Reply
Thread Tools Display Modes
#1
Old 11-14-2012, 08:53 AM
Guest
Join Date: Aug 2003
Location: was Montreal, now MD
Posts: 7,116
Who uses Kaiser Insurance? Do you like it?

It's open enrollment season again and they're raising the costs of my current PPO plan significantly for next year. The premiums are almost the same, but the deductible is going up by 50% and some of the co-pays are doubling. Looking at the numbers, the Kaiser option seems to be the cheapest way to go, but I've never dealt with them before and I'm nervous about having to change doctors.

I'm going to an information session today with a stack of questions to ask, but I'd love some firsthand accounts from Dopers who use Kaiser as their primary health insurance, especially those who are in the Mid-Atlantic area. How long have you been with them? Do you recommend them? Why did you choose (and stick with) Kaiser over other options? How is the care? How long are the waits to see your primary care doctor if you're sick? How long to see a specialist? What's their customer service like?

My "fear of change" side is leaning towards keeping the PPO and dealing with the extra cost, but my "save money" side is seriously thinking Kaiser may be smart.

Thoughts? I need to pick one by the end of the week!
#2
Old 11-14-2012, 10:04 AM
Member
Join Date: Jan 2000
Location: The down hill slope
Posts: 3,034
I have had Kaiser for 2 years, both I and my wife (and my kids) like it a lot. Good system, much better than the PPO we used to have. I am in Colorado BTW.
#3
Old 11-14-2012, 10:20 AM
Guest
Join Date: Dec 2000
Posts: 2,691
I switched over to my husband's Kaiser plan last January and it's been fabulous. I am expecting a baby boy in January and I am amazed how much is covered. Blood tests, CVS test, ultrasounds (including weekly ultrasounds due to my high risk), an overnight stay in L&D for a pre-term labor scare, we haven't paid a dime. We paid 10 bucks to talk to a geneticist and 5 bucks for prescriptions. It is amazing.
#4
Old 11-14-2012, 11:06 AM
Guest
Join Date: Mar 2000
Location: Saint Paul, Minn.
Posts: 454
My wife and I were on the Kaiser plan (in Northern Virginia) for a few years, and we liked it. One thing we had to get used to was not really having "A physician," as in, "a named MD who I always see when I make an appointment." If I recall correctly, you would just call Kaiser and they would set you up with whomever was available. That said, I think they were flexible in that you could avoid an MD who you didn't care for, or express a preference for a male or female MD, etc. When my wife was pregnant with our first child, she saw several different MDs and nurses for her periodic checkups, but they were all "on the same page" in terms of knowing the patient history, etc.

So our experience was good. But we have no serious health issues, and the most medically complicated things we had to deal with were one and a half routine pregnancies. (the "half" ended just fine... we moved and changed providers 7 months in.) I can't speak to what they're like if you have more serious health needs.
#5
Old 11-14-2012, 01:23 PM
Guest
Join Date: Aug 2012
Location: NoVA
Posts: 821
I also have the Kaiser HMO plan in Northern Virginia, and I like it a lot. I like being able to schedule appointments online, and I've never had to wait more than two days for an appointment. That said, I've never had strep throat or anything that I need a prescription for right now, so maybe it gets tricky at that point.
#6
Old 11-14-2012, 01:26 PM
bup bup is offline
Guest
Join Date: Sep 1999
Location: glenview,il,usa
Posts: 11,905
Heather O'Rourke did.

Also a friend of mine - she was misdiagnosed with Leukemia because of anemia that was actually caused by an ulcer.

I know, anecdote != data, but I've steered clear of Kaiser Permanente since.
#7
Old 11-14-2012, 01:33 PM
Sith Mod
Moderator
Join Date: Dec 2000
Location: Bear Flag Republic
Posts: 42,434
I've been using Kaiser here in California for literally my entire life, and my parents for a good forty years or more. No complaints from any of us, but then, not a lot to compare it with, either.
#8
Old 11-14-2012, 01:59 PM
Guest
Join Date: Dec 2005
Location: Van Nuys, CA
Posts: 11,663
I've had a variety of plans over the years including Kaiser. Given my choice, I would choose kaiser over anything else every time.
#9
Old 11-14-2012, 03:57 PM
Guest
Join Date: Aug 2003
Location: was Montreal, now MD
Posts: 7,116
Thanks for the input. After further investigation, it looks like I'd be able to retain about half of my "healthcare team", since they're in the Kaiser network. I'd need a new primary care doctor and a specialist or two, but that's not a big deal.

