Medicare Your Coverage Options

Don’t let your doctor intimidate you: A personal story

Written by Joel Bernstein

It was a balmy fall day last year, when I walked through the surprisingly creaky door of a well-respected ophthalmologist, who shall remain nameless. Let us call him, Dr. G.

Why was I there? I needed to have cataracts removed from both my eyes. Dr. G was highly recommended by my usual ophthalmologist, a wise, older man who long ago gave up doing surgery.

A word about cataracts: When you’re older and have blurry vision, it’s generally caused by something called a cataract. Older adults often have the cataracts or clouded lenses of their eyes surgically removed and replaced with an artificial lens. This surgery requires no hospitalization. The operation itself lasts about ten minutes. Recovery is generally less than half-an-hour. It’s a very quick and common procedure. And, Medicare pays for it.

My vision was actually quite good and the doctor found nothing wrong with it. I could see long distances. And, I could see close up with reading glasses. But, he recommended I see Dr. G. because I had suddenly begun to hate driving at night; the oncoming lights blurred my vision and bothered me. So I made an appointment.

Dr. G’s waiting room was packed to capacity. Even though I couldn’t find a seat, I was impressed. After a long wait, two assistants examined me superficially but well enough to hand Dr. G some needed information. He pointed out to me a machine he liked to use that Medicare did not cover.

“Medicare,” Dr. G said, “doesn’t care how well I do my job, but I care. This machine costs three hundred dollars, per eye, but it provides important information. I’m using it if it’s okay with you.”

What should I have said, “no, it’s not okay with me?” Should I have revealed that I’m a piker, that I couldn’t afford six hundred bucks? I said, meekly, “okay.”

He proceeded with the examination. He told me something my doctor had never mentioned: that I had astigmatism in one eye.

“Really?” said I, “I never knew that.”
”Well, you know it now,” said Dr. G.
Astigmatism has to do with how the eye focuses light. Apparently, my left eye doesn’t do light very well. Dr. G went on to explain that the astigmatism will require a tomic lens.

“What’s that? I asked.

“It’s a more sophisticated lens used to treat astigmatism,” Dr. G explained. “You need it. But it’s not fully covered by insurance. Should we go ahead with it? Say, yes.”

When it was all over it took awhile for my eyes to adjust. Friends who had the same surgery said they could see amazingly clearer right away. I could not. I saw distances the same way I saw them before the operation. Reading was a problem; I needed a new prescription for reading glasses.

A few weeks passed before Dr. G’s office barraged me with bills, some of which I paid until it got to be ridiculous, and I stopped paying.

Moral of the story: Ask questions, don’t be intimidated by doctors, and don’t be so quick in allowing them to do whatever they want to do. There are great doctors out there, as we all know, doctors who are honest and who care, doctors who take Medicare as payment in full. But every once in awhile you come across a doctor like Dr. G. G for gonif.

Here are some tips on how to choose a doctor and four questions to ask yourself about your primary care doctor to understand whether the doctor is meeting your needs. As for your eyes, here are four things to do to protect your eyesight and what to do if you think you may have glaucoma.

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