Medical Aid

[Sinbad]

Care to elaborate why star gazing is out? (Maybe I'm just being thick here as I can't understand why having light pass into your eyes prevents you from star gazing)

They work on a small section of your cornea. If your iris opens wider than that you get blurring and halos
Not sure if things have changed since then...

 

[LottaFun]

Just want to add my 2 cents - I was a discovery member with the daily savings option. I did a comparison between their hospital plan only option and their hospital plan with daily. This was 5 years ago. For me and my family the plan with daily was R1000 more expensive per month than the straight hospital plan. That should give you R12 000 per year for daily items like spectacles, teeth and things like that. What made me leave them and really made me mad, was that you don't get R12 000 per year for day-to-day. At that stage they were taking R2400 per year in management fees leaving me with R9600 bucks!!!

Come on guys, let's face it. They take the interest on the R12 000 + management fee of R2400!!! They are actually billing you for managing your savings. I now only have a hospital plan and manage my day-to-day myself. On top of that I always ask for discount for cash and I always get a discount. I pay that R1000 into my credit card every month and use that to pay the doctors.

Remember, when you go into hospital for an op or whatever, that doctor is covered under your hospital plan.

 

[tRoN]

An optom told me confidentially that the markup on glasses frames is around 400%. Anyone can validate this? Maybe we need some consumerism to fight this ripoff.

 

[DA-LION-619]

An optom told me confidentially that the markup on glasses frames is around 400%. Anyone can validate this? Maybe we need some consumerism to fight this ripoff.

My friends sister is an optom, she's only coming down in beginning of May from Mauritius so only then I can confirm with that statement but from my knowledge if you go to the optom department at UKZN you get a eye test, frame and lenses dirt cheap. If you're friends with optom students you can even get the contact lenses free not sure about other universities.

 

[ld13]

Anyone else pick up that lately optometry (if there is such a word) has become ridiculously expensive?

I work in that business ... and I seriously have no idea what you are talking about*. While the popi act is not 100% in action as of yet, I dare you to come and visit me and pick a number, any file number - I'll print out two invoices for you from said file number (and black out the personal info). One recent invoice and one invoice from a few years ago. We have found that our invoiced prices towards the patients have barely increased, with a few that is getting a better actual price than their previous visits.

*There is one specific type lens that had a significant price increase over the past 12 months: HRI (High Index lenses). Since the price increase recently we have not had the heart to prescribe a patient one of these lenses.

What is true though is that optometric medical aid benefits have taken a significant dive in the recent years. Most of our discovery patients now sit with "savings" on their specific discovery option that provide them with far less actual value than a few years ago when they had specific insured benefits to work with.

For prescription sunglasses (not glasses), will Discovery pay anything? That includes from the MSA (which I treat as Discovery paying).
Got a pretty big amount in my MSA, and would like to bring it down. Sunglasses seems like a good idea

If you have a savings account with discovery, they tend to pay out for anything that has a proper ICD10 code. Prescription glasses that go dark in the sun got their own ICD10 code. Hope that answers your question?

An optom told me confidentially that the markup on glasses frames is around 400%. Anyone can validate this? Maybe we need some consumerism to fight this ripoff.

Actually some markups are more than 400%. Some of the frames out there that might sell for R1000+ cost a few dollars to make. Would you mind sharing with me what you feel would be a reasonable markup on glasses (complete test+frame+glasses)? I'll then gladly do the maths for you to explain if an optometrist can survive on said markup.

 

[akescpt]

I work in that business ... and I seriously have no idea what you are talking about*. While the popi act is not 100% in action as of yet, I dare you to come and visit me and pick a number, any file number - I'll print out two invoices for you from said file number (and black out the personal info). One recent invoice and one invoice from a few years ago. We have found that our invoiced prices towards the patients have barely increased, with a few that is getting a better actual price than their previous visits.

*There is one specific type lens that had a significant price increase over the past 12 months: HRI (High Index lenses). Since the price increase recently we have not had the heart to prescribe a patient one of these lenses.

What is true though is that optometric medical aid benefits have taken a significant dive in the recent years. Most of our discovery patients now sit with "savings" on their specific discovery option that provide them with far less actual value than a few years ago when they had specific insured benefits to work with.



