Kaiser Permanente for insurance?

[Anonymous]

We had Kaiser and were unhappy. While the premiums are relatively inexpensive, the biggest disadvantage is that you are stuck with Kaiser physicians. If you have a medical condition, you are not free to seek out the best specialist to treat you. If you or your kid are diagnosed with condition X and need treatments or surgery, do you want to be able to choose your provider from the best in the field known for treating condition X, or go to whoever works at Kaiser? We also tried to get mental health care and were stuck waiting for months for an appointment.

[Anonymous]

Anonymous wrote:We had Kaiser and were unhappy. While the premiums are relatively inexpensive, the biggest disadvantage is that you are stuck with Kaiser physicians. If you have a medical condition, you are not free to seek out the best specialist to treat you. If you or your kid are diagnosed with condition X and need treatments or surgery, do you want to be able to choose your provider from the best in the field known for treating condition X, or go to whoever works at Kaiser? We also tried to get mental health care and were stuck waiting for months for an appointment.

What makes you think you are capable of discerning the best in their field or getting them to see you?

[Anonymous]

Anonymous wrote:

Anonymous wrote:We had Kaiser and were unhappy. While the premiums are relatively inexpensive, the biggest disadvantage is that you are stuck with Kaiser physicians. If you have a medical condition, you are not free to seek out the best specialist to treat you. If you or your kid are diagnosed with condition X and need treatments or surgery, do you want to be able to choose your provider from the best in the field known for treating condition X, or go to whoever works at Kaiser? We also tried to get mental health care and were stuck waiting for months for an appointment.

What makes you think you are capable of discerning the best in their field or getting them to see you?

Asking for referrals for one. Some people doubt their ability to make decisions and prefer to have a big bureaucracy make choices for them. That's fine.

[Anonymous]

I think it's a relatively small chance that I would need a surgery that only a few surgeons are truly qualified to perform well (heart transplant or the like). If I had something like cancer where there are different protocols, I could pay for an expert to review my scans and lab results and talk with the Kaiser folks. If I were going to need experimental treatment I might either do a clinical trial or appeal if Kaiser denied...I don't think they are any more likely to deny than other insurers (my brother got proton radiation 15ish years ago and it was a huge fight with the non-Kaiser carrier).

For me, being able to get better and cheaper care for routine things is more important than having more (not unlimited, no carrier covers every single provider or treatment) options for very rare things, but ymmv.

[Anonymous]

My family had Kaiser for one year and we vowed to never again use them as insurance. I wasn't a fan of the Falls Church doctors that I saw or facility. I grew up in 'socialized medicine' aka DOD hospitals and doctors. It was too similar. It is worth it to my family to pay the extra insurance premium money and select our own doctors. We are very lucky to be healthy, but want to know we have the choice to see who we want for healthcare.

[Anonymous]

Anonymous wrote:I've heard Kaiser is fantastic where I live (Falls Church) but not very good in other areas. It seems very regionally dependent.

This is spot on. I used to live in Pg County and the centers there were terrible. Long dreadful waits in after hours and even longer waits at the pharmacy. When I moved to Montgomery County, I noticed a big change.

[Anonymous]

Anonymous wrote:When our DCs were out of town in college it got tricky with Kaiser. We were able to turn in bills for urgent care, one ER visit out of network. But decent medical care was hard to find in small college towns so we would not want to use a doctor or hospital there anyway. DC came home to Kaiser for more serious concerns.

I'm currently going through the exact same thing. My son is in school in Minnesota and having eye problems, and Kaiser has been useless with offering alternative care options. We are forced to wait until he comes home for spring break to be seen.

[Anonymous]

Anonymous wrote:We had Kaiser and were unhappy. While the premiums are relatively inexpensive, the biggest disadvantage is that you are stuck with Kaiser physicians. If you have a medical condition, you are not free to seek out the best specialist to treat you. If you or your kid are diagnosed with condition X and need treatments or surgery, do you want to be able to choose your provider from the best in the field known for treating condition X, or go to whoever works at Kaiser? We also tried to get mental health care and were stuck waiting for months for an appointment.

