This week we look at whether it’s more beneficial just to forfeit your optical rebate with your health fund.
It seems like that every year when we visit our local optometrist, we get a new pair of glasses. We find that this is quite common for patients with a health fund with optical extras. But is it worth using your health fund towards the purchase of new glasses even though there is no clinical indication to do so?
On average, for those who wear glasses every day, we visit our optometrist every two years. Recently, we have been going to our local optical shop every year to use up the last little bit of our health fund before it “rolls over” or resets for the calendar year. We are too afraid we might “lose out” on our optical benefits which translates to our natural feeling of “missing out.” But are you actually missing out if you skipped the purchase of your glasses this year?
In our optometry clinic in Canberra, we often find the prescription of our patients varies too much within the year. Unless there’s an active eye disease that changes your vision rapidly (e.g. keratoconus), very rarely we find the prescription has changed so much that warrants a new pair of glasses.
On average, health fund rebates are around $150 – $300. This is probably one of the reasons why glasses are advertised for about $199. If you are like me, who needs to wear glasses every day for even simple things like making a cup of coffee in the morning or commuting to work, your vision requirements would be quite complicated and complex. A simple pair of reading glasses won’t work in all situations. This would require the use of speciality lenses such as multifocal lenses. If you have a high prescription, your lenses would need to be “grind down” which would require additional costs. If you use your sunglasses for driving or fishing, polarising filter lens treatment may be suitable to reduce the glare off the roads.
You often find after taking everything you need into account; whether you’re in a discount glasses shop or a high-end retailer, it will most likely end up costing you more than $200 for your pair new of glasses. The optical rebate now becomes a discount rather than covering the full cost of your new glasses purchase, leaving you out of pocket. Every year, you are tempted to get new glasses because of the health fund rebate. Every year, you’ll spend out of pocket if there’s no clinical need to change your glasses. An average pair of glasses with all the bells and whistles would set you back $600 – $800, which means you’ll be out of pocket $400 – $600 each time you want to claim from your health fund. Would it be better if you just left your optical extras to lapse?
You might say, “I’ll just get the basic $200 glasses with no gap payment.” That is all well and good until you realised that your newly purchased glasses have very thick lenses due to your prescription, making the glasses very heavy and uncomfortable to wear. Or your new glasses don’t have the latest anti-reflective coating which causes a lot of glare and reflection from outside lights when you use them to drive at night. They may be your “spare pair,” but certainly won’t be a functional one should you actually need to use this spare pair of glasses.
Each year, you end up getting a no-gap pair of glasses from your health fund. Each year, those no-frills glasses don’t meet your vision requirements. They are stowed away and are forever forgotten. You repeat the purchase of these no-gap glasses each year fearing “missing out” on your optical extras. Over the years, you end up with a pile of hardly worn, brand new glasses with no use. Not to mention that the optical extras you have available are all compensated from your high health fund premiums.
Not everyone would fit the category that I’ve mentioned above. Your vision may have only deteriorated a little for you to start noticing difficulties when reading or when you are working long hours in front of the computer. In this case, perhaps a simple $200 pair of glasses for you to use during screen work would alleviate all the headaches. If you have a very mild prescription and want to benefit from a pair of prescription sunglasses to both improve your vision while driving and providing you with sun protection, you may only need to spend $200 in which case it would be all covered under your health fund. You might want to replace your damaged lenses as your frames are still in good working order, then providing if your prescription is simple, you may not need to spend any additional amount.
The Bottom Line
At Capital Eye, our optometry clinic in Canberra, we only recommend what is best suited for your circumstances. We understand we live in a diverse community and how we use our eyes varies among ourselves. There is no benefit for both our patients and us to be fitted with a sub-standard lens knowingly would only cause more problems in the future.
We’ve discussed that our prescription doesn’t usually change a lot within the year. Generally, we might see some need to replace the lenses every two years due to normal wear and tear. Buying glasses for the sake of just using up your annual optical extras could add unnecessary cost to your eye care. This rings true for most glasses wearers who, like myself, grab them the first thing in the morning.
However, if you are a contact lens wearer and routinely purchase contact lenses, ensure you claim your optical extras each time you replenish your contact lens supply, so you’re maximising the benefits of your health fund.