I guess I was just nervous about "HMOs" because they have this reputation for being stingy with care, but maybe that's not true.
#10
Old 11-14-2012, 04:31 PM
Guest
Join Date: Jun 2006
Location: Venial Sin City
Posts: 12,376
I know some people that hate them, almost always for anecdotal problems. I had them from a young age (3 or so?) until 23. No complaints.

The only "stingy" thing I've noticed about Kaiser is that in some markets they prefer not to hire PhD or PsyD psychologists in favor of MFTs and LCSWs, because they're cheaper with only Master's degree.
#11
Old 11-14-2012, 06:17 PM
Charter Member
Join Date: Jun 2000
Location: Back in the South, y'all
Posts: 6,937
I'm actually dropping them as of the first of the year after giving them what I feel like is a fair shake for 2 years. I really don't like not having a specific doctor, and maybe it's the ones where I live, but it could really be hit or miss as far as how well I felt like the doctor was willing to listen and hear what I was saying.

But I know people who love them - it just wasn't right for me.
#12
Old 11-14-2012, 06:23 PM
Guest
Join Date: Aug 2012
Location: NoVA
Posts: 821
I'm surprised to hear people talk about constantly seeing different doctors. I've only ever seen one primary and one OBGYN for all my annual exams, and I even went to my primary for a hospital follow-up.

Is it because I have the HMO plan?
#13
Old 11-14-2012, 06:23 PM
Guest
Join Date: Aug 2003
Location: was Montreal, now MD
Posts: 7,116
Quote:
Originally Posted by malden View Post
One thing we had to get used to was not really having "A physician," as in, "a named MD who I always see when I make an appointment." If I recall correctly, you would just call Kaiser and they would set you up with whomever was available.
Quote:
Originally Posted by Lsura View Post
I really don't like not having a specific doctor
See, that's weird - from today's presentation it seemed to me that they really want you to pick one doctor and stick with him/her so you develop a relationship and get better care, and you'd only go to someone else if you had an urgent issue and your doctor couldn't fit you in fast enough. Not sure what to think now!
#14
Old 11-14-2012, 06:27 PM
Guest
Join Date: Aug 2012
Location: NoVA
Posts: 821
Quote:
Originally Posted by Antigen View Post
See, that's weird - from today's presentation it seemed to me that they really want you to pick one doctor and stick with him/her so you develop a relationship and get better care, and you'd only go to someone else if you had an urgent issue and your doctor couldn't fit you in fast enough. Not sure what to think now!
That's exactly what they told me when I enrolled, and that's how it's been in my experience. They even encourage you to e-mail your doctor through the Kaiser website if you have any questions or concerns.

This is the first I'm hearing about going from doctor to doctor.
#15
Old 11-14-2012, 06:39 PM
Guest
Join Date: May 2004
Posts: 1,923
My family switched to Kaiser after my company was bought out in April (they offered Blue Shield or Kaiser). We chose Kaiser because there are a lot of hospitals/centers here in the SF Bay Area, because the price was significantly lower, and because we weren't particularly attached to any of our primary caregivers.

While I have yet to see the doctor (my first appointment is scheduled for two weeks from now), my wife has been very happy with how she and our sons have been treated. The whole middle layer of bureaucracy has been stripped away, so it's MUCH easier to get something done. You don't have to talk to your doctor, then talk to someone at your PPO, refer to a specialist, blah blah.
#16
Old 11-14-2012, 06:39 PM
Guest
Join Date: Jan 2006
Location: NE Ohio
Posts: 5,875
It's been a long time, but I was very happy with Kaiser when I had them. I had a weird illness (sarcoidosis -- it was one of those potential diagnoses that came up on "House" all the time), and they did not stint on the testing to confirm that that's what it was.

I also had a problematic pregnancy. I was really impressed when I went to the ER with early labor signs on a Friday evening. They got me stabilized and sent me home. I had a regular OB appointment on Monday, and she had all the records of the ER visit prior to my appointment. And I had minimal out-of-pocket expenses for a C-section.

Last edited by freckafree; 11-14-2012 at 06:40 PM.
#17
Old 11-15-2012, 05:41 AM
Guest
Join Date: Sep 2002
Location: At long last, home
Posts: 11,043
Had Kaiser for the first 21 years of my life. No complaints, though to be fair, I never used it for anything except occasional check ups, lady visits, and birth control. Low copays, sometimes long waits even with an appointment, but I've come to expect that kind of crap out of doctors and hospitals.
#18
Old 11-15-2012, 12:13 PM
Guest
Join Date: Jul 2001
Location: Chi NYC Berlin LA Vegas
Posts: 13,728
When we lived in California, we had Kaisers - it does help if you live close by a larger facility (which we did).

