Monday, January 28, 2019

The Cost of a Trip to the Optometrist

via Warby Parker, which is not where I went for my new glasses

I have terrible vision, and that's been true for most of my life. When I was a child, starting around age seven, my vision deteriorated quickly. Like clockwork, I needed a new prescription every year, and it changed by a similar (and rather significant) margin every year. Thankfully, once I was an adult, my vision stopped deteriorating quite so fast, and I no longer needed to see the optometrist so regularly, though at my mom's insistence, I still went frequently, generally at least once every two years or so during one of my visits home to California. These days, though, now that I don't get to travel home as often, I'm far less responsible.

Fast forward from law school to earlier this month, and it had been three years since my last optometrist appointment, and nearly five years since I last got a pair of new glasses (and I wear glasses often). Although my vision hasn't deteriorated much since my early 20s, and I generally never notice the slight decline, if any, between appointments, the doctor still adjusts my prescription upward every so often, maybe every other appointment or so. This time around though, I was starting to actually notice and feel that it might be high time for a new prescription. While my vision still seemed clear, I was starting to feel a little eye strain when I'd been staring intently at a computer screen for too long in one day, and feeling a slight urge to squint to read small or faraway text.

In terms of whether I have vision insurance or not, it's been about 50-50 in the years since I was a teen. I was originally going to say that I've often been lucky to have vision insurance. But, actually, looking back, I'm not sure it generally conveys much real benefit, at least, not with the vision plans I've been on. I no longer have the option of getting vision insurance through work, but back when I had that choice, it usually cost around ~$23/month, but didn't seem to offer benefits that were necessarily worth that. I did a little casual research just now into what it would cost to buy my own vision plan, and the first website I looked at was very upfront about how, at ~$20/month in premiums, typical patients only saved around $240/year, which seems to be a rather open admission by the insurance company itself that their product may not be worth it.

Way back in the day, I generally had vision insurance as part of my mom's health plan with Kaiser Permanente (a fairly common provider in parts of California), which could only be used at their in-house optometry department, nowhere else. And the vision insurance part of that health plan was pretty terrible, at least as far as I can recall. (The last time we tried to use it, I was in middle school, so the memories are admittedly quite faint.) The benefits only covered either one of contact lenses or a pair of glasses at a time, not both (which is fairly typical on other plans as well, in my experience), and one may have needed to wait longer than a year in between each instance of actually using the benefit. I'm even tempted to say that the required gap was two years, but may not remember well enough to say for sure. And the price for the exam, although it was supposed to be covered, was always quite high, often an extra nearly two hundred dollars. My mom thought it was such a terrible value that we only ever tried using Kaiser's vision benefits once, actually. We ended up going to Costco instead, for the rest of my optometry appointments in California, even if we couldn't use our insurance there.

From that time at Kaiser in middle school, up until I graduated law school, I relied exclusively on Costco optometry. And going there, without any insurance that could help defray any of the costs, was still reliably cheaper than using the vision insurance through my mom's plan. I'm tempted to say that eye exams were ~$89, with a small extra fee of something like ~$25 to add on a contact lens exam, and they had competitive prices for glasses. Because I have such bad vision, though, the glasses were still quite expensive, typically close to ~$300 or a little more. They always recommend that I add on extra charges for things to make the lenses thinner, otherwise, I guess I'd really have coke bottle glasses. (After starting to use soft instead of hard contact lenses, I've tended to order them from elsewhere online to find the best deal, I've never gone through Costco for those.) These days, though, I can't really get to Costco anymore, and I also don't have vision insurance at present.

All this is a very long way of saying that I was never fully acquainted with how much optometrist services or new glasses cost outside of Costco, where prices are unusually competitive. So I had quite a bit of sticker shock recently when I went to a non-Costco optometrist on my own and without insurance for the first time! Part of the exam could be billed to my health insurance with a $40 specialist co-pay for an exam that typically costs $195. And the rest of the exam, which I paid for without insurance, only cost ~$150, including the contact lens exam, which actually isn't terrible, given that I remember it used to cost around $114 at Costco.

The glasses, though, oh my, that's where the main sticker shock came from. Mine are around $850! And I'm told it's with a significant discount. Holy moly. That's a lot more than any previous pair from Costco ever cost me. I did immediately go to Google to try and find other anecdotes about people paying more than $800 for a single pair of glasses, and did find at least one data point, which made me feel slightly better.

Because my vision is so bad, and because I wear glasses so often, I'm not currently inclined to looking at more affordable online sources like Warby Parker or Zenni Optical. (I've heard an occasional complaint about the fit and quality of Warby Parker glasses, incidentally. I had one colleague who used Zenni Optical, and she had no complaints, but I don't think she wore her glasses that frequently either.)

And we haven't even started factoring in the contact lenses that I also need, especially now that I'm thinking of going with more expensive dailies instead of the ones that can be reworn for approximately three to four weeks. (I only wear contact lenses rarely, so it's likely that dailies are the best choice regardless, as I previously would barely wear a pair three or four times in the four weeks between new pairs.) A full year's supply (which will, with my habits, last far longer than a year) may cost around $600 if ordered through the optometrist. And I'm seeing prices of ~$550 online for that same year's supply, though that's before factoring in things like Ebates that could help reduce the costs. Vision correction is expensive! (And oh, I've heard from others who've done it that Lasik may not be a great choice for someone whose vision is as bad as mine, though I've never looked into it myself.) 

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