Contact lenses

[aryeh1]

Yes. They will apply the amount that they get from your insurance towards the lenses. They are reasonably priced. You can see how much they actually get from your insurance on your online account.

In the past, the full amount came off when ordered from 1-800 contacts. I'm not sure why it would be different here?

[Realshlomo]

In the past, the full amount came off when ordered from 1-800 contacts. I'm not sure why it would be different here?

Yes its confusing when you find out that the amount your insurance gives you off ie $150 towards contact lenses or glasses is not what they (the store) receive. They get a different, lesser amount.

So certain stores are only willing to give you off the amount that they will receive.

This was just recently explained to me at a certain store, and he explicitly told me that he has to be careful with a non 613 because if you call insurance and complain he can get in all sorts of trouble.

[aryeh1]

Yes its confusing when you find out that the amount your insurance gives you off ie $150 towards contact lenses or glasses is not what they (the store) receive. They get a different, lesser amount.

So certain stores are only willing to give you off the amount that they will receive.

This was just recently explained to me at a certain store, and he explicitly told me that he has to be careful with a non 613 because if you call insurance and complain he can get in all sorts of trouble.

Right, but they're supposed to follow insurance and give the full amount as they have a contracted rate , i.e., dental ins (their cost vs cost after insurance) and everything else. For example, I've seen where labs the cash price was much more vs what they get from insurance.

[Realshlomo]

Right, but they're supposed to follow insurance and give the full amount as they have a contracted rate , i.e., dental ins (their cost vs cost after insurance) and everything else. For example, I've seen where labs the cash price was much more vs what they get from insurance.

Correct. I was a bit baffled to say the least.

Can you imagine going to the doctor and he tells you insurance is only giving me $50 but my cash rate is $150 you need to pay the difference??

Unclear to me why a glasses store is different.

[efflpetzel]

Where's the best place to order prescription goggles

[HudZ]

Where's the best place to order prescription goggles

I've gotten in the past from Optical Eye-land in Lakewood. (They're ready made in different prescriptions).

I've also got from a website called swim outlet .com, IIRC, they were like $12 or $13. Great price.

[aryeh1]

Correct. I was a bit baffled to say the least.

Can you imagine going to the doctor and he tells you insurance is only giving me $50 but my cash rate is $150 you need to pay the difference??

Unclear to me why a glasses store is different.

She said insurance pays less and they charge a processing fee, so I'm responsible for the difference. When I said it's supposed to be the full amount- she said I don't know how insurance works.  I told her I'll find out and ask Davis if that's true.  She said it's Mesirah, and they'll make an investigation. Is this true? I feel like if they're playing games..

Edit: she also said she can raise the prices and charge me full retail amount and then deduct the full ins allowance amount. Idk if it's fair to charge different pricing either

[Realshlomo]

She said insurance pays less and they charge a processing fee, so I'm responsible for the difference. When I said it's supposed to be the full amount- she said I don't know how insurance works.  I told her I'll find out and ask Davis if that's true.  She said it's Mesirah, and they'll make an investigation. Is this true? I feel like if they're playing games..

I mean you can definitely call your insurance and ask how it's supposed to work to clarify things without naming a store... maybe record the call to play it back to her.

Definitely a pet peeve of mine when someone uses religion to protect them doing something unethical/wrong, gray area.

But their prices might still be better even without giving you the full amount.

I'm not super involved or understand the whole process, but on the surface this is what it looks like.

[aryeh1]

I mean you can definitely call your insurance and ask how it's supposed to work to clarify things without naming a store... maybe record the call to play it back to her.

Definitely a pet peeve of mine when someone uses religion to protect them doing something unethical/wrong, gray area.

But their prices might still be better even without giving you the full amount.

I'm not super involved or understand the whole process, but on the surface this is what it looks like.

