Vision Insurance Is Making Glasses More Expensive | Hacker News Reader

Vision Insurance Is Making Glasses More Expensive

daniellivingston.com

119 pointswalterbell86 comments

The reason eye glasses cost so much is the multiple monopolies of Luxottica. Luxottica owns: (1) nearly all brand name frames including Ray-Ban, Oakley, Prada eyewear, Armani eyewear and so on, (2) nearly all retail stores such as LensCrafters, Pearle Vision, Sears Optical and Target Optical and (3) EyeMed, one of the largest vision insurance companies.

Luxottica retail brands: http://www.luxottica.com/en/retail-brands

Luxottica eyewear brands: http://www.luxottica.com/en/eyewear-brands

Luxottica vision insurance: http://www.luxottica.com/en/node/6336

See 60 Minutes story on Luxottica: https://www.youtube.com/watch?v=gDdq2rIqAlM

And now Luxottica is buying the largest maker of ophthalmic lenses: Essilor. https://www.bloomberg.com/news/articles/2017-01-15/luxottica...

Thank you.

Non-Luxopoly choices FTW:

https://madeeyewear.com

https://www.warbyparker.com

Also, VSP is the major vision insurance co. in the US (80M insured).

Perhaps the source of standard retail costs of prescriptions is the negotiation powers of insurance co.'s coupled with insured apathy ("it's not my money").

http://www.zennioptical.com

THIS. Before Lasik, I was all about the Zenni Optical.

The dog ate my wife's $250 prescription lenses, so she wore her $40 backup pair from Zenni to her eye exam.

After a shitload of "oh, these aren't our lenses", they reluctantly put the glasses in their refractometer. The Zenni lenses matched the prescription perfectly.

I bought a pair of Zennis in 2013. I have a strong prescription and got maxed out UV, indexing, etc. on a (imo) good-looking frame. $75 for what would have cost me $300-400 out of pocket after my vision insurance credit. Additionally, I was able to submit the $75 as an out-of-network expense. It took some paperwork, but the return on my time was worthwhile.

$75? Way to go big spender. ;-)

My latest shipment of Zenni's came in recently.

$28.26 for two pairs. And they came in ten days!

http://www.zennioptical.com

Salesguy comes in wearing sharp titanium semi-rimless glasses. Notices that I'm wearing very similar. We compare.

His cost $350. Mine cost $35 including shipping. I bought a backup pair, too.

I'm sure some people have had very good experience with zenni, but for what it's worth I gave up after 4 pairs (over about 3 years) that never quite had the right prescription. I had better luck with Warby Parker, but only have a single pair for comparison.

Warbyparker is a ripoff just like all the other middlemen claiming to disrupt an overpriced market. Zenni optical will get you a pair of frames with lenses for under $10. Everything else is paying for personal style preference.

Warbyparker couldn't get my prescription right, even after two remakes. My doctor showed me his prescription, and then showed me how Warbyparker dispensed the lenses. After giving WP two tries to make it right, I just gave up and spent $400 buying two pairs of glasses and a pair of sunglasses from my normal Optometrist (who told me that 'I'd be back' when I mentioned that I wanted to try Warbyparker).

>...and then showed me how Warbyparker dispensed the lenses.

Can you clarify this portion of your comment? I'm interested in hearing whatever insight he gave. I had a similar experience with WP, but I assumed it was due to my tough prescription.

I had a similar experience with Warby. Two attempts to get the prescription right, both sets of lenses were wrong. I don't have a strong prescription, nothing complicated.

FramesDirect and EyeBuyDirect are both owned by Essilor, so their lenses are made in Essilor labs (soon merging with Luxottica/Lenscrafters).

Warby Parker opened their own lab this year: https://www.inc.com/magazine/201706/tom-foster/warby-parker-...

Trying on frames at their brick and mortar helped my decision making a lot. Every time I have to pick out frames, only a handful looks decent on my face out of more than a thousand.

Did Zenni and 39dollarglasses before. Prescription is okay, but some of the frames came crooked and chipped easily.

Another good choice is https://www.aceandtate.com/

Quality frames, all-in for €99,-. I'll never visit a brand carrying optometrist again.

