracts can even noticeably alter your vision overnight. I've seen patients who were fine when going to bed, and they wake up the next morning blurry.
I see a disconnect in the response here.

baconavocado: How can an undetected cataract be bad enough to blur my vision within six months?
climber2020: A cataract might blur vision overnight.

I think baconavocado is asking why the cataract was not diagnosed six months ago, not why (or how could) the pre-existing cataract suddenly blurred his/her vision.
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by an_asker »

nisiprius wrote: Wed Nov 08, 2017 5:18 am
climber2020 wrote: Tue Nov 07, 2017 5:49 pm...Yes this is normal. Every single ophthalmologist that I'm aware of charges for refractions...
I don't think you read the original post. The refraction had already been done. The $30 charge was assessed in the optical shop as the cost of giving her the prescription that the shop already had. That's what she was told it was for.

In my state, every eye doctor charges you for a refraction, and frequently sends your Rx to the associated optical dispensary... and encourages you to get your glasses made there by never suggesting that there's an alternative. But not one of them has ever attempted to assess a charge for giving you your own copy. Not ever.
How it works at certain places in FL is like this: there is an advertised price for the eye exam (say $49). If you don't purchase the glasses at that store, they will say that the advertised price does not apply and hike the price to (I'm using an arbitrary number here) $79. It happened to me the first time I got my eyes checked in FL. Since then, I always ask up front whether or not - for the advertised price - I will get the prescription to take away with me.

It might be bait and switch, but it is definitely standard operating procedure at some optometrists.
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by Pajamas »

It's not 100% clear to me exactly what the $30 charge was for, but if it was for a copy of the prescription, not only should an FTC complaint be made, it should also be reported to the appropriate state licensing board, the state attorney general's office or consumer protection bureau, and to the health plan.
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by Rupert »

Pajamas wrote: Wed Nov 08, 2017 9:00 am It's not 100% clear to me exactly what the $30 charge was for, but if it was for a copy of the prescription, not only should an FTC complaint be made, it should also be reported to the appropriate state licensing board, the state attorney general's office or consumer protection bureau, and to the health plan.
They're going to say it was for the refraction, not the written prescription, and that the cost of the refraction is waived if you purchase eyeglasses at their shop. I'd bet money on it.
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by lakpr »

Rupert wrote: Wed Nov 08, 2017 9:36 am
Pajamas wrote: Wed Nov 08, 2017 9:00 am It's not 100% clear to me exactly what the $30 charge was for, but if it was for a copy of the prescription, not only should an FTC complaint be made, it should also be reported to the appropriate state licensing board, the state attorney general's office or consumer protection bureau, and to the health plan.
They're going to say it was for the refraction, not the written prescription, and that the cost of the refraction is waived if you purchase eyeglasses at their shop.
OP stated that they already have paid $20 as copay for the refraction. If the ophthalmologist accepted OP's insurance, he/she should not be "balance-billing" or "over-billing" the patient above the insurance reimbursements.

Even if we buy that argument -- shouldn't that be made clear and unambiguous terms -- as they say in legal terms (may not be necessarily applicable here), of a 'least sophisticated person' ?
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Re: Eye Doctor $30 to get your Rx? Is this normal?

Post by b4real »

I see an OD who practices at an academic medical center with a large eye center. I go annually for a refraction and checkup and when I made the appointment I was told medicare doesn’t cover the refraction and it would cost $38. After checking my vision the doctor told me there was very little change and it was up to me if I wanted new glasses. He said if he printed and gave me the glasses prescription I would have to pay the $38. If I didn’t want the hardcopy RX there would be no charge. Also, even though they sell glasses there is no pressure to get new ones if not needed - a nice change from the independent optomitrists I used to go to.
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