Prescription glasses and Private Health

bargainhereicome on 07/01/2014 - 18:47

Hi all,

Recently went into OPSM to do new glasses covered under medibank private (with limit $200).
If i want to get fully covered by private health, i'm only allow to choose those cheap crappy frames with crappy lense.
Then i saw those branded frames that were 50-70% off from the original price which bring the price down to less than $100. I asked whether i can choose those frames but the staff said the discount doesnt apply if u get it cover under private health. It doesnt make much sense to me.

What if i dun get them to claim for me, i just choose those heavily discounted decent branded frame and lense, and pay cash for it. Then, i bring the receipt to medibank private to claim myself? Does it work that way? If it does, i'm sure we can get a much better quality frame?

Anyone has same experience? Welcome any comments, much appreciated :)

General Discussion

Comments

  • ihbh on 07/01/2014 - 18:55

    Medibank customers get 20% off OPSM, but you can't stack discounts.

    So you might be better off getting say 70% on the frames, and 20% on the lens, but since you're "bringing your own frames", you incur a $30 handling (or whatever it's called) charge.

    Compare this with 20% of full priced frame plus lens and go with cheaper option.

  • Smulder on 07/01/2014 - 18:58

    There may be some confusion regarding the discount you get on glasses for being a Medibank member (with OPSM the discount is 20%) which cannot be used in conjunction with in-store discounts. So you cannot get the Medibank 20% discount on already reduced glasses.

    From the OPSM website:

    "**Subject to your particular level of health cover, available limit and health funds rules. Excludes eye tests and contact lens consultations and designer brand frames and sunglasses by Chanel, Gold & Wood, Maui Jim, Oliver Peoples, Paul Smith, Tag Huer and Tiffany & Co products. Health fund discounts are not available in conjunction with any other offer, discount, rebate or benefit other than a health fund rebate. "

    Never heard of them denying a health fund rebate just because the glasses are discounted… could be wrong though

  • emiko on 07/01/2014 - 19:14
    +1

    If they give you receipt with itemize code eg 110 for the frame and 212 for the lenses. You can claim yourself.
    It doesn't make sense coz they still get paid the same when you use health fund.
    Did you ask for the no gap cover ? Coz lenses usually quite expensive it will be hard to cover everything with 200 limit plus brand frames.

    • eatwell365 on 10/01/2014 - 00:16

      Emiko, +1 that your knowledge in the business. It is true that the shop gets paid the same whether from health fund or out of pocket. However, margin can be higher on no gap cheap cost glasses than discounted designer glasses. Knowing fund patients pay zero gap and spending third parties money anyway, shops may like to make the There is no need to offer too many choices instead of selling glasses with the highest profit margin ie. 50 cents lenses and "Cucci" plastic frame.

  • bargainhereicome on 08/01/2014 - 00:49

    I end up getting the fully covered (with no out of pocket payment)glasses. From the receipt they gave me, they do itemize the frame and lense separately. So the crappy frame cost $149 (become $80++ after discount) and the lense (with anti-reflective) cost $200 (become $100 after discount) , end up OPSM claim full cost $188 from medibank private for me. The lense seems good but the frame looks crappy, probably cost them less than $20.
    So, not sure how much the lense normally cost for those without private health, but if the normal cost for lense is around ($100-$120) then can choose a better brand discounted frame that cost around $80 , end up with $200 and just send in the claim ourselves?
    Not sure it works that way or not, any idea?

  • PlasticSpaceman on 08/01/2014 - 07:48

    I gave up on bricks & mortar optometrists for glasses a few years ago. I get my eyes checked there & update my script but that's all. Annoyed the heck out of me being $200+ out of pocket after insurance due to stupid expensive frames and upgrades like thinner lenses plus coatings. To compare, bought four glasses last month (from clearlycontacts) for myself & daughter and ended up $100 out of pocket. So $25 each. All designer frames, including some Rayban sunnies. Even without claiming I expect I still would have saved money….

  • PlasticSpaceman on 08/01/2014 - 07:53

    Oh, by the way, one trick/issue is insurers like medibank have sublimits. So (for example) you may have $250 to play with but of that you can only claim (say) up to $80 for a frame. Not actual numbers, but basically that's another reason why you may walk out being out of pocket but still have some credit left….

  • nikey2k27 on 10/01/2014 - 00:07

    (speck savers) i get to pair no gap brand names tommy and contrary road opsm is total rip off. my nan went 699 for nice glass and lenses.

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