I just called insurance not to make a complaint or get them in trouble just so they can "clarify" and call them to tell them how it works and that I'm entitled to the full benefit amount but apparently they're not on the insurance list and when they called they said they don't accept my plan lol (also I recall the lady at Lowys originally telling me that even if I would call insurance they're under a different name or something so won't help).

Anyone know another place that accepts Davis but doesn't play games and is honest?

[yaakovely]

I looked at my EOB and they credited whatever insurance reimbursed them towards the cost of my lenses. What they basically are doing is waiving your deductible which you should be thankful for. I do not believe what they are doing is illegal (waiving the deductible), but it is definitely frowned on by insurance companies and could make them lose in network/provider status..

[aryeh1]

I looked at my EOB and they credited whatever insurance reimbursed them towards the cost of my lenses. What they basically are doing is waiving your deductible which you should be thankful for. I do not believe what they are doing is illegal (waiving the deductible), but it is definitely frowned on by insurance companies and could make them lose in network/provider status..

There's no deductible for me.  Your plan might be different. All I have is X amount towards lenses, but they're saying they will only give towards it what insurance actually gives them, not the full amount, so in essence, they're deducting something (patient cost= insurance allowance or X - what insurance is actually paying).

[yaakovely]

There's no deductible for me.  Your plan might be different. All I have is X amount towards lenses, but they're saying they will only give towards it what insurance actually gives them, not the full amount, so in essence, they're deducting something (patient cost= insurance allowance or X - what insurance is actually paying).

I just checked and I did not have a deductible either (only an insurance adjustment). They gave me all the monies they received through the insurance and their pricing is significantly better then other providers that accept Davis Vision. IMHO, you will end up with more lenses through them then through any other provider.

[aryeh1]

I just checked and I did not have a deductible either (only an insurance adjustment). They gave me all the monies they received through the insurance and their pricing is significantly better then other providers that accept Davis Vision. IMHO, you will end up with more lenses through them then through any other provider.

I understand all this but they're still not supposed to deduct what the final amount that they get from insurance (she claimed Davis charges a processing fee for example), rather they are supposed to deduct the full benefit amount, like @Realshlomo above mentioned..imagine going to a doctor where they charge $250 for a visit but insurance only pays $35 or whatever, so you need to now pay the difference ie $215.

[Realshlomo]

I just called insurance not to make a complaint or get them in trouble just so they can "clarify" and call them to tell them how it works and that I'm entitled to the full benefit amount but apparently they're not on the insurance list and when they called they said they don't accept my plan lol (also I recall the lady at Lowys originally telling me that even if I would call insurance they're under a different name or something so won't help).

Anyone know another place that accepts Davis but doesn't play games and is honest?

What about costco or lens.com? Ezcontacts.com?

Do they accept Davis maybe? 

[aryeh1]

What about costco or lens.com? Ezcontacts.com?

Do they accept Davis maybe?

I think only 800contacts accept afaik

[Realshlomo]

I think only 800contacts accept afaik

So why not price match to 1800 from Costco or lens.com and use them with insurance?

I think that's your best bet. Only other option would be to order from the eye Dr office. You'll pay a higher price, but they should give you the full insurance amount off and sometimes through them they have rebates if you take 6 months or a years worth.

Those rebates are only available if you buy directly from Dr office.

[herb]

So why not price match to 1800 from Costco or lens.com and use them with insurance?

Not when using Davis insurance

[aryeh1]

So why not price match to 1800 from Costco or lens.com and use them with insurance?

I think that's your best bet. Only other option would be to order from the eye Dr office. You'll pay a higher price, but they should give you the full insurance amount off and sometimes through them they have rebates if you take 6 months or a years worth.

Those rebates are only available if you buy directly from Dr office.

Thanks.

I don't think 800contacts matches when using insurance.

I don't believe costco accepts my davis vision plan.

Any other lense places recommended?

Also any recommendations for eye doctors (seems anyways my rx is expired and Lowys said need a new one).