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.

(To ask Helaine a question, email her at askhelaine@gmail.com.)

(EDITORS: For editorial questions, please contact Sue Roush at sroush@amuniversal.com)

Hi, Helaine: My ophthalmologist sells contact lenses. Glasses, too. I used to buy my prescription lenses from his office, but about two years ago, I noticed they were significantly less money at an online store. So I am now ordering them that way. That’s good, right? But it’s awkward. The receptionist always asks if I need to reorder “again” when I come in for my annual checkup. So does the doctor. They both obviously recall when I did buy the contact lenses at the medical practice. I say no and look away. Is there a method to handle this so I feel less embarrassed? Or do I need to find another doctor who takes my insurance and start anew? -- Seeing Red

Dear Seeing Red: Repeat after me: You are not in the wrong. You have nothing to feel embarrassed about. And, by the way, neither does the doctor or the receptionist, as long as they are not aggressive about pushing the service on you. Many eye doctors supplement their earnings by selling contact lenses and eyeglasses and the like in their offices. They aren’t the only doctors who do this, by the way. Have you ever visited a dermatologist’s office and not seen a pile of skin potions for sale? You are absolutely not obliged to buy any of this stuff.

But ... it sounds like you would like to continue giving your business to the doctor’s practice, or you would if the price for the contact lenses were the same. So here’s my advice: When you go in for your next annual checkup, and they ask you to purchase the lenses, say you would love to do that but you found them for a lower price online. They might well ask you what that price is and offer to match it. Think about it from their perspective for a moment: They don’t know why you suddenly ceased buying from them. They would probably like to know the answer to that. And by telling them the truth -- lenses are cheaper elsewhere -- you are giving them the choice of how to handle the matter.

(To ask Helaine a question, email her at askhelaine@gmail.com.)

(EDITORS: For editorial questions, please contact Sue Roush at sroush@amuniversal.com)

Hi, Helaine: My daughter and son-in-law gave me my first (adorable) grandchild last year. My son-in-law has tons of life insurance, but my daughter has none. He's in the military, so life insurance seems to make particular sense, and they are thinking of getting even more. Apparently, the insurance also offers an investment plan, so they are getting two things for the price of one.

My daughter not only works, but she outearns her husband. I hate to think this way, but surely she should be covered too. When I raised the question, they laughed me off and said she wasn't in the military, but I worry. And what about the baby? -- Concerned Grandma

Dear Concerned Grandma: You are right to think this way. No one wants to think about life insurance -- it's truly one of the most depressing subjects out there -- but it exists for a reason. The way I was always taught to think about it is that it is about both replacing lost income and, if a person has caretaking responsibilities, the cost of replacing those services on the open market. For example, studies show that replacing the services of a stay-at-home parent could cost more than $100,000 annually. It sounds to me like your daughter meets both of those criteria.

But here is another question: Why does your son-in-law need more than "tons" of insurance? I've got a rather cynical answer to this: Insurance agents make a nice commission selling life insurance with an investment component. These policies are almost always a bad idea. The annual premiums are high, and the investment options offered within the plans are frequently less than optimal.

My advice? Both your daughter and son-in-law should look into something called level term life insurance, which is plain vanilla insurance that offers coverage for a set period of time, like 20 or 30 years. That's the most cost-efficient way to go. They can take the money they will save on premiums and invest it on their own. I promise they will do better using that strategy in the long run.

There's one person in the setup who doesn't need any life insurance, and that's your grandchild. Life insurance replaces lost income. Unless your grandchild is, unbeknownst to me, a successful child model or actor, he or she doesn't have income. And ignore all those people who tell you that life insurance with a cash value is an excellent college savings strategy. It's not.

(To ask Helaine a question, email her at askhelaine@gmail.com.)

(EDITORS: For editorial questions, please contact Sue Roush at sroush@amuniversal.com)