Luxottica also wholesales their frames to independent retailers -- so even if you're not buying the frames at their stores, or buying their sunglasses at Sunglass Hut, you're still paying for their product. They're also quite aggressive about suing the knockoff Rayban and Oakley retailers -- or so I've heard.

If you're travelling overseas, depending in where you are going and what insurance you have, you can save a lot of money on things like eyewear, contact lenses; as well as things like perscription meds and routine dental work.

Which countries have good offerings in eyecare?

Japan has very good glasses (non-Luxottica) and you can do everything out of pocket and fast even if you’re just visiting.

Basically anywhere in Asia

As someone who previously worked in this industry, I highly suggest that you consider purchasing your eyewear online (through a wholesaler like Zenni Optical, for example). Premiums or not, you're paying a huge markup for brick-and-mortar (plus the Luxottica tax) to buy in-person.

The only benefit to buying in-person is the ability to go back and exchange your glasses for a new prescription, but even if you do that twice and your optometrist charges you for a new exam each time, you'd still be saving money ordering online.

In cases where your exam nails your prescription the first time, it's drastically cheaper (more than one order of magnitude) to shop online. Bonus, you can afford to purchase several pairs of glasses to keep all over the place, ensuring a broken or lost pair is not a big deal.

Note, I only have experience with eyewear; I have never worn contacts, which may be a different story.

I have thick glasses. i usually just order 4 different pairs online. it's about the same price, i have spares. there's a little variation, i'm not happy with every pair i have, but usually 2 or 3 are great. and if i have to i can still use that one pair that's a little off.

I second this suggestion I was able to buy I nice pair of prescription polarized sunglasses for my fly fishing with oil resistant coatings for like $60. The only trick getting your eye doctor to actual give you the prescription I had to threaten walking out with out paying to get the "doctor" to give me my prescription.

I just told the Dr. I didn't like any of the styles they had. Hard to argue with that.

Threaten to call the FTC on them:

What are my rights under the FTC’s Eyeglass and Contact Lens Rules?

If you get a fitting for glasses or contact lenses, the eye doctor must give you a copy of your prescription – whether you ask for it or not. It’s the law. The doctor can’t require you to pay an extra fee, buy eyeglasses or contact lenses, or sign a waiver or form.

https://www.consumer.ftc.gov/articles/0116-prescription-glas...

We did exactly this last time (prescription sunglasses and regular from Zenni). We went to Costco for the exam/prescription which was pretty hassle free. I'll set out the positives and negatives:

Positive: They nailed the prescription (perfect). The lenses were as thin as normal with the 1.67 "high-index polymer" upgrade (which is important as the prescription is bad in one eye, could result in super thick lenses). In all other respects they do what they say they do.

Negatives: We ran into an unexpected and ultimately fatal issue; even with perfect lenses and fine looking frames, my wife could not get them to sit straight or comfortably on her face. They'd slide down her nose and fall, both pairs. We bent them with pliers and a heat gun, followed the guide on Zenni's site, even had the gall to take them into an opticians (Standard Optical) and they tried adjusting them for us, no dice. This is on both pairs (sunglasses and regular). Even after our best attempts and taking them into a Standard Optical, we could not make it work.

We now have two pairs of Zenni sitting in a draw and had to spend another $180+ on just regular glasses from Costco (no sunglasses due to cost). These ones at least stay on her face. It is such an obnoxious and unusual issue to have, but two frames from two different lines of frames both didn't work for us and could not be fixed. It definitely shows the biggest problem with online glasses shopping in general, good prices, but if they don't fit your face then you're now out $170 (Plus whatever we spent at Costco after failing at Zenni).

This isn't meant to be a slam against Zenni in particular, they did what they said they'd do at a good price. This is a cautionary tale about online glasses shopping in general...

Zenni refunds 50% of the price for returns.

Eyebuydirect (14 days) and 39dollarglasses (30 days) offer full refund for returns.

We didn't return because we didn't feel it was Zenni's fault. There was no defect with the glasses, they just didn't happen to fit my wife's face and couldn't be adjusted to.

I was just posting to point out an inherent flaw with the entire concept of online glasses ordering and one I have no solution to.

I'd love to imagine a future where they can 3D scan a face and produce bespoke frames.

The unconditional return warranty exists because fit & style are difficult online. Returns are included in the price you paid, it’s like insurance, not everyone needs it, but sometimes you do.

