Anyone recommend Kaiser?

  1. Megs and I welcomed our baby boy earlier this month and wanted to share the news with the TPF community. Come say hello to Baby Vaughn!
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  1. I'm a fairly new member here, but when I thought about who I could ask this question, my friends at tPF came to mind! :yes:

    DH and I are considering switching our medical insurance to Kaiser for next year, mainly due to the lower premiums for seemingly better coverage. However, I've heard both good and bad things about Kaiser.

    Would anyone here recommend using Kaiser for our health insurance? If so, then why? If not, then why?

    Thanks in advance!
  2. Sorry but I've only heard negative things about them. I don't know how I feel about them spending so much money on advertising either. Also remember that you get what you pay for, so be wary of cheaper medical coverage.
  3. What I can tell you about Kaiser is the following, then you can choose. Kaiser is a "staff model HMO". Meaning, the doctors work for the company (Kaiser). The model is structured in a way that rewards the docs who keep referrals to specialists to a minimum. I have had about 5-6 friends who have needed specialist care who were told they did not need specialist care who finally paid out of pocket and saw a non Kaiser doctor. In one case the guy had malignant melanoma and thank God he went to a non Kaiser doc as the kaiser doc did not biopsy the area at all. PM me if you want more information or direction. I personally would never choose Kaiser.
  4. I'm partial to Kaiser.
    My mil was brought back to life after 3 heart attacks within the last 10 years. My uncle in law was near death twice (he's 30 something with CP) and was rehabbed by Kaiser. If it wasn't for Kaiser my mil and uil would be in graves.
  5. I have heard so many horror stories of misdiagnosing patients (especially the one near me in the south bay area) because they don't want to spend the money to for tests to rule out all possible problems.
    Honestly, I would say it would depend on your age and health, if you are young and will mainly be going for colds this year it would never be a problem.
  6. As a retired CEO in the healthcare field, my professional opinion is to check into other health plans. If you need any help, please feel free to PM me.:flowers:
  7. I've been one of those who have heard many bad things... I'd take advantage of asking some of these ladies that have offered and keep researching other options.
  8. I have Kaiser and wouldn't switch....but there are good and bad things about Kaiser.

    I am a research geek and do not back down from anyone, dr's, hospitals, insurance, when I have met resistence in getting the care, that I or a loved one needed, I did not take no for answer...and there have been occasions when strong tactics have been needed...because of situations that have arose in my family, I now have power of attorney for most of my family and I volunteer as a patient advocate.

    With that said, my mom almost died 8 years ago, and had several procedures, ended up in the hospital for over 2 months, in and out of ICU, had a home nurse for 6 months after, then moved to a bi-weekly visiting nurse for a year after that. Her cost, $ 0...we estimated her total bill about 1.5 mil, no exageration, with a normal insurance, her cost would have been at least 300,000, probably closer to 400,000.....

    Also with kaiser if the kids get sick I can call in the AM, and have them seen by noon, even on weekends.

    With any healthcare situation, you really need to be your own advocate and be in control of your care.
  9. Their billing people are uh, special. I'm biased though, working for Wellpoint and all. (Owns many blue cross/blue shields or Anthem or whatever we are these days)
  10. Thanks everyone for your responses so far. Seems there are strong examples of both negative and positive experiences.

    One of the main reasons why we're considering switching to Kaiser is because their maternity coverage is so great. Shhh, don't tell anyone, we're just in the planning stages right now.

    Our Kaiser plan covers prenatal, delivery, postnatal and hospital stays at 100% (delivery with a $250 one time fee, but that's very reasonable).

    The alternative is UnitedHealthcare, which covers prenatal & postnatal at 100%, but delivery at 90% and hospital stays at 80%. Both plans have copayments, but they're comparable.

    I've been asking around to figure out a general ballpark number for delivery and hospitalization costs, and found that the average, uncomplicated delivery is priced at $6300 (from an online article) and the hospital room will cost at least $5000/night (from a friend who recently was hospitalized). Assuming an uncomplicated delivery and one night's stay at a hospital (which is a big assumption), that's ($6300*10%) + ($5000*20%) = $1630 with our non-Kaiser insurance. I guess that is not bad considering the joy of having child (right moms?), but if we had Kaiser, we would have to pay $250 out of pocket.

    (The difference is enough for a really nice handbag, don't you think? :graucho: I'm kidding, of course!)

    So, with those extra pieces of information... any other input?
  11. experiences with kaiser and pregnancys and kids is one of the reasons I stick with them.

    I have 3 boys, spread out enough that each one CA laws were a bit diff.

    First son born at Kaiser, everything went well, CA law was 3 days hospital stay..had 1 minor problem at the end, decreased fetal movement and they had me come in right away...everything was fine, but no hesitation...come in now.

    Second one we had blue shield. Hated it. Hospital was Good Samaritian, too....suppose to be one of the best..hah! When ever there was a problem, getting in and payment approved was horrid. Doctor barely made the delivery...literally walked in, washed her hands and put on gloves, caught the baby, cut the cord and walked out. CA law at the time was only 24 hour stay. Since son was born at 7 PM, doctor came by at about 3:00 for rounds...I was running a fever, doctor said I really want you to stay, you had some tearing and infection is a concern..(yeah, I tore cuz you were not there for episotomy!! :sad: )...anyway of course we said, if that's what's best ....administrator came by about 4:30 and said you can't stay insurance will not cover it. I was out at 7 pm

    For the third we switched back to Kaiser. I had a car accident at 11 weeks and some you can imagine I was very worried...I was seen immediatly and instantly given an ultrasound. When I was still worried 3 days later, no hesitation...come back in, we will give you another ultrasound.
    After delivery CA law was back up to 2 days. After the first day, Dr came by and said we really like to take your lead are fine and can go home anytime you like, if you want to stay 2 days thats fine...if you feel need 3, just let me know. I stayed a day and a half...I was ready to go...but it was nice that it was my choice.

    The pediatrics are amazing, as I mentioned before I can call at 8:00 am and get the kids in usually by 10, always by noon or 1, everyday of the week!