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Frustrated – the system
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I am just getting so frustrated.
As I’m sure you guys know from previous posts – I strongly suspect dyslexia with almost 10yo Delta, and that 7yo Echo has similar symptoms although she reads at grade level (possibly stealth dyslexia?) and that I haven’t been able to have them tested because of financial reasons…
Well, knowing that there can by eye problems – convergence, tracking, etc – when my kids opthamologist said that they could now go to a regular optomitrist (well, not Golf…) – I did some looking and there is a ‘developmental opthamologist’ in my city – so we booked an appointment there. (Note that I thought that Delta had been checked for these issues a couple of years ago – but I’m not totally sure…)
So yesterday my kids had their eye exams. This was the regular exam, but when I mentioned the issues and that I wanted tests for these other things – he did a quick extra test and agreed that there could be issues, and that I will need to book them for the evaluation. Apparently these issues are common with Far-sighted children (which all my kids are EXCEPT Foxtrot (who reads WAY above grade level…)
Now here is the frustration…
The evaluation costs $275 each. They can’t direct bill our particular insurance company – and apparently some insurance companies will NOT cover the evaluation (some will – some will only if there is a problem diagnosed etc.) And then our company only covers $500 a year for vision therapy (per child) – so over half of it will be gone before anything is even done to help!
Add to this that we also have 3 new glasses prescriptions to fill – one of which (golf’s) will cost more than the maximum coverage for her (for 2 years!). In fact, we would have to pay for all of her glasses if my dh hadn’t changed jobs and therefore changed insurance companies.
So we in theory need to front around $900 for glasses and evaluation. In theory the insurance will pay us back most of it – but not all.
In practice it will be more like (I asked the doctor about priority for updating glasses….)
- find $200 to buy glasses for golf (this would be lenses only – to fit her current frames…) – get $150 back.
- use that money to buy glasses for echo – get it back
- use that money to buy glasses for delta – get it back
- find about $150 more to add to the money to get an evaluation for delta – hopefully get it back
- use that money to get an evaluation for echo – hopefully get it back
- use that money for vision therapy, etc for delta/echo – get it back…. run out of insurance coverage and be saddly out of luck….
What I can’t understand is that I live in a country that has “free medical coverage”… and then on top of that we have insurance…. and it STILL seems that we are often doing without medical help because we can’t afford it…. ARGH!
((Suzukimom)) i’m so sorry, I can’t even imagine how frustrating that must be for you guys. I’ll be praying that the insurance company will reimburse you.
This is frustrating. I didn’t realize the differences in provinces, because in BC that would all be covered for minors. Because of our income level, we take part in the healthy kids program, which has covered eyewear and dental for kids (the exams are already covered by MSP). Have you looked into if your province has anything of that nature? This was not a program MSP automatically enrolled me in – I had to search it out and apply.
I’ll be praying for you guys!
Rachel
Hi Rachel
We have a healthy baby program – it provides pregnant mom’s with less income up to $80 a month, groups for pregnant mom’s and babies <1yo – including free milk coupons for the mom if they go to the group – and I think that is about it.
There is a kids dental program that low income kids with no insurance can have dental work done at the rate of $20 a visit.
That is all I know about.
Standard eye exams (1 a year) are covered for minors but not eyewear or apparently this type of speacialty exam
I know last year in September, one of the stores (superstore?) had free glasses for kids – with an eye exam. Maybe we should have just waited for that…..
Medical care in this province sucks. there is a shortage of doctors – I’ve gone through so many family doctors for me since I moved here, I’ve given up. Delta is on his 4th paediatrician. (One we left because he sucked. the 2nd did both patience and hospital work – and decided to focus on hospital work. the 3rd retired. I suspect the 4th will retire in a few years too… sigh)
(what is MSP? I don’t recognize that acronym)
Medical Service Plan. We definitely have doctor shortages here too. We finally just got a new family doctor after years without one. Of course, there are walk ins, but it’s nice to have a doctor that knows your history. I know I get continually frustrated with what isn’t covered for health care. My eyesight is terrible (~ minus 9), and the cost for my appointments and lenses is ridiculous. Still, I’m so grateful for all that is covered. I am sorry to hear what you’re dealing with though. I have the very unpopular opinion amoung Christians that social services are of paramount importance. I have absolutely no qualms with paying for schooling my own kids don’t take advantage of, or paying taxes. But then I get frustrated when something isn’t covered! I would joyfully pay more taxes to know that everyone was FULLY covered, especially children. Parents should never have to wonder how they’re going to pay for their children’s health needs. It’s a terrible feeling!
