Kaiser Permanente A Good choice?

[savory]

Hi, I moved to an area that offers Kaiser Permanente (KP) HMO for my medicare medical plan. I have heard KP provides great care. I have never used an HMO but understand there can be some advantages and issues.

There is a KP facility in my town small town, so it is fairly convenient. And, I am about a 45 minute drive to larger towns with services, if I need another specialist. If that is how it works.

My wife and I are in good health but have had operations for specific problems.

Your experience, good/bad is appreciated.

 

[Another Reader]

I would not touch Kaiser. In the Bay Area, they used to be considered just slightly above the County hospital. Others here have had good experiences, but leopards don't change their spots in my view.

i do know someone that has an Advantage plan with them after transitioning from an employer plan and is happy. She has a rare autoimmune disease and thinks she is receiving quality treatment. However, she researches everything and is a strong advocate for her health. The average person might not get the same level of attention.

 

[Fedup]

Kaiser used to be known as bad but they did change and I think they are much better now. My daughter has Kaiser for a few years and she’s pretty happy with them. My ex-neighbor had his private office and he left and joined Kaiser two years ago.

 

[Scrapr]

Our family has been with Kaiser for about 25 years. It can be frustrating at times. But for us overall i can't imagine any other way. Looking for a PCP that is "in network" and a lab, and a surgeon. When you decide kaiser it just is all included. I really like the online portal. Docs are great at messaging back.

The bad? You kinda have to be an advocate for yourself. You and your Doc working together. I have had a few Docs that didn't want that plan. But it's easy to change. If you are a long way away from a Hospital/Medical Center you may be driving there for appointments. The specialists are likely in the bigger buildings.

I really like the integrated care

 

[davebarnes]

We think KP is very good to excellent here in Denver.
If you want to “pick your doc”, you will be very unhappy.
If you think all docs are alike, as I do, you will be happy.
I had colon cancer treatment under KP Medicare Advantage and would rate them 9/10.

P.S. If I had a knife or gunshot wound, I would prefer the county hospital.

 

[haha]

Hi, I moved to an area that offers Kaiser Permanente (KP) HMO for my medicare medical plan. I have heard KP provides great care. I have never used an HMO but understand there can be some advantages and issues.

There is a KP facility in my town small town, so it is fairly convenient. And, I am about a 45 minute drive to larger towns with services, if I need another specialist. If that is how it works.

My wife and I are in good health but have had operations for specific problems.

Your experience, good/bad is appreciated.

My girlfriend has Kaiser in Seattle. She likes it, but really she is an army brat and a vet and she is used to that sort of organization. She might not do well in the typical US medical system.

My cousin in LA had Kaiser as an LA County Employee. He was lucky, he got a very strange brain tumor and had a series of operations over a year and charges of more than $1 million, but all free to him at Kaiser. And he has been completely well ever since. He used the main hospital on Sunset near Vermont Avenue. I have heard that this is better than some of their more peripheral hospitals.

Ha

 

[haha]

We think KP is very good to excellent here in Denver.
If you want to “pick your doc”, you will be very unhappy.
If you think all docs are alike, as I do, you will be happy.
I had colon cancer treatment under KP Medicare Advantage and would rate them 9/10.

P.S. If I had a knife or gunshot wound, I would prefer the county hospital.

Almost always the case. Here in Seattle it is Harbor View Hospital, in LA the LA County-USC Hospital that shows up in so many movies.

Ha

 

[calmloki]

We go from Oregon down to SoCal in the winter, then come back in summer. KP is in both places but the bookkeeping is not the same and while SoCal docs can see other KP charting the billing gets all mixed up. I keeled over - Vfib - and was resuscitated and wired up with a pacemaker down south. Later had cardio ablation down south. Still ticking, and the billing is all straight. Much of that is due to a steady CPR administering honey who shepherd's my care, but I've been pleased with the level of KP care administered and am not on the hook for $150k+ hospital bills. Count me a fan.

 

[savory]

Sorry, I also meant to ask about experiences when traveling especially out of the country. Has anyone had any experiences of needing medical support outside of the country while insured by KP?

 

[rodi]

I grew up with Kaiser - had various other plans, through employers, in other areas, through the years and chose Kaiser again when I moved back to San Diego.

My husband is less than a fan - and switched to another system about 4 years ago... He had the same issues with Sharp HMO that he had with Kaiser... and has now conceded the care is about the same. I've got a good primary - and that makes a difference. My kids ped was great - but they are transitioning out of pediatrics - so we'll have to try a new primary for them. (My doctor's practice was full.)

Kaiser was great for diagnosing, and the surgery of my son's ameloblastoma. My other son plays sports rather recklessly - and we've been pleased with the orthopedic department for various broken bones from baseball, basketball, etc.

As others have mentioned, you need to advocate for yourself.... but that is true with EVERY insurance/medical system.

