Eye care in Maine

Ken Anderson said:
::Sigh::

I don't WANT to pay for it myself. I have a Medicare Advantage plan, which replaces Medicare proper. Payments are not supposed to be submitted directly to Medicare, but to the Advantage plan. As far as I am aware, regular Medicare doesn't pay for eyecare; my Advantage plan does. I've been on Medicare for a decade now, and have always paid for my own eye care because my last Advantage plan didn't.
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Ken, have you contacted your Advantage plan provider? When I had my eye surgery, it was at an outpatient facility that insisted that I pay up front. I contacted Aetna (my advantage provider) and was told that normally claims are submitted by the medical facility directly to Aetna and Aetna determines how much will be paid, etc. Then I pay whatever "my portion" is.

However this particular facility has a policy that the patient pays and then submits the claim to their insurance. It's really annoying but I did pay for it and now I'll have to submit the claim.

As for the optometrist that wanted your Medicare info; they may not be an approved provider for your Advantage plan. I have to use doctors and providers that are on my provider list. Thankfully, Aetna has an extensive provider list and I have never had a doctor or facility that didn't accept my coverage.

I apologize if this has already been mentioned in the thread. I'm having trouble reading so I scroll over stuff.
 
They would have no way of knowing because they wouldn't even take an information about my Advantage Plan. Either way, billing Medicare directly isn't going to do anyone any good, and I don't mind paying for the exam and the glasses. I could alwasy deal with the Advantage Plan later.
 
I guess I wasn't clear. Contact the Advantage Plan to see which eye doc is on their "provider list." Then contact that provider.

FYI, most doctors are swamped this time of year because people wait till the last minute to use their benefits so it is sometimes difficult to get an appointment until January.
 
I agree with @Beth Gallagher about contacting your insurance provider for the advantage plan, like Humana, Aetna, or whomever you have the plan through.
The insurance providers usually have a list on their website of the doctors and clinics that accept their insurance program. I usually just go to the insurance website for my advantage plan, and browse through doctors to see which ones are close to us and also are taking new patients.
I think that most insurance companies also have apps.
I know that both Humana and Devoted Health have apps that i can use on my iPad or phone.

However, you can usually call the insurance company on the member services number on the back of your advantage card, and they can tell you if the eye place where you went is on their list of vision doctors or not. If not, they can help you find someone close to you that does accept your advantage plan.

This is how the website for my Devoted advantage plan looks. If I know what doctor I want to find, I can put in the name, if I just want to find one close to me, I can put in my zip code.
By calling the customer service number at the top, i can get someone from Devoted to help me find out about any doctor, or find one that is covered by their insurance.

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Yvonne Smith said:
I agree with @Beth Gallagher about contacting your insurance provider for the advantage plan, like Humana, Aetna, or whomever you have the plan through.
The insurance providers usually have a list on their website of the doctors and clinics that accept their insurance program. I usually just go to the insurance website for my advantage plan, and browse through doctors to see which ones are close to us and also are taking new patients.
I think that most insurance companies also have apps.
I know that both Humana and Devoted Health have apps that i can use on my iPad or phone.

However, you can usually call the insurance company on the member services number on the back of your advantage card, and they can tell you if the eye place where you went is on their list of vision doctors or not. If not, they can help you find someone close to you that does accept your advantage plan.

This is how the website for my Devoted advantage plan looks. If I know what doctor I want to find, I can put in the name, if I just want to find one close to me, I can put in my zip code.
By calling the customer service number at the top, i can get someone from Devoted to help me find out about any doctor, or find one that is covered by their insurance.

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That may also help you find the nearest provider even if it is miles away. It seems odd that there are no providers near your residence @Ken Anderson. We have a eight within 25 miles and we are in the boonies too. Maybe you could try getting an appointment during one of your trips. When I had a similar problem with hearing, there was i provider within 100 miles that accepted my insurance and she was terrible. I went to Everett, Washington to visit my daughters and there were 52 providers around Everett that accepted my insurance and one of them was even a friend of one of the daughters, so I made an appointment to coincide with a visit there.
 
I've been trying (periodically) to get an appointment since early summer, so it's not a Christmas thing. I doubt that it's a matter of not accepting my particular Advantage Plan because they don't know - and aren't interested - in learning anything about my Advantage Plan. It's an Anthem Blue Cross Blue Shield plan, and most providers accept it. There are plenty of vision care facilities in Bangor and the surrounding area, but I haven't yet found one that accepts new patients, except for this one, and talking to them feels like entering Bizarro World. I'm not looking for help, just posting stuff that's on my mind.
 
Finally, I was able to get an appointment to see an optometrist, taking well over a year and calls to several eye clinics. I have an appointment on May 12. Only a decade ago, eye care facilities were taking walk-in patients. Canada might not even be this bad.
 
Ken Anderson said:
Finally, I was able to get an appointment to see an optometrist, taking well over a year and calls to several eye clinics. I have an appointment on May 12. Only a decade ago, eye care facilities were taking walk-in patients. Canada might not even be this bad.
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We used to go to an opthamologist in Walmart for decades. There were optometrist assistants there too. That ended when he retired.
 
Ken Anderson said:
Finally, I was able to get an appointment to see an optometrist, taking well over a year and calls to several eye clinics. I have an appointment on May 12. Only a decade ago, eye care facilities were taking walk-in patients. Canada might not even be this bad.
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Is it something local? Our tiny town has several options. We have been with the same doctor since we moved here. Clinic looks like a Kirkland sale ten years ago. Her staff is up to speed and so is the doc. Appointments take two weeks or so.
 
We have several options as well, including one right here in Millinocket, but no one is taking new patients, and when you can find one taking new patients, appointments are nearly a year away.
 
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