Changes for the worse in optometry.

[Cold War Spook]

For those who have not been to the optometrist in the last few months, there has been a change for the worse. I live 75 miles away from Wilmington NC so I use a non-VA optometrist. I am 76 years old and 100% service-connected disabled and have double vision. Until this week, I would go to a non-VA optometrist near me once a year. I would take my prescription to Wilmington where I would be fitted with glasses and they would be mailed to me in about 10 days. This week I went to my non-VA optometrist and then went to the Wilmington VA. I was told that my prescription had to be sent to Fayetteville to be checked to make sure there was enough difference between my old prescription and the new one. If there isn't, you have to wait another year because the VA is now only allowing veterans one pair of glasses every two years unless someone, I don't even know if it is an optometrist, in prosthetics says you really need new glasses. Also since I was already in Wilmington I asked if I could pick out my frames so I would not have to come back if it was approved and was told no. When I was approved, if I was approved I would have to make another 150 mile round trip just to pick out my frames. The first trip is not covered by travel but the second trip is covered by travel. Even if this does not affect you, please contact your local DAV, VFW and American Legion and tell your primary care doctor. The VA keeps says they are making changes for the better. This is not for the better.

[CharleyDog]

1. Warby Parker, glassess frames on line.

I don't know if they accept your insurance/VA or whathaveyou, but it may save you the driving.
Warby Parker

[SouthernIrish]

4. As an Optician, I would advise against that.

Last edited Thu Jun 6, 2019, 07:43 PM - Edit history (2)

If the patient has double vision, then the patient probably needs Prism included in the Rx. An Optician needs to see the seg height on the lenses in person. To do this online is a serious risk that the patient takes with their Rx being wrong in the lenses which could seriously affect the vision.

As far as the Insurance Companies paying for eyeglasses only every 2 years, they do this if only there is >.50 diopter difference in the new Rx compared to the old Rx. It has become common in most Insurance companies.

[Cold War Spook]

5. Thank you

So it seems that the VA, at least as far as optometry goes, wants to act more like an insurance company than taking care of its disabled veterans. Unfortunately, I can not find anyone at the VA who will tell me what they consider a big enough difference in prescriptions to allow new glasses every year. If anyone can tell me where I can find a copy of the new regulations it would be very helpful.

[Hoyt]

2. Sorry. That really sucks.

Used to work for a state Medicaid Agency. Really liked the job, but those kinds of stupid policies made me move on.

First, two years is a long time for glasses worn everyday. Second, you’d think they could come up with some kind of prescription change algorithm that would yield an approval or disapproval, with right of an appeal.

Lastly, it doesn’t take a lot of time for them to help you pick out frames and take a few measurements, so you don’t have to return.

Good luck.

[marble falls]

3. Every single one of my trips to VA pays milage.

[Cold War Spook]

6. And my trips also.

Until this visit. Now when I go back to have new glasses fitted, they will pay mileage for that. I guess they don't pay travel when you aren't there to do anything but turn in a prescription. My original post was a little bit of a rant, plus to give this latest optometry regulation out there to veterans.

[GP6971]

7. The VA Health Care System baffles me in many ways

and not bad.

I'm a recent entry in to the system. I started with the Choice Program 2 years ago and loved the care, but the management company sucked (out of pocket expenses over $200). So I opted out and am now in the VA system proper which overall, I'm very happy with.

I'm baffled because one day a package arrived from the VA. It was a pair of glasses. I didn't ask for them, didn't have a VA eye exam...they just showed up. I tried them on and I got dizzy...the prescription has to at least 20 years old. Where the heck did they get this prescription? They were bifocals and about 15 years ago I went to trifocals.

When I was in the Choice Program, my primary care DR recommended x-rays and physical therapy for a hip issue and I received a referral for both. Before I could schedule with a Choice provider, the VA called me and said they could handle it. Scheduling appointments was fast and efficient. That to me was very confusing as to how the different systems interfaced with each other.

Overall, my experience with the VA has been very positive. So far, preventive care has been great.

[Cold War Spook]

8. Tri West is now the company hanling non-VA care.

From the time they were put in charge of finding me an optometrist to my appointment was 3 weeks. Let us hope that they will do their job every time.

[GP6971]

9. Tri West was the management company

I dealt with. I was under the impression they handled the western US and another company handled the eastern US. So it appears they have total responsibility.

I hope they're ready for the new guidelines / procedures that went into effect on 6 June.

[beemer27]

10. Thanks for the Heads Up

I've been dealing with the VA since 1970 and have learned that when you figure that you know the rules someone will change them. The VA is not paying a fortune for these specs, so there will not be any great cost savings. One of our "friends" in management is messing with us again. I'll see how the eye exam and glasses go this year. Hopefully, there will be no problems.

