Frames???

[Zephyr]

What is the name of your state (only U.S. law)? WI

Are eyeglass frames considered cosmetic? Here's the deal...

Ex got kiddo glasses, under ex's insurance there are a variety of frames that could have been selected that would have been 100% covered.

Under my insurance, if ex would have taken kiddo to the right place (or let me do it) ANY frames would have had a 35% discount.


Ex ignored the ones offered under his plan, didn't tell me until after the glasses were purchased that kiddo needed glasses- thereby missing the possible 35% discount. Now wants reimbursement for the frames.

IMHO- he opted to incur an expense he could have avoided for cosmetic purposes.....I don't think I owe him- but rather than fight with him about it- I thought I'd ask.

 

[nextwife]

IMHO, you should only owe him half of what the frames should have cost, had ex used the available coverage. If ex could have obtained 35% off, and didn't bother, your share should be the price of the frames, minus the 35%, divided by whatever percent you pay for uncovered.

 

[TinkerBelleLuvr]

How much difference are we talking here?

Remember that your X will then take the child to therapist about mental anguish over mom suggesting that child should have gotten horrid glasses.

You X can get in the same leaky boat as I've wanted my X to be in.

 

[mommyof4]

I agree with nextwife.

 

[Zephyr]

How much difference are we talking here?

Remember that your X will then take the child to therapist about mental anguish over mom suggesting that child should have gotten horrid glasses.

You X can get in the same leaky boat as I've wanted my X to be in.

well under ex's insurance- the frames would have been zero
under mine - 106.60

he paid 164.00

which is why I'm waffling....if it's assumed that he shouldn't have used his insurance to get them for free....then we are only talking a $15.00 difference- which I won't fight about, however...I just don't throw $82.00 away when I don't have too.

Had kiddo been with me....he would have gotten the covered glasses or HE would have paid for the "special" ones....I haven't even seen the things yet- he's not allowed to bring them to my house..but I digress

 

[TinkerBelleLuvr]

Do you have joint legal? Thinking this one might fall under the "must concur prior" decision.

 

[Zephyr]

Do you have joint legal? Thinking this one might fall under the "must concur prior" decision.

Joint legal and joint physical....

 

[Ohiogal]

Then he should have talked to you about this BEFORE purchasing the glasses.

 

[LdiJ]

Then he should have talked to you about this BEFORE purchasing the glasses.

I agree...but glasses are also something highly "personal"...after all, its something that you have to wear on your face every day.

164.00 is actually pretty inexpensive for frames. Yes, you can get them much cheaper than that (particularly with discounts) but they are often MUCH more expensive than that as well.

However, again, as someone who wore glasses as a child and teen, and still wears them now, I wouldn't quibble over the cost of frames unless the frames were incredibly expensive designer ones, and these were not. Like I said, this is something that the child has to wear on their face every day. You want the child to be happy with them, within reason, and I think that 164.00 is within reason.

Now, if the child manages to lose or break them quickly, then I would quibble.

 

[thedoctorisin]

well under ex's insurance- the frames would have been zero
under mine - 106.60

he paid 164.00

Just to be clear - Are you saying that your ex could have gotten some frames for free, and other frames for $106.60, but instead of doing either of those things he chose a completely different set of frames that cost $164.00?

Or are you saying that if he had done things differently, he could have gotten the exact same pair of frames that cost $164.00 for only $106.60, but there is something preventing you from submitting the difference to your insurance after the fact, so that you are stuck for the full $164.00 cost?

 

[haiku]

I like my husbands order, it says if you go out of network when you don't have to, you get stuck with the full bill.

I just got my young kiddo her first pair of glasses, she is 12, so the 3 frame styles plus color choices she could get for free, were more than adequate. Even when I was a teen, and my mum was poor, I was able to get cheap glasses within my mothers budget that suited my teenage taste.

 

[nextwife]

164.00 is actually pretty inexpensive for frames. Yes, you can get them much cheaper than that (particularly with discounts) but they are often MUCH more expensive than that as well.

No, it isn't if one has the option of paying ZERO for frames. My kiddo wears glasses, and she is ONLY allowed to select new frames annually, when she again has coverage for a new set of frames. And, there are plenty of nice frames that ARE available within the coverage or for a very modest amount in excess of coverage. As a parent who buys their kiddo glasses, I see nothing wrong with saying "NO" to one pair that is not covered, and restricting the options to those that are covered.

 

[Zephyr]

Just to be clear - Are you saying that your ex could have gotten some frames for free, and other frames for $106.60, but instead of doing either of those things he chose a completely different set of frames that cost $164.00?

Or are you saying that if he had done things differently, he could have gotten the exact same pair of frames that cost $164.00 for only $106.60, but there is something preventing you from submitting the difference to your insurance after the fact, so that you are stuck for the full $164.00 cost?

the second one, and I cannot get the discount now I don't think because my insurance doesn't actually cover glasses, they just work with some providers to give a discount, ex didn't go to one of the providers

 

[thedoctorisin]

the second one, and I cannot get the discount now I don't think because my insurance doesn't actually cover glasses, they just work with some providers to give a discount, ex didn't go to one of the providers

Then to make the excess cost argument, you should find out what that exact pair of glasses (frames and lenses, which also vary in quality) would cost at one of the allowable providers under your plan. It may turn out to be $164, or it may turn out to be marked up higher to offset the 35% discount they have to provide. Get that amount documented in writing. Then, the 35% discounted amount from the allowable provider should be the maximum amount that you should reasonably be held liable for under the circumstances.

 

[Drake01]

Most optical plans offer free frames that are quite a bit nicer than the thick black plastic frames of yesteryear. $164 is on the excessive side for a pair of children's glasses, some of the lower tier designer frames start around $100. If you have joint custody you should have been consulted, so I wouldn't offer to pay anything. Dad made the call so dad can flip the bill for it.