If you have a savings account with discovery, they tend to pay out for anything that has a proper ICD10 code. Prescription glasses that go dark in the sun got their own ICD10 code. Hope that answers your question?



Actually some markups are more than 400%. Some of the frames out there that might sell for R1000+ cost a few dollars to make. Would you mind sharing with me what you feel would be a reasonable markup on glasses (complete test+frame+glasses)? I'll then gladly do the maths for you to explain if an optometrist can survive on said markup.

what are costs like on contact lenses? im interested in the throwaway kind. I've never had so would like to try them.

 

[tRoN]

Actually some markups are more than 400%. Some of the frames out there that might sell for R1000+ cost a few dollars to make. Would you mind sharing with me what you feel would be a reasonable markup on glasses (complete test+frame+glasses)? I'll then gladly do the maths for you to explain if an optometrist can survive on said markup.

Thanks for sharing this info but as a consumer we cannot help feel shocked at the fact that we are being charged 1000% more for a product.

Please elaborate about what u said about "not surviving" if the markup was lower. I don't understand.
If glasses were cheaper then I would change my pair every 4 months rather than wait 2years

 

[Sinbad]

what are costs like on contact lenses? im interested in the throwaway kind. I've never had so would like to try them.

I wear daily disposables. The cost is around R750 per month - which is lunacy - so I wear them 3 days each (I take them out at night). My optometrist doesn't want to hear this of course.

 

[Slaught3r]

I work in that business ... and I seriously have no idea what you are talking about*. While the popi act is not 100% in action as of yet, I dare you to come and visit me and pick a number, any file number - I'll print out two invoices for you from said file number (and black out the personal info). One recent invoice and one invoice from a few years ago. We have found that our invoiced prices towards the patients have barely increased, with a few that is getting a better actual price than their previous visits.

*There is one specific type lens that had a significant price increase over the past 12 months: HRI (High Index lenses). Since the price increase recently we have not had the heart to prescribe a patient one of these lenses.

What is true though is that optometric medical aid benefits have taken a significant dive in the recent years. Most of our discovery patients now sit with "savings" on their specific discovery option that provide them with far less actual value than a few years ago when they had specific insured benefits to work with.



If you have a savings account with discovery, they tend to pay out for anything that has a proper ICD10 code. Prescription glasses that go dark in the sun got their own ICD10 code. Hope that answers your question?



Actually some markups are more than 400%. Some of the frames out there that might sell for R1000+ cost a few dollars to make. Would you mind sharing with me what you feel would be a reasonable markup on glasses (complete test+frame+glasses)? I'll then gladly do the maths for you to explain if an optometrist can survive on said markup.

Keep your pants on.

Three years ago when I got my current set of glasses the most expensive thing was the frame (R1200). This time round the frame cost me R750 - discounted to R250. I had to PAY IN R3400. That means R3400 + R1500 Medical aid contribution = R4900 for my glasses R4900 - R250 = R4650 for the lenses (the actual appointment is covered somewhere else). The lenses are the same strength as the ones I am wearing now. Why am I getting new glasses? Because my current lenses are scratched *****ed up.

Do you see my point? Or are you still feeling a little precious?

 

[akescpt]

I wear daily disposables. The cost is around R750 per month - which is lunacy - so I wear them 3 days each (I take them out at night). My optometrist doesn't want to hear this of course.

I was wanting to try the 3 month ones. A bit freaked out about the inserting and taking out of the eyes. I've been assured it's not a big deal but....

 

[Sinbad]

I was wanting to try the 3 month ones. A bit freaked out about the inserting and taking out of the eyes. I've been assured it's not a big deal but....

Takes a couple times to get used to it but yeah no big deal. Been doing it since I was 13 (with the 12 year lasik gap)

 

[ld13]

what are costs like on contact lenses? im interested in the throwaway kind. I've never had so would like to try them.

Over 90% of the lenses we prescribe these days are throwaway (monthly) lenses. The remaining patients either wear daily disposables or the "old generation" hard contact lenses. The exact price depends on if you need single vision or multifocal lenses and what brand you would prefer. But in general there is a break-even at around the 2 year mark when compared to normal glasses. This is of course when I compare my C/L pricing with my specs pricing. I am not going to comment on the wearing of daily lenses for more than a day. Those babies work out quite expensive compared to normal glasses, but they fill a certain gap in the market. What glasses do you currently wear? Do you know if you have astigmatism by any chance?

