Royce Shook quietly paid for his premium cataract lenses when his ophthalmologist offered them several years ago. While basic lenses were covered under the medical services plan, the Coquitlam, B.C.-based retiree was told that premium monofocal lenses were preferable. They were also costly – and not covered provincially.
"I had the cataract lenses and paid extra for them," Mr. Shook, 69, says, adding that he was happy in the end.
He is less happy about the other health costs seniors face. "The biggest costs of retirement are the hidden medical costs, and our age group is one of the least informed," he says.
Mr. Shook should know. He is a workshop facilitator for the Health and Wellness Institute of the Council of Senior Citizens' Organizations of British Columbia, a group that aims to educate retirees about health and wellness.
He says many people just do not know where to turn for advice on the costs of the health-care products they need.
Part of the problem is that there is next to no information on the health-care upselling that occurs in Canada. It's not tracked – and the issues that arise are often dealt with on a province-to-province basis.
In British Columbia, for example, the province decided in April of 2012 to end the practice of ophthalmologists upselling expensive cataract lenses to patients – by paying for foldable, intraocular, monofocal lenses. According to reports in the Vancouver Sun, provincial authorities had been deluged with complaints from seniors about being charged anywhere from $250 to $1,800 a lens.
"The law prohibits physicians from charging on top of what they're reimbursed by the province for providing," says Isobel Mackenzie, B.C.'s seniors advocate. "It would appear that some are either trying to upcharge to the next level of the medical services plan or they are still charging them for what the medical services plan reimburses them."
Judith Wahl, executive director and senior lawyer for the Toronto-based Advocacy Centre for the Elderly, says she hears all the time from low-income seniors about improper costs of medical products and services. "We are getting people being charged for things they shouldn't be charged for," she says. "People don't know what an appropriate charge is."
Then there is the costs of the products themselves. Regardless of whether they're upsold or not, many health-care products sold to seniors – eyeglasses, hearing aids, dentures – are expensive, and there is little information for retirees on how to shop around to get a lower price.
Dentures cost $600 to $1,000 for a basic full set, and can run $4,000 to $8,000 for a premium set. Eyeglasses can run $500 to $1,000 for custom lenses, plus several hundred dollars for a frame. Then there are hearing aids, which run $1,500 to $3,500 per device.
"What my office is concerned about is how are low-income seniors able to pay for some very necessary things that cost a lot of money?" Ms. Mackenzie says. She says those without private insurance struggle to pay for these products on an income of $19,000 a year, in many cases.
Ms. Gray says retirees need to do some research before making a big health-care purchase, whether that means recruiting friends or family for help or talking to an expert. Her advice is akin to bringing a friend when buying a car. "Do some homework, get a couple of quotes," she says. "Have someone with you who isn't emotionally invested and who isn't shy about asking questions."
She also says seniors should inquire about provincial grants for health-care devices or access community care centres, which can refer them to lower-cost retailers. And word of mouth can go a long way in securing a cheaper cost. "Ask friends for references," she says.
Ms. Wahl, too, wants more education around costs. To that end, her organization is producing a booklet about what medical costs are covered provincially while educating its clients about being more aggressive when they are facing an unexpected health-care bill.
Mr. Shook has taken that advice to heart. Needing a hearing aid, he decided to shop around. "I got it for half price," he says.
But he says many seniors do not have the resources or time to do the research required to obtain a lower price. "It's a shock to people."