Insurance Coverage and Compliance of Polycarbonate Lens

1. Insurance Coverage and Compliance of Polycarbonate Lens Recommendations in a Young Patient Population Jay M. Rumsey, O.D., F.A.A.O. College of Optometry - Ft. Lauderdale, FL Karla E Rumsey, O.D., F.A.A.O. Private Practice - Pembroke Pines, FL Purpose: This study investigates the effect of vision care insurance on compliance to polycarbonate (PCL) recommendations. Ninety percent of ocular injuries are preventable with use of protective eyewear1,2. Therefore, the use of PCL’s in the pediatric/adolescent population is particularly important. In our previous study3 we investigated PCL compliance in a private practice that did not accept vision care insurance. In that study 57.1% of the patients under eighteen years of age were compliant to PCL recommendations. In the current study we investigate whether vision care insurance is a factor in compliance to PCL recommendations. Table 1. Number of patients compliant to PCL recommendations in patients without insurance, insurance with PCL coverage and insurance without PCL coverage. ___Insurance Benefits___ Yes No PCL materialsa Yes No PCL Compliance Total Yes 34 12 3 49 No 38 26 2 66 Totals 72 38 5 115(b) a Insurance included coverage benefits for PCL materials b Not significant for any p value, Chi square=2.03, df=2 with Yeats’ correction for continuity applied. Methods: Five hundred twenty-six (526) patient records from a private optometric office were reviewed for compliance to polycarbonate lens recommendations over a 42 month period. Record analysis was limited to patients 3 to 18 years of age and included information about prescription wear modality (full-time, distance or near only), contact lens wear, PCL recommendation compliance, insurance coverage of polycarbonate lenses and patient participation in organized sports. Chi squared calculations using Yeats’ correction for continuity was applied to all the collected data. Table 2. Number of contact lens patients compliant to PCL recommendations. Prescription Modality PCL Compliance Contact Lenses Yes No Totals Yes 4 15 19 No 45 51 96 Totals 49 66 115c c Significance is noted with Chi square=3.33 (df=1; p<0.10) with Yeats’ correction applied. Conclusions: It appears that patient compliance of PCL recommendations is not based upon insurance coverage. Additionally, patients who wear contact lenses are significantly less likely to be compliant with PCL recommendations. The optometrist should continue to improve patient education about the importance of polycarbonate lens materials in reducing ocular injuries. Results: Sixty (60.1%) percent (316 of 526 patients) received prescriptions and 49 of 207 prescriptions (23.7%) filled at the practice were PCL compliant. No significant difference in PCL compliance between patients with or without insurance that covers PCL materials was found. A significant difference in PCL compliance was found among patients who chose contact lenses as a correction modality compared to non-contact lens wearers. Ten of 512 patients (2%) reported being active in organized sports but only one patient was PCL compliant (0.2%). • References: • ‘http://www.preventblindness.org/safety/prvnt_injuries.html‘; website recommended by “medlineplus.gov”, a service of the National Library of Medicine. • ‘http://www.aao.org/aaoweb1/Library/11266_1321.cfm’; website of American Academy of Ophthalmology, Policy Statement: Protective Eyewear for Young Athletes. • Rumsey JM, Rumsey KE Poor compliance for polycarbonate lens use in a pediatric/adolescent population. American Academy of Optometry Annual Meeting – December 2000, Orlando, Florida. Opt Vis Sci 2000; 77:249.