Planning to apply for Health Insurance

I was with Kaiser for a few years, and I agree with CFB.  They are good about doing basic stuff efficiently... You get appointments fairly quick and there's hardly any paperwork.   

But if you need to see a specialist it becomes really difficult.  I'm used to PPO insurance where I can just make an appointment with a specialist myself, but with Kaiser it always required a visit to the primary care doctor before he would refer you to a specialist.  Then they try to funnel you back to the primary care doctor for followup.  So you almost have to plan on spending twice as much time going to the doctors, because you have to see your primary care doctor almost every time you need a specialist.  Sometimes you can get to the specialist right away but other times you need to see your primary doctor a few times before they will give you to a specialist.  And you have to be loud about demanding the specialist.  I never had to deal with any particularly time-sensitive conditions while I was with Kaiser, but I've heard horror stories (kidneys anyone).

The quality of their primary care doctors is poor.   Turnover is high; I went through three I believe while I was there.   Two were truly bad, flat out rude and uncaring.  After every appointment you get a survey in the mail and at least it's satisfying to know there's a computer somewhere tabulating my poor experiences. 

On the plus side they do offer good value, and the specialists I saw were good.  They have great scheduling automation so you don't wait very long after your appointment to see the doctor. 

The downside to all the automation is that there's nobody to tell you what's going on.  For instance I had a regular prescription filled at the kaiser pharmacy (you can't go anywhere else), and the amount I would pay for the prescription varied almost each time.   Nobody could tell me why the price was different each time, just "that's what the computer tells us your price is".  At walgreens or other independent pharmacies they will tell me things like "If you refill before such and such a date you will have to pay more because you need to wait X days, starting on Y date".   At kaiser they somehow couldn't tell me that kind of stuff, just "your price is Z this time because that's what the price is".
 
FYI

The FACT act (FCRA, part II) includes a free health care record. You can get it at

http://www.mib.com/

I don't have one and I've had individual policies for years.
 
I think the state you live in is the biggest factor.

As stated  previously skies the limit with Hippa rates so even though they have to insure you is it really realistic at $2000 a month to go Hippa.

State risk pools seem cheaper and usually will accept you if are rejected by one company or the outside policy you are offered costs more than the state risk pool rate. Or if you have one of the selected illnesses on their list.
New Mexico is real cheap maybe $400 or $500 for one person and if your income is low maybe 200% of poverty level premiums can be less than $200.
Most members here have higher incomes but if you have tax free invesments you may qualify since your taxable income is low.
Colorodo is also cheap for a risk pool.

Then there are the guarantee issue states. NY will take everyone and you can get an HMO such as HIP for maybe $400 plus. Low income reduces premiums. New Jersey and Mass also have to take you but premiums may be higher. And HMO's some people do not like.

Any opinions on HMO's as opposed to Blue Cross PPO's.?
 
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