Insights From Our Editors

How to Educate Patients About Vision Benefits

By Mark Wright, OD, FCOVD,
and Carole Burns, OD, FCOVD

July 18, 2018

Retired, or soon-to-be retired, patients may need education on vision insurance options, according to a recent survey commissioned by VSP Vision Care. A combined total of 332 retirees and pre-retirees participated in the survey.

The majority of respondents were sure of their post-retirement medical plans (67 percent), but far fewer were as sure of their vision (35 percent) or dental options (35 percent).

That means nearly two-thirds (64 percent) of respondents planning for retirement were unsure if they will have access to vision coverage in retirement or, in fact, were convinced that they won’t. That’s a coverage gap that would be unheard of on the medical side. Forty percent of retired respondents reported that they do not have vision coverage at all. Yet only 2 percent of them said the same about their medical plan.

This lack of understanding about vision care benefits is not restricted to patients at or above age 65. Defined benefits, benefit packages, benefit contributions, flexible spending accounts, health savings accounts, insurance coverage, primary versus secondary coverage, deductibles, co-pays, out-of-pocket expenses, upgrades … the list goes on and on. Anyone would be confused.

It is the responsibility of the insurance/benefit company and/or the employer to educate patients about their benefits. Yet anyone who has dealt with patients on the doctor side realizes very quickly that most patients do not understand their vision care coverage. The VSP Vision Care survey clearly bears that out.

What most often happens is that it falls to doctors (and their staff) to educate patients about their vision care benefits. Let’s state this in a different way, insurance/benefit companies and employers have shifted the burden of patient education onto the doctors. This increases the doctors’ expenses, and often puts a barrier between the doctor and the patient. Neither of these situations helps the doctor-patient relationship. Do you expect this to change? As long as there is no incentive for the groups doing the cost shifting to change, there will be no change.

So, what do doctors do? There are laws that restrict what doctors can say to patients. As a doctor, you cannot tell patients/employers to boycott insurance/assurance/benefit companies that do a terrible job of educating patients about their eyecare coverage. Do you call patient relations, tell them the patient does not understand their benefits, and then hand the patient the phone? How well do you think that is going to go?

To make the best of a bad situation, doctors can step up and become the patient advocate. Jay Binkowitz tells practices to use consumer language with patients instead of billing language. The script would be something like this: “If you did not have vision benefits, this pair of glasses would cost you $512, but because you have XYZ vision benefits, your cost today is only $275.” Stop breaking down fees using the al-a-carte fee presentation method, and instead, use the single-fee approach. Stop trying to explain the differences between XYZ vision benefits and those of a different company. Instead, get to the point simply, quickly and efficiently.

Take this week to examine your vision benefit explanations for patients. Always keep in mind the end game of getting patients the care they need.

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