“I love dealing with vision insurances. They’ve helped me make more money, and make my business run more smoothly”– said no optical professional ever.
If anything in the optical world is most aptly compared to Skynet, it would be vision insurance plans. They started off as a great idea to try and help people get eyecare. Over time, however, they seem to have morphed into something else completely. They are starting to reimburse less, cover less, and want to take more. They’re the perfect machine. They look so unassuming, and can work their way in very easily. Once they’re in there – it’s almost too late to get rid of them. Or is it?
From listening to all manner of different conversations about vision insurance, I don’t think I’ve seen anyone say that they have a problem by not having it. That is, of course, assuming that you are able to make your product offerings sufficiently different to get your patients to stay in the store. Part of the problem here can be if you offer the same thing that everyone else in town has. In that case, you aren’t standing out from the crowd, and you’re not giving your patients anything new or different. You make yourself just another cog in the insurance machine – nothing special, just a replaceable part.
Much of that goes back to how optical is becoming more easily accessible to people, through online sales and big box stores. You don’t want to be competing at the bottom of the scale, as the big box stores are always going to be able to undercut you if they want. Their business model and yours aren’t really the same thing, as they tend to focus on giving people the ‘cheapest options’ and then upselling to make the margins they want. You, as an independent professional, are focused on giving better quality options, so you’re not going to be in the bargain basement. If people really want to get the cheapest thing possible, they will find a way.
The online sale of eyewear, in this case, can actually be a good point for you to consider. People aren’t going online to places like Warby Parker or Zenni because they want to use their insurance (usually). They do it because they like the selection, the price, or both. But usually they’re paying themselves for the glasses – no insurance is involved. That should be enough to tell you that people aren’t adverse to paying out-of-pocket for eyewear, assuming they see some benefit to them. Whether it’s the look or quality of the product, or other factors, it shows us that we don’t necessarily need insurance to be successful.
Insurances are also trying to (or have already) get into the realm of online sales themselves. They want to take that part of the market as well, and ultimately cut out the optical stores. There have been some that will email their patients and tell them all about how they can ‘get more with their benefits’ by shopping at the insurance company’s website instead of buying them from someone like you. Of course, they still need the patient to be able to go somewhere to get an exam and Rx (for now), so the insurances still ‘need’ you. But what happens when technology gets to a point where it can all be done online?
There’s plenty of tools floating around promising ‘online refraction’ and similar services. What do you think insurance companies are going to do when they can make more money by cutting out independent stores completely? Since technology is making this more likely every year, it’s starting to become prudent to drop these insurances all together and build your business around your own products and services.
One thing that you need to keep in mind if you’re considering ‘dropping insurance’ is that just because you don’t accept it doesn’t mean that your clients can’t use it. They can still file out of network for applicable claims. That can be important for them to keep in mind, since they are still ‘using’ the insurance, but since you’re making it a separate step from the transaction at hand, they are going to feel less bound by the terms of it. That is to say, less likely to go with “whatever insurance covers and nothing more”.
You do need to be prepared to explain why you don’t take insurances, however, as your patient may wonder. There is, of course, nothing wrong with having an explanation ready, since you need to make sure you communicate correctly to your patient. You don’t really want to tell them it’s because insurance was “too much of a pain to deal with” (even if true), since that’s not really explaining it. You don’t accept it because you didn’t like the way it limited what you could offer to your patients. You wanted to make sure you could offer better quality products, and not just the cheapest thing possible.
A major question that does come up when considering dropping insurances is how the patients will react. How do you make it clear to them that you don’t accept the insurance any more? The best recommendation for this is to make it clear when calling to schedule the recall appointment – that way you don’t have to make them come in to find out that you don’t accept it anymore.
This is where whoever is making the call is going to have to be familiar with being able to answer the “why?”, as that’s bound to be the first question that the patient asks. If you can communicate that effectively, you shouldn’t have much push back from them, especially if they are longer-term patients. You could always offer them a discount to get them over the ‘shock’ of not accepting the insurance, as the transition period is likely to be the toughest time with patients not really sure what affect their insurance being ‘dropped’ has.
It does seem that practices that have dropped insurances haven’t really regretted it. I have yet to see someone say “Man, I wish we didn’t stop taking Big Insurance”. The feedback seems to be an overwhelming positive, assuming you don’t mind putting in some work to keep your patients engaged with you. Some of the people dropping insurance have noticed that yes, they may see slightly fewer patients, but the amount they’re making hasn’t gone down. They’re able to see more profitable private-pay patients more quickly, since they aren’t booked out with insurance patients for three months.
Ultimately, it’s going to come down to where you’re located, your patient base, and how you want to run your business. You just need to consider what the market is going to look like in the next five or ten years, and consider how vision insurance fits into your plan. And you should also consider how you fit into the plan of vision insurances.
