Switched to BCBS from Kaiser— ugh!

[Anonymous]

Anonymous wrote:Some of you go to the doctors constantly and are not even chronically ill.

You really have no idea who here is or is not chronically ill; what this the purpose of this carping?

There is some standard screening recommended to people in their 40s-40s that PCPs don’t do. It could easily explain OP looking for a derm and GI, for instance.

[Anonymous]

Anonymous wrote:I'll be experiencing this soon...leaving kaiser for united healthcare. Sad.

We did this 2 years ago. Generally I like UHC better than Kaiser but my kids need OT and PT and UHC reimburses so little that no providers around DC will take them. So there is good and bad.

[Anonymous]

Kaiser is great when you don't have health issues or have something very complicated where they can't ignore it and they actually help you manage care.

For me and my child it was awful. Had to leave to get my child an autism diagnosis and get therapies paid for. Kaiser refused to evaluate my child. After switching to BCBS, we found a much better pediatrician.

I do miss my Kaiser PCP, but as great as she was, she still couldn't get me proper treatment for my chronic pain. Finding a PCP through BCBS has been a bit bumpy (the first one went concierge soon after I established care) but I am hopeful that I will find someone. And accessing urgent care is so, so much easier now. Kaiser only has one urgent care in my area and it is 30 minutes away. Urgent cares that take BCBS are everywhere.

[Anonymous]

Why would you use the BCBS website? Weird.

[Anonymous]

I have had BCBS my whole life and love the flexibility and being able to go to specialists without a referral. I live near Virginia Hospital Center so I decided to try and use only VHC-affiliated doctors. They have a patient portal that makes scheduling appointments super easy. I don't find it hard at all and love being able to research and choose my own doctors.

[Anonymous]

Anonymous wrote:Why would you use the BCBS website? Weird.

It’s great for BCBS for sure. It gives them leverage with physicians, allowing thenv cut reimbursement more.

Problem is that patients don’t use it.

[Anonymous]

You pick up the phone and call the doctor. You know what is great, if you need a specialist, you also pick up the phone and call. If you do not like that specialist, you get to find another. You are no longer stuck in a closed network with mediocre doctors who have limited referrals.

[Anonymous]

Anonymous wrote:You pick up the phone and call the doctor. You know what is great, if you need a specialist, you also pick up the phone and call. If you do not like that specialist, you get to find another. You are no longer stuck in a closed network with mediocre doctors who have limited referrals.

Personally I think many Kaiser primary care doctors are really good. The problem is the limited referrals. It's fine if you are perfectly healthy. Convenient even. But if you have some non life threatening health issue that impacts your quality of life or your kid's, good luck.

[Anonymous]

Anonymous wrote:I'm not in DMV, but yes, I call. I do not use BCBS to book appointments whatsoever. I find doctors on the web and use the BCBS website to confirm they are in network (although the BCBS reps say the website is useless and you should also call their hotline to confirm because what they see is different than what's on the website... that's a whole other rant).


This is exactly what I do.
Then I call and book the doctors. My doctors are all affiliated with the local hospital in my region so all use the same portal, but that has nothing to do with BCBS. They used the same portal when I had different insurance.

If I were you, the first thing I would do is check whether the doctors you already see take BCBS.