As eyecare providers, we are vital healthcare members of our communities, but unfortunately many Americans do not schedule routine eyecare. Did you know about half of Americans don’t enroll in a vision plan, even if they have health insurance? Though vision insurance itself isn’t prohibitively expensive, not having it does cause natural inequities in which Americans seek routine vision care because these plans contribute significantly towards an annual eye exam and glasses. For those who go without insurance, the cost of an exam can become a barrier to care.
People with Medicare or Medicaid also have additional barriers to proper eye care. Medicare programs, which provide insurance coverage for Americans 65 and older, don’t include coverage for routine eye exams, refraction testing or eyeglasses. Medicare does cover tests for higher risk medical conditions like glaucoma or cataracts, and surgical treatments of these conditions if needed. Unfortunately, those with Medicaid have trouble even getting eye appointments. That’s because many practices simply don’t accept Medicaid, which is utilized by low-income individuals and families as a form of payment.
As a case in point, Nanodropper Digital Content Creator, Kristi Hargiss. She signed up for Medicaid in 2018, thinking it would help her get the care she needed. Kristi wears glasses and needs them to see. After an exhaustive search, she couldn’t find a local eye doctor who would accept Medicaid, so she had to pay more than $400 for her exam and new eyeglasses. This is a prophetic dollar amount — numerous reports cite that many American families, as many as 40%, would not be able to handle a $400 emergency expense with savings.
“If you have government benefits you rely on such as Medicaid, it is significantly more difficult to identify places for eye care that you can go outside your community health center,” said Anthony Idaspe, owner of Insurance Simplified LLC, an agency that works with individuals to identify and enroll in the proper insurance plan for them. “There needs to be more awareness and assistance for disadvantaged individuals and communities to find and receive care. Many of these individuals don’t have access to a cellphone, computer or community operative to help them find this care near their house.”
A recent study in Ophthalmology revealed a disturbing trend regarding insurance coverage and disparities in glaucoma care. According to the study, the odds of white Medicaid members having no glaucoma test were found to be nearly 200 percent higher than those with their own private insurance. For Black Medicaid members that number balloons to almost 300 percent versus those with other insurance.
When it comes to addressing racial disparities in healthcare, it’s easy to blame differences in genetics — glaucoma does occur about five times more often in Black Americans, due to a variety of factors — but in reality, that just makes it more vital for this segment of Americans to receive proper eye care, especially with the COVID-19 pandemic disproportionately ravaging communities of color. As we continue to gather more data, it’s becoming more evident than ever that inequities present in our healthcare system accounts for more disparities in outcomes for people of color than any other cause. The narrative is progressing in the scientific community as well.
Too often, these communities simply don’t get what they need. Numerous scientific studies show that early detection of glaucoma can allow sight to be preserved and ocular complications can be prevented. And yet, as many as half of the estimated 3 million people living with glaucoma in America don’t even know they have it. How can this be? Well, it goes back to getting those pesky eye exams and having the money to pay for them. While there is no cure, glaucoma has a variety of treatments that, with diligent adherence, will preserve patients’ vision. One of the frequently overlooked causes of additional medical expense is the wasted medication resulting from eye drop sizes being too large for the eye. Nanodropper exists to help this patient population afford eyedrop medications that can be cost prohibitive.
From the perspective of the insurance companies, fewer exams means fewer claims to pay. But it also means worse care for the patient. And that just won’t do.
So What Can You Do?
For those who are in need of proper eye care but don’t think they can afford it, there could be a wealth of resources at your disposal.
Due to the COVID-19 pandemic, Vision Service Plan is currently offering a free discount program through the end of 2020. It’s not an insurance plan, but it will offer substantial discounts on certain out-of-pocket costs, like exams, guaranteed pricing for lenses with prescription glass purchases, and savings on sunglasses, contacts and other related items. VSP also offers vision insurance plans for as little as $13 per month.
The National Eye Institute has put together a list of programs that patients can apply for to get free or affordable eye care. Optometry Cares — The American Optometry Association’s Foundation, also provides a list of assistance programs that might help individuals in need.
EyeCare America, offered by the American Academy of Ophthalmology, offers free eye exams and up to a year of care for people over 65, and people with a high risk of glaucoma.
InfantSEE offers no-cost eye assessments for infants 6-12 months old.
Lions Club International has a robust network of chapters around the globe that help with a number of charitable initiatives, with vision being one of their top priorities. Look up your local chapter to see how they can connect you to resources.
VSP Global’s Sight for Students program provides glasses to children from low-income families. Go through your child’s school or a community partner for assistance.
Mission Cataract USA offers free cataract surgery to those who can’t afford it.