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!
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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!
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.
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.