PDA

View Full Version : Kaisar or Blue Shield PPO?



ssingh
11-17-2010, 01:14 PM
This is time of the year for enrollment period. Anyone with experience with Kaisar Permanente(Claifornia only I think)? I been with Blue shield PPO for last 12 years. It has gotten so expensive, premiums are more then double, I am thinking about going to Kaisar.. any suggestions?

Nonna
11-17-2010, 10:34 PM
You are used to a PPO, KAiser is more like an Hmo. They have their own doctors so you'dhave to switch docs. This is why i've stayed with plans that let you choose your own docs. Hope this helps

Saysusie
11-18-2010, 12:40 PM
I have been with Kaiser since 1974. I have heard some major complaints about the HMO, but my experience has been that, if you know how to use Kaiser correctly, you can get excellent care. First, you have to ask for each specialist and, if you do not like the one you get at first, you simply ask member services to give you a new one (They will ask you what you want and try to find a doctor that matches your requirements). Once you have been assigned a doctor in each department that you need, you can develop a personal relationship with them (i.e..here is an example list: a gynocologist, ob/gyn, rheumatologist, internal medicine doctor, endocrinologist, eyes/ears/throat, dermatologist, pediatrician).
Many people fail to get themselves assigned to doctors in each department and, instead, use family medicine as their health care. Doing so means hours of waiting, busy harassed doctors who dismiss you, missed diagnosis, and poor health care. Getting your team of doctors together works well at kaiser because your records are on the computer and each doctor can see everything done by the other doctor and they confer as a team.
I have to say that the team of doctors that worked for my daughter saved her life more than once because they all worked in conjunction with each other. For that matter, my team of doctors have saved my life twice. All of your doctors will always be in the same facility (unless they are specific professionals, then they find one that is close to your home facility!).
The other thing I like about Kaiser is the fact that you can e-mail your doctor with questions, issues, etc. and they MUST respond within 24hours (Failure to do so means they are reported to Member Services and quick action is always taken!). Also, you have access to your medical record, test results, etc. on line (test results are often posted the very same day!) and your doctor must contact you (usually by e-mail or phone call) within 24 hours of receiving your test results.
Kaiser is an HMO wherein YOU must take charge of your health care. If you do this, Kaiser works very well. There are several plans that are available, because my daughter and I both had Lupus which meant many hospitalizations, my husband chose to pay a high monthly premium. As such, we pay NOTHING extra for our hospital stays (regardless of length), NOTHING for any surgeries (of which I've had many) and only $10.00 for prescriptions.
As I said, YOU must make Kaiser work for you, you cannot let Kaiser determine how your health will be managed!
I hope that this is helpful..I'm sorry that I have no information about Blue Cross :-(

Peace and Blessings
Namaste
Saysusie

magistramarla
11-19-2010, 09:34 PM
I'm using Blue Cross/Blue Shield PPO in California. I haven't had great luck with the docs in the Monterey Bay area. The nice thing about it is that I can self-refer to better docs in San Francisco.
Thanks to my hubby working for the Air Force, I have the same sort of insurance that those awful congressmen and other government workers have. Our rates aren't too bad, since Federal workers are such a large group, and no company can refuse me because of my "pre-existing condition". That's why I so wish that they would pass a healthcare system that would give everyone this advantage.
Hugs,
Marla

Nonna
11-19-2010, 11:57 PM
Saysusie is right about Kaiser, I was young and insurance ignorant when I had kaiser. If you get the right docs it is an excellent system. We paid $ 5 when my daughter was born and that was for the TV.

Han
11-20-2010, 12:55 AM
We paid $ 5 when my daughter was born and that was for the TV.

LOL Nonna!