#it is very odd being anticapitalist but also breaking the news to patients about costs

[skruffie]

I went on tiktok trying to see if I could find a video to demonstrate an interesting encounter I had today and this one is actually perfect. We had someone come in who originally had scheduled for an exam yesterday but didn't realize there would be a $10 copay, so he rescheduled to today and brought in cash. Our assistant manager told him to bring at least $80 because I think we were believing he didn't have insurance, but he did!

His insurance plan had a material copay of $25 but when it came time for the glasses he said he wanted only what his insurance would cover. His current glasses were similar in thickness to the ones in this video and, going with his prescription, they would not be any thinner.

Insurance companies (at least here in the states) will cover the cost of basic plastic/CR-39 but lens upgrades to something thinner and generally more comfortable to wear are rarely fully covered. Where I work, the retail price for polycarbonate single vision (no bifocal) is $220 but insurance plans can bring that cost down to around $33 sometimes. Polycarbonate is often fully covered for kids because it's also impact resistant and it's a safer choice for younger patients.

This guy should have been getting hi-index, which is the thinnest one we have (optical folks out there: ours is I think 1.66 and our lab is out of state so I don't know if we can offer Trivex or anything thinner), but... whatever insurance covers, it's not going to be the hi-index. Out of pocket cost for that can range for SV to about like $70-80 with a lot of plans, and ours is bundled with a non-glare which bumps it up over $100 just for the lenses. He found a frame that was fully covered but the material copay kept him from buying them.

So if you're getting glasses and the optician is recommending upgrading your lens materials, it's not meant to be an upsell. It is for your own literal comfort and, in some cases, because the frames you picked might not be compatible with a thick lens. If you're getting base plastic but your prescription is -6.00/+6.00 or stronger, you are going to want a fully enclosed frame, preferably plastic. If you get a thin metal frame and you're only able to afford the CR-39, be aware that the lens may sit kinda heavy on your face and in some cases with stronger prescriptions you might not be able to close your temples.