3D scan & custom frame: https://www.3dna-eyewear.org

Warby Parker is using the iPhone X camera for facial scan & frame recommendations.

how good a recommendation can be is based on resolution http://eyednamarket.com/multivendor/images/5.jpg

Thanks. What’s the best USB-connected camera that can be purchased today for high resolution facial 3D scanning on a PC?

Artec Eva but is very expensive.

This may be a dumb question....I recently had my eye checkup at Costco and they said I could get by with reading glasses for now, but if it's not too expensive I wouldn't mind getting a pair of progressives - does that require a more in-depth test or can I just use the number they gave me from the exam? (It was about 6 months ago, so perhaps I should go get another exam? And let them know I'm thinking of getting progressives? I know nothing about it.)

Progressive lenses can be really tricky to get used to from what I’ve been told, you may want to give cheaper bifocal lenses a try first or just buy a pair of reading glasses you take on and off. If you feel they aren’t your thing you would feel less shelving the cheaper option first.

My doctor was hesitant to prescribe me progressives given how difficult it can be to get used to them, and he spent a fair amount of the exam figuring out where to set the focal distance (had me hold my phone at a natural reading distance, had me read from a card at different distances, etc.). I have a very odd prescription, so that could have been part of it. Still, if it’s not too much time and cost, I’d go back and get the exam and get a prescription that explicitly includes progressive values.

Also, someone on HN talked about getting a prescription for reading up close (essentially the bottom focal distance of a progressive lens across the entire lens) and another standard prescription for non-reading use. When I have the time to get my prescription re-done, I’m going to do that instead of progressives. They’re a real pain to get used to, and they correct neither near nor far sight perfectly.

A dedicated computer or reading pair gives the best optical quality. Second best is magnetic (Chemistrie from Eynavision) or clip-on (Eclips) custom reading lenses that attach to your existing glasses, to adjust the focal plane.

Progressives are expensive at local retailers, difficult to dispense correctly online, start off with distortion in periphery of lower half of the lens and the distortion increases as you get older and the ADD gets higher.

Bifocals and trifocals are available in different configurations (half-round, round, different diameters).

I have progressives, from Warby Parker though my initial prescription was by a trusted local optometrist who gladly provided the pupillary distance measurement, and it took a few weeks to get used to them and the constant tilting my head. The lenses are a compromise. They're great as general purpose glasses where I am frequently switching distances and I wear them many hours a day at the screen but they don't correct my astigmatism as well, they seem "dimmer" than my prescription readers, and they're inadequate for close work (electronics) and reading. By the end of the day I often use my readers at the screen.

A clipon can temporarily convert the "distance" portion of a progressive for use at intermediate/reading distance.

+1 for Zenni. With a prescription in hand (make sure to get the pupillary distance measured), you can get great glasses with Trivex material (the Cadillac of lens materials, if you will) with the top end coatings for $80 shipped. I've been using them for years and at this point it feels like a lifehack.

Trivex markets their material aggressively, but it's debatable if it's actually best, especially if you don't need a very thick lens. The traditional CR-39 resin has noticeably better chromatic aberration performance (higher Abbe number).

It’s difficult to find small frames that work with CR-39 and higher prescriptions. Best ones are based on “vintage” styles from the days of glass lenses, when small lens widths kept the weight down.

Personally what I like about it is that it has impact resistance; they're not quite safety glasses (unless you get really big glasses), but they're pretty close.

My optometrist wouldn't measure my PD. He said that's included in the price of glasses. I offered him $20 to cover the service but he wouldn't budge.

You can get your eyes examined by an independent optometrist at most Costco stores without being a member. Not sure why it's set up that way, but I've heard it's something to do with the monopoly that Luxottica has.

They won't sell you glasses without a membership though, so if you're looking for somewhere that won't force you to buy something, that's a pretty safe bet.

I ended up measuring myself at home. It's not a difficult measurement to make.

iOS app for PD measurement: https://appadvice.com/app/pd-meter-pupil-distance-measure-by...

I should have said "won't try to force you to buy something," since as I pointed out in another comment they're required by the FTC to give you your prescription.

https://www.consumer.ftc.gov/articles/0116-prescription-glas...

Unfortunately it looks like IPD is not covered in that, but I'm sure the independent optometrists at Costco would be willing to measure it no-strings-attached since they're not selling you glasses.