Rachel
I don’t know if this will help, but I have several friends that purchase their eyeglasses online and save huge amounts of $. They order from the following two places, the first being the favorite.
Zennioptical .com
Eyebuydirect.com
Theyve said it’s even cheaper if you search the site for a Coupon code to get a bigger discount. The friend that uses this the most says she limits the price range to the cheapest frames before they even choose them in order to stay within a reasonable price range for their family.
Can’t help on insurance. We don’t have any and have to figure out how to afford it soon when we are already living on a zero based budget every month.
I have known families that have used books to do their own vision therapy at home because they couldn’t afford diagnoses and appointments. They didn’t get evaluations because of the same situation. So, on their hunch, they went the DIY direction and it helped. I cannot recall the title of what they used. I’ll see if I can get that for you.
Praying,
Becca<><
I don’t know how helpful this might be, but my daughter has had problems with her eyes staying together since she was born. They wanted to do surgery and I refused. But when she was very little, I started having problems, and they said I had a convergence insufficiency. So I started vision therapy on the computer. I asked if my little girl couldn’t do that too instead of waiting til she was “old enough” for the usual therapy. She really did great with it.
It’s called Home Therapy System by Jeffrey Cooper ad Rodney K. Bortel
We both really benefited from it. If you find yourself having to pay, it may be less expensive than other kinds of therapy (which I know nothing about). They have a website that I just peeked at for the first time ever. It looks like they talk a lot about eye strain. My eye dr. never said it was that, so don’t get the idea that’s all it’s good for.
hope it works out
Is an online optical store an option for your kids? I know that they can’t fill some unusual prescriptions, but for standard type glasses, (near-sightedness plus some nasty astigmatism) I’ve had good experiences so far. I use http://www.zennioptical.com but I know there are others. My insurance covers 80% of my glasses, but even then, my 20% of $30 or $40 is much easier than 20% of $400 or $500, which is what I used to pay. Three years ago I bought 4 pairs, including one pair of prescription sunglasses, for $140 total, including shipping. I’m still wearing them.
That doesn’t help with the fees for extra testing and therapy, of course, but perhaps it can lighten the burden a bit.
Joanne
Yeah, Delta and Echo’s glasses really aren’t a big deal – they only cost around $70 or so dollars… A bit of a pain to come up with the money up front, but not really a frustration – more a matter of trying to time it. Golf’s are a pain because she is so little (she started wearing glasses at about 16 months) and the prescription is SO strong…. so thay have to be specially made to make sure they will be strong, yet light, and not too thick or heavy.
My dd6 began wearing glasses at 13 months. We opted for regular plastic frames not the rubbery ones. She fit in that set of frames until she was five. That saved a lot. She has a very strong prescription, too. She has never broken her glasses.
We picked the Mira-Flex frames for Golf when she was 15 months, and I intend to just buy lenses that will fit in them this time. Delta got glasses when he was 3.5 – regular ones – and broke them within the first week (during a temper tantrum) – they were covered under warranty – but it was a big pain. All our frames need adjustments now and then – except Golf’s. They are the most maintenance free frames I’ve ever seen – and if it wouldn’t look goofy on older kids I think I’d buy that type for everyone!
Just popping in here quickly to say that zennioptical.com has AMAZING prices for glasses. I bought 3 pair, one for me and one each for two different daughters for 75.00 total. It is VERY worth it. All you need is the prescription, and you can go on there to order.
HIGHLY recommend!
My daughter also began wearing glasses at 13 months. I had her first checked by a vision therapist at 4 and he rcommended the book Developing Your Child for Success by Kenneth Lane, OD. Dr. Lane is who did her 1st evaluation and the book has been a great resource. Cathy Duffy’s review of the book is pretty good if you want more info. Dr. Lane’s website used to have a test that you could take for free to see where your child’s problems may be, but I don’t see that link at the moment. He also has some other books with more vision exercises, but for my daughter, this was a great starting point. We have continued to struggle with various issues and have had an international move. She is now six and seen two other doctors who have had varying opinions. We have spent a lot of money, all out of our pocket, and I haven’t felt that any of the therapy has helped her tracking or ability to read. I would love to hear more success stories on vision therapy, but I have only ever heard one.
wife2gr8man–did you see my post above about Home Therapy Systems? I really do recommend it. You do need a prescription to get it.
Here’s a link to their website describing it.
http://www.visiontherapysolutions.net/index.html
At the bottom of the page you have to keep clicking Next to read more. The website isn’t all that impressive, but the product is. On the last page it looks like there’s alink to find a dr. in your area to prescribe it. But it looks like you might be able to get a free trial (unless that’s for doctors).
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