I’ll start by saying it is a fact that I am an idealist. Albatross and blessing, I can’t escape it and I no longer try. That said, every now and again, I run smack dab into the wall of my own idealism and sometimes, it smarts a bit more than others.
I recently posted about a fabulous new pair of glasses. I can honestly say they are the best pair I’ve had in my life (I’ve had many, as I’ve had to wear the blasted things since age 7).
It is a specialty lens, hand ground, computer calculated for maximum peripheral field and exact placement of bifocal as well as the blend from near to mid-range to distance. The frames, well, they speak for themselves.
I paid a damn pretty penny for them. 79,500 of them, to be precise. I didn’t count it extravagant at all, since I’ve had real difficulty with both glasses and contacts since my prescription crossed the -6.50 threshold for my left eye, with my right one nearing the same boundary. (Yes, I am near blind without them.)
I didn’t mind it because I figured my insurance provider would cover most of the expense, though likely after a deductible.
I called the insurance company today to figure out what I needed to file for reimbursement and was told the following:
(1) The place I got my frames and lenses is “out of network”.
(2) They only cover $90 on frames and $40 on lenses if out of network.
(3) They require higher than usual co-pay on out of network choices.
The upshot? I’m receiving less than 20% back on the expense, even as it’s a fact that I couldn’t get hand-ground, computer balanced lenses (i.e., ones that actually work!) at the local outlets that are in network. (Believe me, I’ve tried. I’ve got four pairs of glasses from various in-network providers laying around that I just can’t wear because either the near vision doesn’t work, or the mid-range is shot, or the distance is blurry, or the peripherals are non-existent.)
So yes, I’m mildly annoyed. I mean, silly me, I thought the purpose of insurance was to assist you in expensive purchases. Well, no, I’m an idealistic fool. The purpose of insurance is to soak you for premiums and try like hell to avoid ever having to pay out, or to make what you have to pay out so minuscule in comparison that your insured often wonder why the hell they bother… they could just as easily do an FSA or HSA or interest bearing savings account for things like this, take the appropriate write-offs each year on taxes, and likely come out near or ahead of the game.
I’m aiming for Lasik sometime next year. Hopefully I can then kiss both glasses and vision insurance goodbye. I suppose we’ll see. For now, I’m feeling snarky, even if I can see straight while doing it.