He knew that would be the last time he ever saw you. They keep those numbers for themselves to keep you coming back.

At this point it's so much a part of the culture that even optometrists without a direct relationship to the company that provides your glasses still believe people can't be trusted with measurement of their own eyes.

> The only benefit to buying in-person is the ability to go back and exchange your glasses for a new prescription

You are overlooking a huge benefit to buying in person... seeing what the glasses look like on your face before buying them

I've never had the luxury. Even if I try on their empty frames, and lean close enough to the mirror to get a general idea of what they look like, I have to take on faith (or ask someone else) that they look decent. By the time my heavy prescription is added, the refraction alters the way they look anyway.

Zenni has a feature whereby I can upload a photo, and get a reasonable facsimile of how a frame is going to fit, while wearing my current prescription to be able to actually focus on it. After 3 years of zenni, I went back to brick-and-mortar once, and faced extreme sticker shock.

Back to Zenni I went, and have been super happy with them since.

This is similar to how medical insurance or student loans drive up prices.

Divorcing consumers from the cost of these services causes them to be less price sensitive. Even if they ultimately end up paying higher premiums there is no direct feedback occuring at the time the exchange takes place. So consumers are less thrifty, and there is less pressure to drive down prices through competition.

>Divorcing consumers from the cost of these services causes them to be less price sensitive.

When a family member collapses and you call an ambulance, I can't imagine anybody being particularly price sensitive.

Emergency care is around 2% of health care spending in the US so most healthcare decisions are not that time critical.

That's an order of magnitude lower than I would have guessed.

vision "insurance" isn't for reducing risk, it's actually a vehicle for delivering tax-free compensation by employers. since you're not paying income tax on the benefits, you're saving at least the marginal tax rate (~35% depending on the state). IANAL, but the arrangement might also cause no sales tax to be collected. also, your employer who's buying in bulk presumably gets a % discount over whatever rate the blog's quoting. in the end, i would be surprised if there wasn't a net savings.

it's possible to save in LPFSA for some people. Either way, my insurance premium through my employer is pretty low, so it makes no sense to decline it.

This is true. I'm able to use my HSA account to purchase glasses from Zenni Optical though too.

Don't. Use LPFSA. Keep HSA for investment.

That only applies to people wealthy enough to cap out a HSA at $6750/year.

source?

On what part? People not having over $6750 spare each year or that being the HSAs cap?

For the 2016, 17, and 18 contribution limits see here https://www.shrm.org/resourcesandtools/hr-topics/benefits/pa...

What you said was lpfsa cannot be used without capping hsa, or something along those lines.

No what I said was that there's no value even having a FSA until you cap your HSA. An FSA is worse than a HSA by every metric, cannot invest it, lose it after twelve months, many lack a debit card (or charge), cannot increase or decrease it after open enrollments and so on.

Does california treat LPFSA similar to HSA?

I get a HDHP, put the savings from not paying high premiums into HSA. The problem with california is, this is treated as income, and capital gains/interests/dividends trigger income either way. Not that it'd matter, but i see your point about FSA coming after from HSA. IT's fair.

Most employers also wouldn't add their contribution towards vision insurance to your salary if you decline coverage. I'd decline several of my employment benefits in an instant if I could get the employer's contribution added to my salary somehow. But that is not the world we live in.

I could get a much better plan individually on the insurance market with just what my employer pays per month to our insurance trust. On the other hand, I’m also young - a lot of the employees in my company are middle aged or higher, so that contributes a lot to our costs, if I were older it would change a lot of things.

And this ultimately brings us to the reason why universal healthcare would be cheaper. Having our population of 300MM+ spread into so many different risk pools screws with financials of premiums a ton. Even with our aging population we’d be paying significantly less if the entire country was in a single risk pool.

I noticed this last year getting my first pair of glasses in the bay area. My VSP plan doesn't cover high index lenses which is $100 upgrade, which is mandatory for my prescription, and there's non covered add-ons for scratch resistance and glare for ~$70. So my out of pocket cost after my VSP premiums is still $170 IIRC.

I tried to shop around quickly but I was informed that optometrist had put a hold on my insurance preventing me from getting another quote. I asked for my prescription and they were hostile. Turns out I can get a pair of glasses online at zennioptical without using my insurance for less than just my out of pocket cost using my VPS plan. I wonder how much my employer is paying for this 'insurance' plan that requires me to pay more for glasses than online retail.

