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mrmpa

(4,033 posts)
Thu Feb 27, 2014, 12:42 AM Feb 2014

Took my 83 year old mother to the Opthamologist today............

it was her annual visit. However, we learned she has wet macular degeneration in her left eye. An appointment was made with a retina specialist for this Friday. She wanted to wait till next week, so she could "think about this". I said "no" you're going Friday, no ifs, ands, or buts. The sooner she starts treatment, the more sight might be saved.

Mom handed me her checkbook in order to pay on our way out. The charge was a $35 copay for the visit and $35 for a prescription for eyeglasses. I asked why a charge for the prescription. Some convoluted answer about how Medicare doesn't compensate for the prescription. My reply to her was that when Mom goes to her Primary Care Physician he doesn't charge for the prescriptions (plural) that he hands over to her.

WTF, charging for something that the patient goes to the Doctor for.

10 replies = new reply since forum marked as read
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Took my 83 year old mother to the Opthamologist today............ (Original Post) mrmpa Feb 2014 OP
I think what it is -- Medicare does not pay for refraction to prescribe glasses. Hoyt Feb 2014 #1
Well that's very interesting, because........ mrmpa Feb 2014 #2
I am on Medicare and RebelOne Feb 2014 #3
That sounds fishy. Scruffy Rumbler Feb 2014 #4
Thank you....... mrmpa Feb 2014 #5
That's the plan I have .. 840high Feb 2014 #6
Hi mrmpa, Scruffy Rumbler Feb 2014 #7
FYI, wet macular degeneration is better than dry n/t TexasBushwhacker Feb 2014 #8
My Dad has both. progressoid Feb 2014 #10
Caring for my 80-something year old mother too... barnabas63 Feb 2014 #9
 

Hoyt

(54,770 posts)
1. I think what it is -- Medicare does not pay for refraction to prescribe glasses.
Thu Feb 27, 2014, 01:04 AM
Feb 2014

$35 is a common charge. Since Medicare considers it a "non-covered" service, you gotta pay. They'll cover the looking in the eyes, diagnosing retinal problems, etc., but not prescribing lens (except once after cataract removal). It's handled like cnon-covered cosmetic surgery in a sense. Sucks, but those are the rules.

mrmpa

(4,033 posts)
2. Well that's very interesting, because........
Thu Feb 27, 2014, 01:25 AM
Feb 2014

when Mom had her cataracts removed last year he refused to give her a prescription. He said she could use "readers". She has found readers to be inconvenient and she can't really find the right strength.

Isn't diagnosing a need for lenses, a normal part of his job. Why would he even think to charge that to Medicare? Prior to Mom's cataract surgery she saw this same Doctor and he prescribed lenses but never charged for the prescription. Is this new? It's really ridiculous.

RebelOne

(30,947 posts)
3. I am on Medicare and
Thu Feb 27, 2014, 06:00 PM
Feb 2014

when my eye doctor gives me a prescription, I am never charged for it. But the drugstore pharmacy charges me dearly, as I don't have the plan D prescription coverage.

Also, I had cataract surgery in one eye and will have surgery in the other eye this coming Tuesday. I don't have supplemental coverage, so I am having pay a few hundred dollars out of pocket to pay the 20% deductible that Medicare does not cover. But thanks to Medicare, I am able to get the surgery.

Scruffy Rumbler

(961 posts)
4. That sounds fishy.
Thu Feb 27, 2014, 11:35 PM
Feb 2014

It seems to me the writing of the prescription is part and parcel of the general visit charge.That seems kinda of like double billing. If your mother is going to be seeing them on an ongoing basis, you may want to check this out. Medicare can be reached at 1-800-633-4227. I'm my mother's money handler. And deal with her Medicare Summary Notices (EOB). That is where the number is from. And of course, I could be wrong about this!

Hope your mom does well with the treatments. My mother has been having the treatments in both eyes for a few years now. Once you start, it is important to maintain the regime. And if she ends up requiring the treatment in both eye, you may want keep your own personal record on a calender to keep track as to which eye has been treated when. During my mother's course of treatments, one was cancelled for weather. Her next appointment came up and they continued as if no appointment had been missed. This resulted in one eye being skipped and that resulted in rapid progression in the missed eye.

Good luck!

mrmpa

(4,033 posts)
5. Thank you.......
Fri Feb 28, 2014, 02:59 AM
Feb 2014

my Mom has a medicare advantage plan and not the traditional medicare coverage, though it has to follow all the same rules. I am going to call her carrier.

Scruffy Rumbler

(961 posts)
7. Hi mrmpa,
Fri Feb 28, 2014, 12:44 PM
Feb 2014

My sister and I share guardian duties for our mother. We are starting our 3rd year caring for her. If you ever have any questions or just need to chat about it, feel free to DUmail me. I may not have answers, but I can always listen!

Please, update this thread when you get an answer from her carrier!

progressoid

(50,012 posts)
10. My Dad has both.
Fri Feb 28, 2014, 06:36 PM
Feb 2014

One in each eye. His wet eye isn't responding to treatment - he's virtually blind. The dry one seems to be stable.

barnabas63

(1,214 posts)
9. Caring for my 80-something year old mother too...
Fri Feb 28, 2014, 05:57 PM
Feb 2014

Hang in there, you've got your hands full, no doubt. Mine's pretty healthy so far and has been with me for about 3 years too.
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