[Everyman Jackal]

11. Cold War Spook may want to call Fayetteville

prosthetics if he does not have his glasses yet or anyone else needing glasses. I just found out that Fayetteville does not inform you when new glasses have been authorized. Even though you haven't been told, they close it out in 2 weeks and you then have to have them open it again. On another note, if your doctor puts you in for radiology and they can't schedule you, after 30 days they close that out also. If you need any tests, ask your doctor to message you and then call radiology 3 days later. Someone working there can bypass scheduling and schedule it themselves. If not, keep calling schedule, but be really nice. I did today and she called me back within a half hour with an appointment for tomorrow.

[The Polack MSgt]

12. Welcome to DU cousin

And to the Vet's forum

[pandr32]

13. Welcome to DU

Aren't the glasses authorized yearly, or if there has been a vision change?

[Everyman Jackal]

14. Not any more.

Every year you are allowed one visit to an optometrist. This does not include glasses. You can get glasses every two years. This change was made in April of this year. All prescriptions are sent to prosthetics for authorization. I do not know if an actual optometrist is the one giving the authorization, but I hope so. If this is a replacement for a pair of glasses 24 months old or older then there isn't supposed to be any problem getting a new pair. If the new prescription is less than 24 months, it is up to prosthetics to decide if you really need a new pair. I have not been able to find out what that criteria is. I am going to Wilmington VA HCC tomorrow for carotid arteries ultrasound and to be fitted for my new glasses. I will ask the lady who will be fitting me if she knows the criteria and if she knows and will tell me I will post it. These criteria are not just for veterans who are let me call them healthy, but also for 100% service-connected veterans, but I am sure at least I hope so that veterans whose eyes were damaged while in the service can get them whenever needed. Hope you can understand that last sentence. Now you can see why I need the ultrasound.

[pandr32]

15. Well that sucks

Here in Hawaii (Big Island) and applying through the VA (have to get authorization still) glasses have been available each year so far, or if vision changes (a few times now) or they make a mistake (which has happened). Two years is a long time to keep glasses in good condition for anyone--especially since the frames are flimsy.
Diabetes and all kinds of service-connected illnesses or trauma can affect vision besides aging and so this sounds like they are just needlessly making things tough for veterans, healthy or disabled.
Good luck with your ultrasound.

[GP6971]

16. Thank you for your post.

As you can see from my above post, I'm new to the VA system. I'm in the actual VA system...not the Choice program. I'm very lucky in that I only live 8 mils away from our VA facility.

I'll be curious to see if the VA is different from the Choice and now Mission programs. MY guess is probably not at all.

I went to the VA Eye Clinic yesterday. I went in without an appointment with a eye problem. They squeezed me in and was out of there in just under 2 hours. Full exam and a quick Laser procedure to clear up the eye program.

So far, I'm pretty impressed with the system.

And welcome to DU!

[Everyman Jackal]

17. Tri West

Tri-West now handles most of the non-VA appointments. I use the VA healthcare system as much as possible. Even though I could use Tri-West for almost everything since it is 75 miles for me to travel for all VA medical except for primary care, psych, and labs I prefer to go to the Wilmington HCC whenever possible since it is an easy drive. Travel does pay me $57 a trip but that is not why I go there. I believe a veteran's main concern is whether or not he or she is receiving proper care. One of my main reasons for using VA is healthevet. In three days of an exam or lab, I can look at the physician's notes, lab work and my MRI pictures. I also have found that many doctors not in the VA system also have set it up so you can see the results of tests. Just be careful when using non-VA that you first receive authorization from the VA. One other thing. I had to go to a non-VA neurologist. He could only do exactly what the VA told him he could. I have a VA neurologist now in Wilmington who goes over everything. He even had me look at the pictures of my last 2 MRIs of my brain. We compared the picture. Hard to find a doctor that will spend 20 minutes with you just looking at pictures of your brain. Luckily almost no changes. I have been with the VA since 1995 and have been lucky enough that no matter where I have gone in the system I have received very good care.

[Everyman Jackal]

18. I went back to the Wilmington HCC yesterday and found out a couple of things.

I first want to state that I will not be giving out the names of the people I spoke to. Everything I write in this post is things that people in the know at the VA have told me. SouthernIrish, you are correct, the VA is now using the same criteria as insurance companies, >.05 diopter to decide if someone needs new glasses in less than 2 years, otherwise, you have to wait 2 years. I was told if it is less than that and you have a good reason for needing new glasses, you MAY get new glasses once a year but don't count on it. Make sure your optometrist writes down on your prescription every reason you need new glasses. If you don't want to drive to where you are fitted for new glasses ask your optometrist to fax your prescription where it needs to go. Your best bet is to call where you will be fitted with glasses to get the correct fax number. No one I spoke to could tell me who it is at least at the VA hospital in Fayetteville NC that authorizes new glasses. They all seem to think that it is not an optometrist, but is a technician. It could be anyone in different areas. I will continue trying to get more information. If anyone has more information, kindly share.