They were great - sort of the one-stop Walmart of medical care - they would just send you up to another floor for this test, over to that side of the building for that doctor and back to the other side of the building to get your prescription.

I know a lot of people hated them, but when SO had a very serious illness, they diagnosed it quickly and we didn't even have to leave the building to have tests, speak with specialists and get the treatments started quickly. I vote a hearty YES!
#19
Old 11-15-2012, 12:16 PM
Guest
Join Date: Aug 2003
Location: was Montreal, now MD
Posts: 7,116
The deed is done. I used my benefits website's online calculator to guess at healthcare needs for next year, and no matter how I did it, Kaiser came out on top. Spectacularly less expensive. I suppose it's possible I'll get what I pay for, but if it's horrible, I can probably look for something different next year.

Thanks for all the advice.
#20
Old 11-15-2012, 01:42 PM
Member
Join Date: Nov 2004
Location: Bellevue, WA
Posts: 1,865
Kaiser in North California has been great. My wife and I are insured through them, and had our first child in their facilities.

The staff was great, the facilities were great, they were very accommodating to her wishes (using midwifes, etc). In the end it was a complicated birth with surgery, and I think our out of pocket total was around $100.

I don't have experience with big medical procedures outside of Kaiser, but from friend's experiences I imagine it being a closed shop is helpful (i.e. Kaiser is the insurer and the hospital chain). There was no being sent bills by dozens of providers or difficulty dealing with insurance companies. Everything just got taken care of. That would be a big deal if I was involved in a stressful car crash, etc.
#21
Old 11-15-2012, 02:03 PM
Guest
Join Date: Jan 2010
Location: 3 East Market Street
Posts: 930
I just wanted to chime in that my experience with Kaiser has been great. I grew up in NoVA, and my Dad's insurance was Kaiser. When it was my time to choose my own health insurance (after about 8 years of PPO's), I went with Kaiser.

I always see the same doctor and OB, unless I just need to pop in for a strep test or some such (which they can always accomodate on short notice). The entire OB staff is just incredible. I had three miscarriages prior to the birth of my son. I truly came to know those folks on such a great level, and they took such good care of me, physically and emotionally.

I could not sing Kaiser any higher praises! Welcome to KP Antigen! Thrive!

ps. the fact that I can email my doctor, AND have universally gotten a personal response within 48 hours every single time is incredible.
#22
Old 11-15-2012, 04:14 PM
Charter Member
Join Date: Feb 2003
Posts: 11,403
I wonder if the thing with seeing the same doctor, or getting potluck each time, varies by location. I mean, if you need to be seen for something semi-urgent, you get whomever they can fit you in with and that's cool. But it would seem to be really a bad thing to have potluck for ongoing stuff.

Back when Kaiser first came on the horizon, I was living in North Carolina. Closed health systems were pretty new - the industry was pretty much all the standard 80/20 reimbursement. As I understood it, you couldn't go anywhere BUT their in-house doctors, though even back then they must have had arrangements for *some* specialists and deals with outside hospitals, because it would have been too cost-prohibitive to build their own.

That said: for the OP: Do you have a number of doctors you already have dealings with, and would have to leave? Or are you at a stage in life and health where it's no big deal to switch?

What kind of access would you have to specialists if something Big were to happen? I know if I got cancer or something, I wouldn't want to be limited to someone who worked only for Kaiser.

What kind of reputation do they have in your area? I've heard good stories in some areas and bad in others. My officemate has Kaiser (northern Virginia) and is happy, then again she's young and doesn't have a bunch of health problems.

On rereading, I see you've chosen Kaiser. Cool! Driver8's mention of billing *is* something worth thinking of. When I had my gallbladder out I got bills from the hospital, the surgeon, the anesthesiology practice, the pathologists, and someone's nanny's dog-walker (or so it seemed!).

Last edited by Mama Zappa; 11-15-2012 at 04:16 PM.
#23
Old 11-16-2012, 06:47 AM
Guest
Join Date: Aug 2003
Location: was Montreal, now MD
Posts: 7,116
These are all good questions, Mama Zappa, and I tried my best to get them answered to my satisfaction before making the decision. Of course, it's hard to really know what it'll be like, since the Magic 8-Ball has been just useless lately.

