Reimbursement

[Ericska]

Since I am sensitive to preservatives, my eye drops, ointments and gels are all OTC and not covered by my insurance. Does anyone know if this is covered some other way? Since August I have already spent hundreds of dollars and if this is going to be a lifetime treatment for my eyes, I need some help .....

[alb1967]

yes I know we are all in the same boat. I do not know of any agency that will help pay for OTC products. I have spent tons on money in the last 2 years on MC goggles, sclera lenses, ointments, gels, otc drops and warm compresses. Dry eye is a very costly disease

[Ericska]

Yes, I was afraid of that but had to ask. Thank you for responding ..... I am in the process now of getting the goggles and soon will be in need of the sclera lenses .....

[PaulineD]

Just to say that I'm shocked that pour insurance don't pay for preservatrice free eyedrops... Even hylovis-hylocomod? (Preservatrice free but multi-dose) Oo
In France, Social Healthcare pay 60% and my insurance pay the other 40%. And when you have a "long illness", Healthcare pay 100%

[LaDiva]

While insurance does not pay for OTC eye products, I think Medicare/Medicaid covers schleral lenses: https://www.cms.gov/medicare-coverag...=AAAAQAAAAAAA&

I am being fitted for schlerals tomorrow, so hope this to be the case. Not sure about other types of insurance, but I would ask. Those of you who already have schleral lenses can speak to this better than I.

[Ericska]

Hi Pauline, I actually use the HYLO products but since it's PF, it is not covered by insurance. I am going to speak with my optometrist to see if he could write a prescription anyway for it so that I can try to have it covered. Yes, it is very, very POOR insurance here for this sort of thing.

[LaDiva]

Nope, Medicare does not pay for schlerals unless they are prosthetics, and I am not sure what that means.

[Ericska]

Yes, it is unfortunate that the government doesn't help with what is NEEDED .....

[PotatoCakes]

Do you have a flex spend plan or something similar? If a physician writes a prescription, you can get re-imbursed by submitting the prescription letter to the flex plan. You might also try the same with an insurance company.

[Ericska]

Yes, thank you. I just found that out yesterday. It's not much at all but it's something ...

[OompaLoompa]

Have you ever tried going for some time without artificial tears?
I very much ackonwledge that artificial tears are absolutely necessary for many dry eye patients.

However, I indeed have extremely low schirmer test results and every doctor I've been to kept telling me about artificial tears and how important they were: For a long time I took them slavishly until I once went on holidays for a longer time. I didn't have many opportunities to regularly take my eye drops and realized how less of a difference they made.

Naturally you can only even consider not using artificial tears if you make sure with your doctor that not taking eye drops does not cause any damage for your eyes.
In my case, my eyes are very dry but somehow my conjunctiva and corneal are fine. So in my case taking eye drops is all about the subjective feeling, the comfort. And there they don't make any difference at all which is why by now the only thing I use is a night gel before going to bed.

[Ericska]

Hi OompaLoompa - Wow, aren't you worried that over time your cornea will be damaged? You say your eyes are very dry - do you have the scratchy/gritty feeling? My eyes are very dry and sometimes during the day if I don't use the tears, when I blink, it's like suction cups - the stickiness - I couldn't possibly go without. I think that's part of the problem I had this past summer. I wasn't diligent with the night ointment and certainly not with the daytime artificial tears and I was in hell over the summer. The burning, the feeling that I had knives in my eyes and the fact that I didn't have any tears, even when I cried, maybe a drop .. I guess it depends on the type of dry eye you have? I'm aqueous deficient.

So what do you do during the day? If they are that dry, it must cause discomfort ...

[OompaLoompa]

Well, first of all to clarify: The last time I got a schirmer test it was nearly 0 (but of course those can vary a bit). It was in a university hospital. The chief resident entered looking down on my test results, hadn't seen me before and acted extremely surprised when he saw my eyes. From what I gathered between the lines his experience made him expect to see at least really red eyes, possibly even with lesions of the cornea or conjuctiva. However, there wasn't anything. Yes, if you look closely my eyes probably are a bit more bloodshot than the average ones but that's mainly just detectable if you're really close. And yes, my eyes can get red for example in front of the pc if I really forget myself writing a text or something. However, mainly my eyes themsleves seem to be relatively healthy.

So, yes of course I have a fair amount of discomfort.
But the point is: My doctor confirmed that there are no lesions at all on my eyes, that my cornea and conjunctiva look ok - without taking eye drops.
Therefore taking eye drops for me is all about the subjective feeling. And it does not help. Actually I feel that many eye drops rather irritate my tiny, instable tear film so that I find myself with more sensitive eyes for easily 10-15 minutes after having taken eye drops.

And about the discomfort: Cyclosporin reaööy helped me very much in that regard. I always had that "stickiness" you described which decreased greatly with cyclosporin, mainly i think because it is anti-inflammatory.
But seriously, even when I had that "stickiness" big time: It never felt like eye drops would have improved that feeling at all. Maybe for a few minutes, just because there was some additional liquid in my eyes but that was it.