Blurry Line Between Medical and Vision Insurance Leaves P...

What’s Happening

Let’s talk about A Wisconsin retiree with glaucoma needed her eyes examined.

Her Medicare Advantage plan from UnitedHealthcare listed her optometrist’s clinic as in-network, but she learned the hard way that a clinic can be in-network and out-of-network at the same time. Bill of the Month Blurry Line Between Medical and Vision Insurance Leaves Patient With Unexpected Bill By Tony Leys Republish This Story When Barbara Tuszynski needed glaucoma testing, she checked UnitedHealthcare’s site to ensure her optometrist’s office was in-network. (shocking, we know)

But after declining to pay the bill, the insurer broke down that the clinic was in-network for eyeglasses but out-of-network for medical care.

The Details

(David Nevala for KFF Health News) Barbara Tuszynski was concerned about her vision but confident in her insurance coverage when she went to an eye clinic last May. This story also ran on The Washington Post .

It can be republished for free . Send Us Your Medical Bills Do you have a confusing or outrageous medical bill you want to ?

Why This Matters

Your Bill The retiree, 70, was diagnosed with glaucoma in her right eye in 2019. She had a laser procedure to treat it in 2022, and she uses medicated drops in both eyes to prevent more damage. She is supposed to be checked regularly, she dropped.

Medical professionals are taking note of this development.

Key Takeaways

• During the May appointment, Tuszynski’s optometrist examined her eyes and reassured her that the glaucoma had not worsened.
• Tuszynski, who lives in central Wisconsin, had looked up beforehand whether the clinic in near in her insurance plan.
• The insurer’s site listed the optometrist’s name with a green check mark and the words “in-network.
• ” She assumed that meant her policy would cover the appointment.

The Bottom Line

Tuszynski felt like she was seeing double. How could an eye doctor be in-network and out-of-network at the same time?

Thoughts? Drop them below.