Why Your Eye Doctor Doesn’t Take MediCal: An Eye Doctor’s Explanation
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If your optometrist has recently dropped Medi-Cal and left you scrambling to find a new eye care provider, you are not alone. Many optometrists in California had opted out of seeing Medi-Cal patients. Why? Because optometrists in California are being forced to choose between providing quality patient care and providing for Californians on Medi-Cal.
The Growing Need: Optometrists and other eye care professionals who accept Medi-Cal are acutely aware of the need for Medi-Cal eye care providers. With over twelve million Californians who rely on Medi-Cal for their healthcare needs, having one or two eye doctors, or non-profit organizations per a given area who are willing to accept Medi-Cal leads to long wait times and poorer patient outcomes. Some patients are waiting months to be seen and missing their follow-up appointments due to a backlog of patients who need to be seen for eye emergencies and primary eye care alike. This leads to missed follow-ups, past-due eye exams, and even referrals that are not completed because another eye care provider has stopped accepting Medi-Cal.
When you have a patient with a severe ocular problem and you are looking to refer them to a specialist for treatment, their insurance shouldn’t matter. But it does because many ophthalmologists and optometrists with special interests and skill sets will not accept Medi-Cal.
Stagnant Reimbursements: Medi-Cal Reimbursements in California, one of the largest economies in the US, are the third lowest in the nation- trailing far behind other developed economies like New York and Texas. Then consider that Medi-Cal Reimbursement rates for an eye exam and refraction average around $47.50 less than a quarter of the $200.00 estimated eye exam cost in California.
So Why Not Just See More Patients? If few eye doctors are accepting Medi-Cal, it may seem reasonable to those who are not healthcare professionals for optometrists to simply see as many patients as possible to make up for the lack of reimbursements. However, in seeing more patients eye care professionals must also ensure that they aren’t compromising the quality of care that each patient receives.
It takes time to perform a thorough eye examination and to correctly identify and treat ocular and vision conditions. While eye exams can be streamlined for maximum efficiency, there is still a minimum amount of time that the eye doctor needs to spend with their patients. Many eye care professionals are committed to providing quality care and refuse to cut corners to the detriment of the patient.
More Than An Ethical Dilemma: Many California optometrists are dedicated to providing quality care and they must now choose between accepting Medi-Cal patients and dropping Medi-Cal altogether. While the quality of care is always top of mind for California eye doctors, it is also important to remember that doctors of optometry are also often small business owners who must pay their staff a living wage while also struggling with the rising costs of living and doing business in California.
The California Optometric Association (COA) is working hard to ensure that optometry is included in the Medi-Cal budget increase, which is currently under review by the California government. Increasing Medi-Cal reimbursements can help ensure that more California optometrists are able to take Medi-Cal, which increases care options for patients and decreases wait times. You can help by contacting your local representative and letting them know that Medi-Cal patients deserve quality eye care.
