Boston Sclerals #2

[Rebecca Petris]

I would not say I am severely disabled by any means, but it is something I deal with on a constant basis, and have yet to find complete relief.

Again I don't want to speak for BFS... just talking my own impressions here. I think that failure to find complete relief with other treatments is certainly not enough on its own. It's more about whether you can get things to a manageable level with other treatments or not.

[Vicki In Oregon]

What are the side effect of Sclelerals that they only consider some patients and not others? And how long must i be in pain for a doc to give me that referral? Does insurance generally help with these costs? Is there anyway to know in advance before they make them for you if you can even handle gas permeables? Thanks!

[kurt]

What are the side effect of Sclelerals that they only consider some patients and not others? And how long must i be in pain for a doc to give me that referral?

Sounds to me like you are mostly frustrated at your doctor. He may not know that much about sclerals. He certainly has not read this bulletin board. It may take a while before he is receptive.

Does insurance generally help with these costs?

Probably it will cover the $350.00 initial consultation. It might cover a part of the remaining $7,600, since for patients going to BFS the lens is considered a medical necessity, but most insurers don't cover the full cost.

[kaypeeoh]

ESPECIALLY if the problem was caused by elective surgery. I couldn't get insurance to cover Restasis because the company decided my dry eye was the rusult of LASIK. Even though I had LASIK 7 years before Restasis was prescribed.

[Rebecca Petris]

I couldn't get insurance to cover Restasis because the company decided my dry eye was the result of LASIK.

That's mind-boggling. Fortunately also extremely unusual! LASIK patients make up a substantial portion of the Restasis market and I think most get their insurance to cover it (assuming they're insured) - otherwise nobody would be buying it - the co-pays are bad enough. But even if the insurer won't cover treatment for lasik complications for whatever reason, how could any practitioner say with a straight face that your dry eye is without any shadow of doubt due to a surgery that happened 7 years ago? A lot can happen in 7 years.

[Rebecca Petris]

I couldn't get insurance to cover Restasis because the company decided my dry eye was the result of LASIK.

That's mind-boggling. Fortunately also extremely unusual! LASIK patients make up a substantial portion of the Restasis market and I think most get their insurance to cover it (assuming they're insured) - otherwise nobody would be buying it - the co-pays are bad enough. But even if the insurer won't cover treatment for lasik complications for whatever reason, how could any practitioner say with a straight face that your dry eye is without any shadow of doubt due to a surgery that happened 7 years ago? A lot can happen in 7 years and dry eye is a relatively common condition.

[Lucy]

That's mind-boggling. Fortunately also extremely unusual!

I once was reminded privately via email by a physician who has a bad lasik outcome that I should NOT be charging any of my post lasik stuff to my insurance company because it was a result of an elective procedure. I have not now, nor back then, any idea of who he/she is.

Perhaps it's something we just haven't heard much about. I am only relaying my one experience with this subject. I thought it was a pretty ballsy thing to do - remind me not to charge my eye medical problems to my health insurance. Especially since it was someone who knew me and I was unaware of their identity. I also didn't know it was any of their business.

[kaypeeoh]

Since the prescription was written by a doctor, I imagine I could have argued that the reason for the Rx was so I could wear RGPs. But I was able to use the veterinary version of the drug. Restasis cost $90 for a month's supply. The veterinary version, Optimmune, cost $5 a month.

[Rebecca Petris]

So... "Today's Tip" from Kay-Pee-Oh

Borrow your neighbor's dry-eyed dog (after all, we all know how to recognize the signs by now)... quick visit to the nearest vet... an Rx... and $50 copays are suddenly a thing of the past

[kaypeeoh]

It's a small tube. The cyclosporine is in a petrolatum base. What worked best for me was to put a dab in the eye at bedtime. First thing in the morning, I rinsed the oil out.

http://s77.photobucket.com/albums/j4...gAnch=imgAnch1

[dianat]

I guess insurance shouldn't cover labor & delivery then since sex is elective.

[Lucy]

I am not being funny, or trying to make a message. Many health insurance policies state they will not cover charges resulting from elective surgeries.
Better read our policies and be sure.