Switching to Kaiser insurance, need feedback

[Anonymous]

I miss my Kaiser! Mostly great doctors. So convenient to walk from floor to floor— see doc, swing by lab, stop by pharmacy on the way out. I was always able to see non-Kaiser specialist.
The only thing I didn’t like was you can only go to their urgent care centers (unless an emergency). Which sucks when hurt or sick.

[Anonymous]

I've been with Kaiser my whole life, except for about 5 years in my 20s when I went with Blue Cross. I am a big fan and have received excellent care including emergency room visits, surgery, specialists, etc. The doctors respond to online messages, I can schedule everything online and order Rx online. They are progressive on women's and children's care (well visits, BC, etc) and preventative care like smoking cessation and flu shots.

The two things Kaiser is *not* good for are mental health care, and sleuthing unusual diagnoses. If you have a diagnosis they will get you excellent care, but they don't like to do Dr House tests for rare conditions.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Kaiser is good if you are a squeaky wheel and relentless. It might take months to see a specialist but if you are willing to call everyday and ask if there are cancellations then you get in sooner. If the doctor realizes you are well educated and outspoken you get better treatment. If you go along without questioning you will have really long wait times to see doctors and then with the doctor the visit might be rushed. They need patients to be in and out quickly for their model to work.

This hasn't been our experience at all. We've been referred to specialists very quickly, often getting in on the same day as the referral. For instance, my husband was having issues with his elbow. Went to his dr and got referred to an orthopedist. He saw the orthopedist 45 minutes later, got an x ray, and had a follow up with the orthopedist immediately. He walked out three hours later with a full treatment plan.

We have never had a rushed visit with Kaiser. At my 3 yo's well visit she was scared and didn't want to cooperate, so the ped took the time to read my daughter a book so she would be comfortable. No rush. Lots of time to get to know the doctor and for the doctor to get to know our kids. Really wonderful.

That's my experience as well. They try to get you in with a specialist within 24-49 hours when possible and my doctor has made the appointment for me. While I dislike having to drive 20-30 minutes to get to a center I really appreciate having the doctor, lab and pharmacy in one building. I recently had to switch and miss Kaiser

[Anonymous]

I've had Kaiser for 3 years and liked it a lot more than i expected. I think it matters that we're a young family with a lot of preventative and maintenance health care needs (kid checkups, prenatal, etc), but not a lot of actual sickness requiring specialists. For our needs we've found it affordable, convenient, and centralized in a way that's quite helpful (except the urgent cares open on weekends and holidays all seem to be a 30-45 minute drive from us in Alexandria). Since it is a somewhat restricted network I can imagine the experience being very different if you needed very specialized care though.

[Anonymous]

Anonymous wrote:Kaiser is good if you are a squeaky wheel and relentless. It might take months to see a specialist but if you are willing to call everyday and ask if there are cancellations then you get in sooner. If the doctor realizes you are well educated and outspoken you get better treatment. If you go along without questioning you will have really long wait times to see doctors and then with the doctor the visit might be rushed. They need patients to be in and out quickly for their model to work.

This happens with my insurance as well, so I wouldn't take this as an argument against Kaiser. I have heard great things about Kaiser and wish it were an option for our company. We have Aetna, which gives me freedom but causes lots of stress.

[Anonymous]

Anonymous wrote:We are thinking of switching from Cigna to Kaiser. This is offered through my job.
Any feedback from people with Kaiser insurance? would you recommend?
We live in DC but closer to silver spring? can we go to any Kaiser location?
How does it work in case of emergency? can u go to any hospital?

I have worked in different healthcare areas for years, from private practice to hospitals. I have never personally had Kaiser, but unless you live in an area with lots of Kaiser providers it can be a pain. If you need to see someone outside the Kaiser network it can be a pain. I had a patient that could only get one visit authorized on a referral. Every appointment needed a referral, even though the patient was a regular patient on infusion therapy. They wanted records every single time a referral was requested. It is too many hoops to jump through. California is a good example where Kaiser is probably very beneficial. This area has Kaiser but its not the biggest provider and I would hate to be stuck in a referral nightmare because I had to be outsourced for care because Kaiser couldn't provide it at one of their locations.

[Anonymous]

Been with Kaiser for the last 5 years. I usually go to the Largo Center or the Old Branch Ave location. Used to go to Springfield when I lived in VA.

I like the convenience of having everything in one place and find them to be rather efficient. However, I have rather basic health needs. GP, pediatrician, ob/gyn.. The most unusual item i've dealt with is having an ultrasound to check for fibroids. It was easy to get an appointment for everything.

I also appreciate that I can go online and renew my prescriptions and they are mailed to me.

[Anonymous]

I have Kaiser and have some complex medical needs. You need a referral from primary care to see a specialist but you only need that referral once. Wait times for specialists are super short like 3 days especially if there is an urgent need. One of my kids needed physical therapy but kaiser did not have pediatric physical therapist. Took a week to get an outside referral approved. The referral was for one year of 2 appointments a month Do not need referral for gyno or mammograms. Many centers open 34 hours a day. My only beef with them is that they have few pediatric specialists and that they are very spread out. For example to see a urologist, we had to go to Capitol Hill with our 3 year old, we live in Rockville, so it turned into an all day affair.

[Anonymous]

i am PP centers open 24 hours a day not 34 hrs.Going to get a cup of coffee now

[Anonymous]

Anonymous wrote:Doctors are salaried rather than being paid by the procedure/patient (so no incentive structure to overbill/overmedicate).

Payor is the same as the provider, so the incentive is the other way, to go with the cheapest treatment option.

[Anonymous]

Anonymous wrote:i am PP centers open 24 hours a day not 34 hrs.Going to get a cup of coffee now

I wish i can have 34 hours a day...

[Anonymous]

I've had Kaiser for a long time and really like it, I think it's one of the better models for health care that we have in this country. Just an anecdote on the opposite side of the person whose relatives died - I nearly died several years ago, and thanks to Kaiser, I survived, am doing fine, and paid almost nothing out of pocket for my ICU stay/surgery/follow-up care (I did have co-pays when seeing doctors and physical therapists, and I think co-pays for a few CAT/MRI scans).

[Anonymous]

I had Kaiser for only 1 year (thankfully) as that was the insurance provided through my graduate school. After that 1 year, the school switched to BCBS. I did not live in an area with Kaiser hospitals, but all of my doctors were covered. The problems that arose were all billing-related and really crazy. They insisted that an annual physical was not covered by my insurance and kept charging me an astronomical amount for the visit. I refused to pay, contested, spoke to dozens of people at Kaiser over the course of several months, and eventually they relented. I heard the same story from multiple other students.

[Anonymous]

Anonymous wrote:Kaiser is good if you are a squeaky wheel and relentless. It might take months to see a specialist but if you are willing to call everyday and ask if there are cancellations then you get in sooner. If the doctor realizes you are well educated and outspoken you get better treatment. If you go along without questioning you will have really long wait times to see doctors and then with the doctor the visit might be rushed. They need patients to be in and out quickly for their model to work.

+1

[Anonymous]

Kaiser is fine if you are in generally good health, and super convenient if you live close to one of their centers. My DH had a lot of trouble getting referrals to a specialist though and we switched to BCBS after a year.