When my kid has severe facial injuries requiring facial reconstruction I wanted the top pediatric plastic surgeon specializing in facial reconstruction. You know what I did? Got his Kaiser pediatrician to refer him to that doctor at Children’s. He did the surgery, my kid did great, I was happy, but actually missed being fully in the Kaiser network for the experience. Surgery with Kaiser is a very well oiled machine. They know what they are doing and they do it very well.

It frustrates me when people trot out the whole, “it’s fine if you are young and healthy”. You know what Kaiser is excellent for chronic conditions, surgery and challenging illnesses too. In our family we’ve dealt with surgery for broken bones, the facial surgery, a knee replacement, a heart condition, arthritis, hypertension, pneumonia and more. The care is seamless and the fact that you don’t have to seek out providers for every little thing, check insurance status and coordinate your own care, is amazing and should be standard everywhere. For my kids, the pediatrician has picked up on issues and immediately sent them to a different floor to a specialist, minutes later. I hope e we get to stay with Kaiser forever.

[Anonymous]

I’ll add that I have friends who were treated for breast cancer at Kaiser and another who has a kidney transplant. Both extremely happy.

[Anonymous]

I have friends also who have gone through cancer with Kaiser. They are doing well. Another friend is bipolar and doing well with therapy and drugs. These people are years out from their diagnoses.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:We had Kaiser and were unhappy. While the premiums are relatively inexpensive, the biggest disadvantage is that you are stuck with Kaiser physicians. If you have a medical condition, you are not free to seek out the best specialist to treat you. If you or your kid are diagnosed with condition X and need treatments or surgery, do you want to be able to choose your provider from the best in the field known for treating condition X, or go to whoever works at Kaiser? We also tried to get mental health care and were stuck waiting for months for an appointment.

What makes you think you are capable of discerning the best in their field or getting them to see you?

Asking for referrals for one. Some people doubt their ability to make decisions and prefer to have a big bureaucracy make choices for them. That's fine.

Funny, studies that look at it have concluded that patients are terrible at discerning good doctors form mediocre and usually judge based on bedside manner.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I've heard Kaiser is fantastic where I live (Falls Church) but not very good in other areas. It seems very regionally dependent.

This is spot on. I used to live in Pg County and the centers there were terrible. Long dreadful waits in after hours and even longer waits at the pharmacy. When I moved to Montgomery County, I noticed a big change.

We live in PG County and have been very pleased with our pediatrician at the Kaiser building next to PG plaza. We drive to the Kaiser building by Union Station for all our other doctors. Also, I've had a good experience with urgent care, radiology and other testing, and out-patient surgery at their Largo center, and in-patient surgery with a Kaiser doctor at Suburban Hospital in Mont. County.

The number weakness with Kaiser is mental health. They are notorious for a long wait times for appointments. They get so much bad press for it that I don't understand why they don't bite the bullet and hire more staff.

[Anonymous]

*number one weakness is mental health

[Anonymous]

Kaiser has been fantastic for my family in moderate health, we even gave birth through the system. We like having a single reference point and it is so much less stressful for coordination (we had carefirst before). Can't recommend them enough. I can only see choosing a concierge service over them.

[Anonymous]

Anonymous wrote:

Anonymous wrote:When our DCs were out of town in college it got tricky with Kaiser. We were able to turn in bills for urgent care, one ER visit out of network. But decent medical care was hard to find in small college towns so we would not want to use a doctor or hospital there anyway. DC came home to Kaiser for more serious concerns.

I'm currently going through the exact same thing. My son is in school in Minnesota and having eye problems, and Kaiser has been useless with offering alternative care options. We are forced to wait until he comes home for spring break to be seen.

My mom has Kaiser in CA, and was able to see a Kaiser doc in VA when visiting me here - just a phone call to the advice nurse and she had an appointment, even though Kaiser CA and Kaiser Mid-Atlantic are different entities.

But I think it is unreasonable to expect Kaiser to cover non-emergency care in an area where they don't do business at all.