Monday, November 28, 2011

The EyeGlasses that Took Forever....

I don't recall if I have ever actually blogged about it, but we recently took Marek to a Pediatric Ophthalmologist for his eye. His right eye was showing signs of being lazy, and initially (like before he was 2) I only noticed it being very slight and only when he was very tired or very angry or upset. Then It started to become noticeable when he was thinking about something or trying to find the words he wanted to say. Eventually it became more prominent and more noticeable, and The pediatrician (who hadn't noticed it) said I could take him to a PO for evaluation. We had to wait close to 2.5 months to actually get in to see her. I had prepared myself for what I was sure would be patching of the good eye in order to strengthen the muscles in the traveling eye. What I was NOT prepared for was the announcement that he needs glasses. He has astigmatism in both eyes, and the astigmatism in his bad eye is preventing or making it more difficult for the muscles to pull the eye back to center. So while she can see the muscles working, she believes the astigmatism needs to be corrected so that we can see how his eye responds to the muscles.

So. I was kicking myself because never once, not even ONE TIME did glasses cross my mind. Oy. We have Health Insurance Through UHC of the River Valley, which does not include any vision coverage. Luckily, the lazy eye is a medical problem that would be covered under our health insurance.... but the vision/astigmatism and needing glasses part is not. Amazingly, we had JUST began to use a secondary insurance in November (the month of his appointment) which covered vision and 1 pair of glasses. Our income qualifies us for Illinois All Kids, at a premium level. This means that we pay a monthly insurance premium and get coverage in exchange. The monthly premium is fairly low (based on your income) and it eliminates or lowers most of our current co-pays and deductibles. I don't like to talk about this program, or WIC, with many people, because I often get to hear the "Popping out kids on welfare" crap that people like to spew.... and I don't want to be a part of that discussion. WIC and All Kids are not comparable to Welfare in my opinion, but again, not going to start that conversation because if I needed welfare to get my kids what they need I would have it.

Anyway. The Pediatric Opthalmologist that we had chosen was highly recommended locally by lots of friends and family who had been to her and her practice. She also was a Preferred Provider on our UHC PPO. Turns out that she also accepts Kid Care, which ended up being nice, but we didn't know that until we were there at the appointment, and it wasn't even relevant until we knew he needed glasses. So that day, after his appointment, we were taken right into the "optical" store in the Illinois Eyecare Center. It was very nice and everything they did at the center was AMAZING. They did so well with checking his eyes, I know already that there aren't many other places that would have had the knowledge, experience, and all those little tricks and tools to get his eyes checked. Well, we find out right away that the even though the doctor accepts Kid Care, the optical center in her office does not. This means that I get to spend the next 30 minutes in the parking lot on the phone with Kid Care and Illinois Health Connect trying to find somewhere that not only provides exams, but actual GLASSES. That proved to be very difficult. After searching unsuccessfully for a place in Peoria, we decided to go closer to home. Just by chance I decided to pull up my own eye doctor at Lifetime Eyecare in Geneseo, and they DID accept Kid Care and also provide glasses through the program. So Marek and I put gas in the van and called Grandma to see if they could keep Ardyn for a while longer, because we were going to drive from Peoria to Geneseo to get eyeglasses for Marek.

Now come the downsides.... Please don't see these as "complaints" for KidCare, but more as things that I have learned from the experience. Firstly, KidCare gives you a limited amount of frames to choose from (which is not unreasonable) and for Marek's size, that meant there were TWO Frames that we could choose from. One metal and round and one plastic and squared. Luckily they did come in various colors :) Secondly, Kid Care and Family Care glasses are made at the State Prisons in Illinois. Which also means that ordering a pair of glasses takes 3-6 weeks to receive. Now, bear in mind that the PO's office had expected that we could take our glasses home THAT NIGHT, or perhaps the next morning. An average pair of glasses takes about a week to receive at the eye doctor's office. And the PO had made an appointment for Marek in one month, to see how his progress with the glasses would be, and to re-evaluate his eye periodically. But in one month, we wouldn't even HAVE his glasses yet, let alone be able to have worked up to full-time wear as we were asked to, or to be able to analyze how well they were working. Above all, this frustrated me and made me feel like the world's worst mom, because I couldn't just go drop $200 for glasses for my son who obviously needed them. Yuk. So now we wait.

During this waiting period I find a cool website and facebook group "Little Four Eyes" (group of parents who have small children with glasses) and get information on the different types of frames that are available for kids, unbreakable, or at least LESS breakable, and made of lightweight materials, twistable materials, and with warranties. This leads me to ask the girls at the eye doctor's office what happens "if" (when?) the two year old breaks the frames. is there a warranty? Will we need to wait another 3-6 weeks? This is when I find out that there is no "warranty" but that the Kid Care Program will replace broken glasses within reason. AND that the wait will then be TWO MONTHS because someone will have to approve that second set of frames and then the whole process will have to start over again. And Kid Care won't cover a spare pair because their program allows for a pair per year. I decide to make some phone calls and ask some questions. Kid Care tells me that if the PO writes a letter to the state to request that Marek be provided with two pair of glasses for the purpose of backup and necessary full time wear, that the state may allow two pair to be made. Might. And who gets to make this decision? Someone at the State Prison. So I get to call my PO's office and ask them to write a letter directed so the state prison, and then fax it to the eye doctor who is placing the frame order so that they can send it along to the prison and ask for a second pair. And the PO Agrees to do it, no problem, but tells me that she is pretty sure it won't happen anyway. So now we wait another week for the letter to be dictated and faxed... with me following up the whole way via telephone calls. AND it's been nearly two weeks since we requested the letter and it hasn't been received from the PO yet.

In the meantime I start to investigate how much it will cost to get glasses for him if we have to buy them. $179 for the frame package and lenses through my regular eye doctor, and that is a 2 year warranty on frames with complete replacement with any breakage. Isn't cheap but doesn't seem unreasonable. IF you happen to have an extra $200 laying around before Christmas in addition to your $200 of license plate renewals due, and your $300 power and gas bills. And IF you want to explain to a 4 year old and a 2 year old that Santa didn't come because mommy had to buy marek some glasses and couldn't get the gear off layaway in time. *sigh*

I decided to look into eyeglass assistance and programs. VSP (who I used to get my eye insurance from when I worked at the hospital) has an awesome program for kids with no insurance that allows them to get glasses free of charge. But that won't qualify us, because we technically have insurance  (Kid Care) and this is more of a timing and replacement/spare issue. So next I contact the Lions Club and find that I have to go to Wal-Mart to get an application. In the meantime I hear from someone that Wal-mart has $9 kid frames and cheap lenses and that I should be able to get two pair of glasses from Wal-mart for him for $60 or less (for BOTH pair) So I need to go there sometime and get some better information on that. But hopefully with just ONE CHILD and not with both of them, so that if indeed there is a chance to get glasses for him there, I can actually try them on him right there and get them ordered. That's like 1/4 of the cost of one pair through the eye doctor. Nothing involving kids can be easy!

So, We Wait. More.

1 comment:

Janice and Jessica said...

Try Zenni Optical. If you have the RX you should be able to order a back up pair pretty inexpensively. It's worth a shot!!!

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