Vision insurance that covers Medically Necessary Contacts

[RetiredAndLovingIt]

When I was working I had great vision insurance with Eye Med (Insight Network) through my employer. It even covered my medically necessary contact lenses and it only cost me a $10 copay for everything.
Now that I'm retired and my Cobra has ended, it seems the available individual insurance offers and ACA vision plans use different networks that don't include the specialists that I need to see. I was only able to find a Humana Vision option that showed my doctors but their insurance people told me Humana is horrible to work with and takes forever to approve anything and will probably not pay from their experience even though they are in network. I can't even call Humana direct with questions because all the numbers seem to go to insurance agents that don't seem to have a clue. A few days after I've talked to them, I get a letter thanking me for considering Humana Dental Insurance!!!! That's happened three times now.
I have my vision appointment for next month and will willingly pay the $900 that it will cost me (Blow That Dough) if I have to but if I could possibly get some insurance that would pick up a portion of the cost that would be great.
Has anyone else ran into this situation before and been able to figure out a solution? Again, it won't kill me to pay in full but my natural cheapness makes me want to check all options first..

 

[Philliefan33]

Why do you think an eye exam + contacts will cost $900?

We’ve never had vision insurance. DH and I have our eyes checked at the optometrist inside Costco. I think it’s about $200 for the checkup (including the surcharge for contact lens fitting/Rx). I order my contacts through Costco.com for about $30/month. If my eyeglass Rx changes I usually get the first pair through Costco Optical and any extras from Zenni.

 

[MrsHaloFIRE]

Similar question do you have special eye concerns?

 

[RetiredAndLovingIt]

Why do you think an eye exam + contacts will cost $900?

We’ve never had vision insurance. DH and I have our eyes checked at the optometrist inside Costco. I think it’s about $200 for the checkup (including the surcharge for contact lens fitting/Rx). I order my contacts through Costco.com for about $30/month. If my eyeglass Rx changes I usually get the first pair through Costco Optical and any extras from Zenni.

These are custom made in RGP hard contact lenses. I had RK many years ago and like many others that had this surgery I have a lot of eye problems. My vision can't be corrected with glasses. I see specialists at a teaching clinic that are really good at what they do and for what they give me $900 is a steal. I used to pay full board before my ex employer offered a vision plan and if I have to pay it again I gladly will but it would be nicer to get some help with an insurance plan and I hoped someone in the group might have some suggestions.

 

[RetiredAndLovingIt]

Similar question do you have special eye concerns?

Yes, distorted corneas and dry eye.
I'm still in RGP contacts at this time but Scleral lenses might be in my future and that's when you can get into some really big bucks.
I'm lucky that I found a good facility and my doctor gets the fit almost spot on every time I need to replace them.

 

[omni550]

I've worn Boston EO RGP lenses for years.

I have a local ophthalmologist check my eyes.

I ask for a copy of the RX and order the lenses from one of the inexpensive (approx. $35/lens) online sources.

omni

 

[RetiredAndLovingIt]

I've worn Boston EO RGP lenses for years.

I have a local ophthalmologist check my eyes.

I ask for a copy of the RX and order the lenses from one of the inexpensive (approx. $35/lens) online sources.

omni

Tell me more.
That's pretty cheap, do you have any vision complications or is this just a fairly standard prescription? Mine are medically necessary due to previous eye surgery.
I looked at my last EOB, the claim for the actual lenses was $540 (pair) and EyeMed paid them $513 back in 2019. So I looked a little further and on every claim they paid 95% of the amount billed for the lenses. I also noticed the cost of the lenses climbing a lot each year.

 

[omni550]

Tell me more.
That's pretty cheap, do you have any vision complications or is this just a fairly standard prescription? Mine are medically necessary due to previous eye surgery.
I looked at my last EOB, the claim for the actual lenses was $540 (pair) and EyeMed paid them $513 back in 2019. So I looked a little further and on every claim they paid 95% of the amount billed for the lenses. I also noticed the cost of the lenses climbing a lot each year.

RetiredAndLovingIt,

I have astigmatism and vastly different corrections needed for each eye to achieve 20/20. No other vision complications.

These different RXs, as I've aged, have worked out well. For the past 15-20 years, my eye doctor has had my eyes corrected for monovision (L eye for distance, R eye for 'close work'). So the actual corrective prescriptions now are quite close. And I'm fortunate to have excellent corrected vision.

My eyes keep changing a little bit now and then, so I keep my old lenses as a 'library' (making sure to label them with the RX). I select my emergency back-up pair from these. Plus I check my 'inventory' when I get any RX changes to see if I have the lens in stock. If not, I order online.

Additionally, I asked my doc for "low-light booster" glasses, as I noticed some eye strain in low light (like in theaters/night-time driving). So she gave me a low-power RX which effectively corrects both eyes to slightly sharper distance vision. This is a huge help. I've ordered these booster glasses for about $10 from goggles4U online.

omni

 

[RetiredAndLovingIt]

I also have all my old lenses in cases going back probably more than 15 years. It helps when you break one to have a spare. My mistake was not labeling the year they were retired so I could at least grab the newest "old" one.
We decided a long time ago with all my problems just to correct for long distance and wear reading glasses for close up. They get me close to 20/20 in one eye and 20/40 in the other and for that I'm very grateful. Glasses can do nothing to correct my vision, but a pair of pinhole glasses are extremely effective when I'm laying in bed at night watching TV, I just look weird and certainly can't wear them outside.
I never asked for a copy of the prescription so I'm definitely going to ask for that this time. and may even order a pair just for curiosity to compare them to my expensive ones.
I'm really happy with my current doctor at this teaching facility and what she's been able to accomplish.
You really can't put a price on your vision so i really should stop whining about insurance and just spend the money, it's not even that much.