That's a pretty terrible insurance plan if you ask me.

Once I started thinking of vision insurance as more like a bad coupon, where you get some small amount off if you buy a certain overpriced brand, it lost its appeal.

You may be able to submit your purchase receipt and get some partial reimbursement for it as an out of network expense.

Does this surprise anyone? Insurance companies have massive overhead. I work near a large insurance HQ. It is a beautiful building with lots of nice cars in the parking lot.

That's because the insurance companies can negotiate steep discounts from eye glass providers, given they have so many members and choose what eye glass providers they can buy from "in network". So the eye glass providers up their prices so that 25% discount from last year takes a smaller bite out of their profit margins. Rinse and repeat for 40 years and you'll get what has already happened to the health insurance market place: $800 for a pair of Advil "base price". Insurance companies get a huge discount. Non insured individuals are shit out of luck (though the providers normally waive a substantial percentage of cost for the neediest patients.)

I have VSP insurance and got some new glasses recently. The staff was pushing Flexon frames because she said they were priced better for my insurance. I only found out later that Flexon is a company owned by VSP insurance. Now I figured out how they make money on the small little they charge for insurance coverage monthly through my employer.

I was surprised how cheap glasses can be when I moved to Malaysia. Back at home in Poland I was used to paying $100 to $250 for a pair of glasses. Here there are many home brands that offer good quality glasses for $50.

(My vision isn't very bad, so I'm mostly paying for fashion)

The truth lies somewhere in between. I'd recommend finding a good eye doctor you trust (ask around) and look at your itemized bill and insurance closely to figure out what's best for you. I'll say that my insurance, while not great, is absolutely a better deal than a flex or HSA account when purchasing glasses. I do, however, spend a little more and typically buy frames from my optometrist. I've gone the online frame route before and I think a lot of people can find value there, but I wear my glasses everyday and am willing to spend a little more for better quality.

There was a time where prescriptions were not required to be given to the patient. The patient had to buy glasses from the doctor. Glasses were routinely $100-$200 in 1980s dollars (that's what, $300-$400 in 2017 dollars). Now you can use your vision insurance to get your eyes checked and take your prescription wherever... It ends up being a pretty good deal. $50-$100 for the checkup and $10-$30 for really nice glasses online.

Eyeglasses and hearing aids are a racket. In my local hospital, there's large section just for frames. It's the only area where they have salespeople convincing you to buy frames above what your insurance will cover.

Same thing with hearing aids, I went and had my hearing tested and there was a salesman just outside the test room waiting to sell you their services which sold hearing aids for $999.00+ plus services.

One factor the article missed is that your vision insurance also covers the eye exam. VSP covered $180 of my most recent exam, which is more than I pay annually in premiums. Therefore, by including the entire premium in the cost of glasses with insurance, I think the article overstates its case. (One could probably argue that the exam cost is higher because of insurance, but the article didn't make that claim.)

$180 is only part of the cost of the exam! its < £25 in the uk for an eye exam

The total was $190. My insurance statement says it was $50 for refraction (coming up with the prescription, I assume) and $140 for the rest of the exam.

Optometrists have at least a 10% error rate. That’s for prescriptions so wrong that the patient cannot “adapt” (read: their brain cannot error correct) the lens. An even greater percentage of prescription or lens errors are corrected by the brain’s visual cortex, which means the brain is doing avoidable work and wasting energy.

Warby Parker charges $40 for an online exam: https://www.warbyparker.com/prescription-check-app

Smart Vision Labs startup is lowering cost and improving accuracy via telemedicine and better auto-refraction, http://nordic.businessinsider.com/smart-vision-labs-iphone-p...

An eye exam is more than just getting your prescription, though. They also screen you for eye diseases and assess your overall eye health, which the online services don't do.

I just had an eye exam last month and it was around $50. That was just for the prescription and it took around 15 minutes. Everything else was an up charge. The most expensive option was some kind of scan of my retina for an additional $40.

The parent company for Marchon eyeware is VSP insurance company. Fact is I like their Flexon 623 frames. But I’ll never pay a dime for VSP again. Vision insurance is like free phone plans. They cost more not less.

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