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Who Should Pay for Second Opinion?

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  • Who Should Pay for Second Opinion?

    We noticed not long ago that my stepson was having difficulty with his vision, and this past week his teacher confirmed the concern with us. We informed his mom about our concern and offered to take him to an optometrist next time he was with us. She agreed, but ended up taking him herself when she found out that OHIP covers eye exams in children. It turns out that our suspicions were correct and the little guy will require glasses. However, his mom indicated that she doesn't feel comfortable with the optometrist's diagnosis and asked if we could take him for another eye exam ourselves. (Of course, because OHIP only covers one exam per year and she just blew it.) When asked why she didn't feel confident about the diagnosis, she responded that the optometrist she took him to did not slow down enough for her to take notes about the diagnosis, did not explain the diagnosis to her liking, and declared that she did not think the lenses the optometrist prescribed were the right ones for the child because "he still had difficulty reading some of the letters."

    Now, OHIP does not cover second opinions. With my fiance having lost his job and slowly rentering the workforce now, we do not have the means to pay for an eye examination out of pocket. The child is supposedly still covered under his mom's work medical benefit plan, as far as we know, however we do not know if eye examinations are covered, and do not want to risk paying and her not reimbursing us later (likely the case).

    Most of all, we do not believe a licensed optometrist would write a prescription based on an incorrect diagnosis.

    Because the mom rushed to save the day and took the child to the first optometrist whose sign she saw at a local plaza, she is now asking us to fix her mistake (yet again) by taking him to an optometrist that specializes in children's vision... and to pay for it ourselves.

    My fiance doesn't feel he should pay for her mistake and whimsical actions (typical of her).

    Any ideas on how to approach this? We want to do what's best for the child, but we also don't want to be taken advantage of.
    Last edited by #1StepMom; 12-14-2008, 10:32 PM.

  • #2
    New glasses take getting used to. If child continues to have problems, the mother should go back to the optometrist.
    Since she undertook the eye exam it now has nothing to do with you.



    • #3
      His mom took him, and I don't think it is fair to categorize that as a 'mistake or whimsical action'. She does not trust the diagnosis, and you seem to agree, so now she is taking you up on your offer to take him.

      It is a positive thing that she took him, and now you both agree that a second opinion is needed. I am not clear if you agree he needs a second opinion because you seem to contradict yourself about this. Lets assume he does. You had offered to take him, so it is simply a matter of money.

      It seems you have to get the facts from the ex - is he covered under her plan or not? This information would be good in general, you don't have to ask her, you can get the plan info from her company probably. If he is covered, then maybe she should take him again and you can do some work to help her pick a reputable one. If he is not covered ask her if she will pay proportionally for exam based on the agreement for medical expenses you have (and also considering the dads work situation)? I assume you have an agreement in place for such expenses. It seems fair to me that she pay for some of it as she took on the responsibility for getting a proper diagnosis from the first free one.

      If she won't follow your agreement, or be fair all things considered, go back and call the optometrist and ask him to explain the results perhaps and discuss the concerns of the mom.


      • #4
        We don't disagree with the diagnosis. We knew there was a problem. It is her that is saying that she isn't comfortable with the diagnosis because the optometrist didn't take the time to explain every single detail to her.

        It isn't unusual for her to act on a whim, trying to be the number one parent. Before we make any decisions, we look into the credibility of the professionals and make an educated and informed decision. We had provided her with a list of optometrists we thought would be good choices... and indicated we could take him to one of those next time he is with us. Instead, she made her own appointment with an optometrist she found herself. And now that she didn't like the experience with this particular optometrist, she's asking us to take him to one we had recommended... and pay for it ourselves. Is that a little clearer?

        We inquired about the health benefits to see if the child is eligible for coverage for an eye exam, and are awaiting a response.

        Either way, even if she doesn't respond in kind, we will ensure my stepson is properly taken care of, even if it means putting ourselves even further into debt. I just wish there was something we could do to ensure that the child is properly looked after AS WELL as not have to foot the bill each time his mom does something and isn't happy with it, or changes her mind about it (which happens regularly).

        I guess I'm just frustrated about it always being us having to step in and "save the day" with our own money (or loaned money)... which wouldn't be the problem if the mom stopped and thought things through a little before acting (especially when deciding on an optometrist without even notifying us of who this optometrist is).

        I guess I just needed to vent.

        Thank you for the replies.


        • #5
          Your first post was clear, #1 Step Mom.
          I understand what you meant when you think that she stepped up to take the #1 Mom credit when the problem had to be pointed out. Jump in before Dad can get points, kind of thing.

          Anyway, like anything, I suppose some optomertrists are better than others but it's not like the glasses he's prescribing are from DOLLARAMA, right?

          I'm sure that the Doctor is better able to assess the eye exam, decide on a lens strength and prescribe than your step-sons Mom! Does she have her degree?

          Ask the office for the info that the Mom obtained. Hopefully the receptionist will be helpful.

          Then YOU & his Dad can come to a better decision on whether worrying about it is necessary.


          • #6
            first off it takes time to get use to new glasses. I got my first pair in grade 3 or 4 and it took a while for me to get the full benefit of them.

            second she took the little guy to the eye doctor and she probably expected immediate results so that is why she is wondering if the prescription is right.

            As for the health coverage it may only cover one eye exam a year for adults that do not fit under any exemption catagory or covered by the provincial plan. Company health plans are usually pretty sticky if there is some way they can get out of paying something.

            Before jumping the gun and taking him to another guy, wait and give him time to get use to the glasses. Explain to bio mom that the child needs to get use to the glasses and show her some research that proves that. if you feel the first guy was right,then do not feel like you have to take him to someone else. All that is doing is validating what the bio mom thinks. That you also do not agree with the first guy.

            You seem a bit bitter and remarked about having to fix her mistake once again. If she knows that the bio dad will do that then she will always expect that. Bio dad started the trend so now it is up to him to stop it. I do not mean to sound harsh,it looks like you guys have the "rush in to save the day"attitude also.


            • #7
              Well, she hasn't yet purchased the glasses... because she doesn't think the prescription is right. She doesn't have much to say about WHY she doesn't think it's right other than "the optometrist rushed through telling me what exactly she was doing, and he still couldn't read ALL the letters with the lenses she tested."

              We try not to bail her out, but sometimes, for the sake of the child, we have to. It doesn't happen as often as it once did, thank goodness for that, and I guess that now when it does, it's just frustrating and irritating and costly.

              Suchislife hit the nail on the head about being #1 the second the problem is pointed out before Dad can get any points. An Standing on the Sidelines is right about the glasses taking some time to work, even if the prescription is slightly off (perhaps it's supposed to be, to help train the eye) - as my stepson's mom claims it's not right.

              And no, the glasses are not coming from Dollarama, and I trust that she wouldn't take him to some whack-job optometrist. But, if Standing on the Sidelines is right, and the coverage is only for those who are not covered by OHIP and once annually, then we will need to shortly decide on whether this battle is worth pursuing, or if it's better to just fork out the $80 for a second opinion.


              • #8
                Well, we managed to avoid a second opinion cost. Turns out "this prescription will be fine." The little guy will get the prescription filled and have a new pair of eyes soon! ;-)


                • #9
                  Originally posted by #1StepMom View Post
                  Well, we managed to avoid a second opinion cost. Turns out "this prescription will be fine." The little guy will get the prescription filled and have a new pair of eyes soon! ;-)
                  I am glad to hear that. It can really effect school work etc when a child needs glasses.


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