Quote:
Originally Posted by Mama Zappa View Post
That said: for the OP: Do you have a number of doctors you already have dealings with, and would have to leave? Or are you at a stage in life and health where it's no big deal to switch?
I'm in my early 30s and don't see the doctor too often. My therapist is within the Kaiser extended network, so I won't need to drop her, which was a huge consideration for me. The Kaiser plan offered by my employer is a "select" plan, which means I have access to a number of doctors outside of the Kaiser buildings. I've been told that it will affect the "seamlessness" of care I would get if I stuck with the one-stop-shopping option of all my doctors in one center, but I'm okay with that. The other big one was my OB/GYN. All the official Kaiser OB/GYNs have privileges at hospitals that are really far from my home, and I would rather deliver (if I ever manage to get pregnant) at my local hospital. It turns out my "Women's Care" group is Kaiser-affiliated as well, so I won't need to drop them either. My primary care, my dermatologist, and my endocrinologist will need to change, but I'm not attached to them. I really like my primary care doc, but I only see her twice a year, so that didn't seem a strong enough reason to avoid switching to Kaiser.

The hardest part was figuring out my infertility coverage. I may not even need it, but we've been trying 16 months and only managed one (lost early) pregnancy. My old plan covers more, percentage-wise, but has a lifetime maximum. Kaiser covers a lower percentage but there's no limit. Given that all the prenatal and delivery costs are astronomically more expensive under the old plan, I figured I'd jump over to Kaiser and just eat the extra cost of IVF if I need it.

Quote:
Originally Posted by Mama Zappa View Post
What kind of access would you have to specialists if something Big were to happen? I know if I got cancer or something, I wouldn't want to be limited to someone who worked only for Kaiser.
It looks like they have a pretty big number of specialists and deal with several good area hospitals, so I'm not too worried. Again, who knows until I'm in that situation? The Kaiser folks claim it's all going to be world-class care with their doctors, but if I have rare XYZ Super Cancer and the best guy to help me is in a non-Kaiser hospital, I guess maybe I'd be stuck. I do know I could use Kaiser stuff across the country if necessary.

Quote:
Originally Posted by Mama Zappa View Post
What kind of reputation do they have in your area? I've heard good stories in some areas and bad in others. My officemate has Kaiser (northern Virginia) and is happy, then again she's young and doesn't have a bunch of health problems.
Half my coworkers are with Kaiser and love it. Everyone I've spoken to about their use of Kaiser has either been healthy or dealing with basic chronic health issues like diabetes or autoimmune problems. They all say it's cheap and convenient and they feel like it's a healthcare system instead of an insurance system, which they love.


Quote:
Originally Posted by Mama Zappa View Post
On rereading, I see you've chosen Kaiser. Cool! Driver8's mention of billing *is* something worth thinking of. When I had my gallbladder out I got bills from the hospital, the surgeon, the anesthesiology practice, the pathologists, and someone's nanny's dog-walker (or so it seemed!).
That's going to be my favorite part. I hate that about the American system. When I go to a movie, I pay to see the movie. I don't pay the cashier, the ticket-ripper, the projector guy, the actors, and the key grip separately. So why do they do that crap with a hospital? Take my money and then give it to the right people, instead of sending me weird bills six months later. Gah!
Reply

Thread Tools
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is Off
HTML code is Off

Forum Jump


All times are GMT -5. The time now is 04:13 PM.

Copyright © 2017
Best Topics: gpc one oh myy berzerk game deaths area code 020 thunderbirds 2004 sweet caroline movie crypto racism waterworld dryland swinging dicks polio vaccine mark mulder's father frank langella naked crocker sacks eat swans nr film bid retraction ebay father son masturbation military date stamp u kosher sherlock names nair for scalp attached earlobes non prophet mace and chain vhs history wwii scrap drives my ruthschris double sawbuck racal suit welding ships can churches discriminate beard removal cream what does anesthesia feel like stale gas in lawn mower how to calculate percentage in calculator with percentage key pathfinder srd bag of holding holding your breath until you pass out diagonal lines on the pavement warn drivers of what is a wry sense of humor howie mandel hair loss raven teen titans age cat eye reflection different what happens if you get stabbed in the stomach mole removal surgery on face cost johnny cash in a bush eating cake not screened for critics i had sex with my step daughter is the kiss of the dragon a real technique how long is a horse penis how to reduce garlic flavor why is purple a halloween color can someone else register my car for me in ny getting paid in cash tell the bell complaint high pitched noise from speakers does gray hair make you look older what do toads eat as pets does walgreens have a photo scanner what is considered room temperature in fahrenheit does ibuprofen help you sleep how to eat fresh guava im i being detained alcohol and muscle cramps door to door salesman salary do polygamist wives sleep together