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Question:

May 26, 2009

Does anyone have experience getting their benefits provider to pay for something they normally wouldn’t pay for?

Our provider normally covers $300 every 2 years per person for glasses. But with Penny being almost 5 months old, and her prescription is expected to change 2 or 3 times a year… that’s a whole lotta moola out of our pocket. I was reading for Americans (I’m Canadian, remember), that if the glasses are considered prosthetic instead of cosmetic, you can argue for your benefits provider to cover them as a medical necessity. But… aren’t every pair of glasses with a prescription considered a medical necessity?

Argh! I don’t expect them to pay every cent of every pair of Penny’s glasses. But when 1 pair costs $300 and we are theoretically looking at 4-6 pairs in her first 2 years (assuming she doesn’t break any, which I’m sure she will)… anything over that $300 would be nice. But I don’t know how to go about arguing that with them.

Anyone with experience on this? Or any input on the matter?

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One comment

  1. Some of these suggestions will work for smaller companies.
    First, ask the employer to increase the vision coverage. The vision coverage gets used the least, and to increase it costs very very little.

    Second, ask if the employer would consider using costplus on the frames. (the company pays for a one-time thing not normally covered in exchange for the tax write off)

    Third, you could always do a flex spending account on your own even if the company doesn’t offer one. It would at least save you the taxes on it.



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