Thanks for sharing this info but as a consumer we cannot help feel shocked at the fact that we are being charged 1000% more for a product. Please elaborate about what u said about "not surviving" if the markup was lower. I don't understand. If glasses were cheaper then I would change my pair every 4 months rather than wait 2years

You are probably never charged a 1000% more for a product. Although, I have seen quotes from other optometrists that have hit the R20 000 mark. Usually branded lenses. In the end it all comes down to cost. It is not cheap to run a business that only sells 1 thing in the end. Give me a markup that will make you feel comfortable as a consumer and then also what your perfect salary would be if you were the owner of a practice. I'll slat the maths for you and tell you how much people you would need to see a day to make money.

In general, if glasses were cheaper people would not replace their pair more regularly. In fact from what I've seen the return cycles in our area have been slowing down.

Three years ago when I got my current set of glasses the most expensive thing was the frame (R1200).

How much did you pay for what lenses 3 years ago?
How much did you pay for what lenses this time around?

How did you scratch your lenses? Did your optometrist not show you how to take care of your glasses?

 

[Sinbad]

I am not going to comment on the wearing of daily lenses for more than a day. Those babies work out quite expensive compared to normal glasses, but they fill a certain gap in the market.

Monthly disposables are not practical with the watersports I do - the financial hit of losing one is too high. Dailies are just too expensive - nearly R9k a year, the limit on my medical aid for optometry is R3500.
Dailies stretched out for 3 days are the sweet spot. The lens remains comfortable, it's stored in Renu disinfectant solution - I don't see a problem here. If on day 2 or 3 the lens starts bugging me, I throw it away and move on to the next one.

 

[akescpt]

Over 90% of the lenses we prescribe these days are throwaway (monthly) lenses. The remaining patients either wear daily disposables or the "old generation" hard contact lenses. The exact price depends on if you need single vision or multifocal lenses and what brand you would prefer. But in general there is a break-even at around the 2 year mark when compared to normal glasses. This is of course when I compare my C/L pricing with my specs pricing. I am not going to comment on the wearing of daily lenses for more than a day. Those babies work out quite expensive compared to normal glasses, but they fill a certain gap in the market. What glasses do you currently wear? Do you know if you have astigmatism by any chance?

ive just got normal glasses. am short sighted.

 

[AlmightyBender]

I am also thinking what does Discovery get me? I mean, all that happens is that some of my money is diverted into a medical savings account. Discovery then profits from the interest, and pays it back out to me when I claim for something. Now there is a whole lot of dentistry, and essentially I need to pay for it all myself. My medical savings account will be finished very quickly, and then I'm on my own. And since I paid for what is currently in my MSA, I am paying for everything.

I cannot think of a single thing that 4 years of medical aid premiums have got me, that I have not paid for myself. The only thing that I think is worth having is insurance for hospital cover.

EDIT: I am on the saver plan, so I have no above threshold benefit. Once I have used up my MSA, that is it.

Just to answer this question, what it gets you is insurance more than anything. So if you get cancer that results in R2 million in medical bills that is what Discovery is for, or if you're in a car accident and you need extensive surgery etc.

 

[ld13]

I don't see a problem here.

Yes you don't ... we see the problems in the end. But yes, those daily lenses are freaking expensive. How many lenses have you lost in the past year? What is your script?

 

[Sinbad]

Yes you don't ... we see the problems in the end. But yes, those daily lenses are freaking expensive. How many lenses have you lost in the past year? What is your script?

I've probably damaged or lost 4 or 5 lenses in the last year.

-1.75, -0.5
My eyes are just fine, health wise.

 

[D3nz]

R11k for glasses? Dafuq? Did she get them made out of 18 carat gold?

Jeez, you typed the words right out of my mouth!

 

[Ancalagon]

Just to answer this question, what it gets you is insurance more than anything. So if you get cancer that results in R2 million in medical bills that is what Discovery is for, or if you're in a car accident and you need extensive surgery etc.

So MSA is pointless.

It seems like most of my premium is wasted.

 

[Sinbad]

So MSA is pointless.

It seems like most of my premium is wasted.

MSA is merely enforced saving for day-to-day expenses.