Life and Money With Helaine by Helaine Olen

Doctor's Treatment of Medicare Patient Is Eye-Opening

Hi, Helaine: I just read your article on medical expense etiquette. What do you suggest if you tell your doctor, following an exam covered by Medicare, that you can get new glasses for much less elsewhere, and he flies into a rage saying, "You know, we don't get much from Medicare, and you want cheap, crummy glasses from somewhere else. We lose money on people like you. We don't need customers like you. In fact, we don't want customers like you. Don't ever come back. I'm putting a note in your file that we will not serve you." This really happened. I was flabbergasted. -- Astounded

Dear Astounded: Your letter is similar to my column last week in which I counseled a letter-writer who was made to feel awkward by her eye doctor when she didn't purchase contact lenses at the practice because she could get them for less money online. I suggested the writer be up-front about why she was no longer doing so and see if the doctor would match the online price. As your letter shows, my advice isn't going to help everyone.

You need to find a new eye doctor. This behavior is simply not acceptable. Yelling at a patient -- for any reason -- is a no-go zone. It's rude and bullying.

I am not denying the truth of what your doctor said: It's quite possible you will get a better-fitting pair of glasses in person rather than online. It's also quite possible the reimbursement rate -- whether it is via Medicare or Medicare Advantage (since Medicare doesn't cover routine eye exams, only ones related to the possibility of cataracts or glaucoma; I suspect your doctor is complaining about the latter) -- is not adequate. But if the practice wants you to compensate for that by purchasing corrective lenses like contacts and glasses from them, they need to explain the value added -- what they can give to you in return -- in a courteous and persuasive way, instead of attempting to intimidate patients into using their retail arm. They should also understand that many seniors live on a limited fixed income and might not have the financial ability to pay extra money for uncovered services.

When you do leave the practice, I suggest writing a short email explaining why you are moving on. You don't want this to happen to anyone else.

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