 

[clifp]

I had Kaiser for a couple of years in Nor Cal, and for 18 in Hawaii. I've been happy with them, and in Hawaii, they are cheaper than the Blue Cross equivalent. I've not had any serious health issue, so I appreciate the simplicity. I've gone through 4 or so Primary Care so that's been a pain.

I've had three friends with Kaiser in NorCal with cancer, 2 are alive and one isn't. The husband of one who passed away was happy with the treatment, but understandably upset that they didn't catch her breast cancer when it came out of remission faster.

How reasonable this is, I don't know.

 

[Just_Steve]

I used an HMO one year back in the early 90's. Left a bad taste in my mouth. Never again.

 

[Fedup]

The early 90s is when it was really terrible. I avoided them then. Honestly I wouldn’t have changed my mind until my daughter used it. She said where she goes, the building is so big, it’s like a spaceship.

 

[stepford]

I have an unusual perspective here as I am on BCBS while DW is in Kaiser (all her life).

I often see her frustration with the automated robocall system of making appointments, the delays and the difficulties in getting to see a specialist.

In contrast, I make appointments with whatever doctor I want with no "gatekeeper". I'll end up paying 20% up to my deductible, but the convenience and access are night and day compared to DW's experience at Kaiser.

All that said there's a kind of all-encompassing care that Kaiser provides that is absent from my plan. I am obliged to be rather "hands on" about my own healthcare. Doctors will advise me, but deciding what to do and when is all on me. DW on the other had doesn't really need to think about it. All appointments, procedures, whatever, just magically get scheduled for her. Maybe not quickly, maybe not the doctor she wants, but ultimately not much falls between the cracks. I have to be much more vigilant on my plan to ensure this is so.

So I think which works better for you depends a bit on your personality type and how much of a role you wish to take in your own care.

Finally, in fairness I should add that, while at the Primary Provider level we have found the doctors available through Kaiser to be of variable quality, once you get through the various hoops and require actual hospital care the quality of the specialists and surgeons has been excellent - every bit as good as the highly ranked university hospital I go to through BCBS.

 

[Bamaman]

We were on Kaiser Permanente in two different cities, and later switched back to conventional health insurance. They were great for sniffles and minor day to day medical issues. But in retrospect Kaiser was really hesitant to refer us to the best specialists.

My wife was 39 when our last child was born. And she had serious issues that Kaiser's OB/GYN physicians didn't get to the bottom of the problem. She suffered for years. Upon switching to a conventional health insurance, my wife was referred to a first class doctor who diagnosed the problem and took care of the problem in a simple 1/2 hour outpatient procedure. Problem solved.

Today is not the 90's in healthcare. But if anything, companies like Kaiser are rationing healthcare more now than then. They may be okay for minor issues, but retirees often have more serious issues. I wouldn't consider going with a HMO type program for my healthcare, and that includes Medicare Advantage plans that are somewhat like a HMO. My preferred hospital chain (1700 physicians) (if I get seriously ill) opted out of Medicare Advantage.

 

[pjm-7]

Currently using Kaiser for my ACA coverage in Colorado. Reasonably satisfied with them. Issues have come up between them and Connect for Health Colorado (ACA marketplace) but it is getting better with time. When I was working I would never touch an HMO. Kaiser does seem receptive to questions or concerns about coverage.

 

[mountainsoft]

We have had Kaiser for at least the last 30 years and overall we have been happy with them. It's easy to make appointments, contact doctors, and get test results online. We have a few different offices we can go to within 10-20 minutes from home for most things. For any major surgery we have to drive about 45 minutes to the main Kaiser hospital, but that's not something we do often enough to matter. For emergencies we can go to the local major hospital, which is still 30 minutes away. No complaints.

 

[Fedup]

It depends on the location too. My daughter lives very close to UCLA area. Guess where all the young doctors are going to work once they graduate from UCLA.
She has better care under Kaiser than the Fed BCBS.
She didn’t know who to go to, etc.. under Kaiser she just show up. Granted she doesn’t have any major health problem. Mostly minor ones. I think that would be a real test.
But as I often mentioned to her, if she doesn’t like Kaiser than she won’t like those free healthcare system everybody wants the system to till toward. So at least test it out and see.

 

[ocean view]

I’m finding the varying responses interesting. It sounds like it may differ significantly by region.

That said, here’s my experience in the SF Bay Area. We switched from Sutter Health (a large N. CA PPO) to Kaiser when we retired and had to buy coverage through ACA. We have been thrilled with it and I had my doubts as I’d heard the Kaiser horror stories from co-workers in the past. We had some health issues this year and used them a lot.

Here’s what I like:
-I got to select all of my primary care doctors
-Coordinated care among depts
-Ease in getting in to see MY doctors (same day if needed), video & phone appointments too
-convenience of one stop shop; the most frequently used depts are all available in one building, even at the smaller satellite office.
-ability to email my docs with a question (Old PPO didn’t offer this) or just call the advice nurse 24/7
-reminder system for upcoming tests (it’s been 5 yrs, time to get scoped type things)
-access to online records and health research
-you know your provider is in network (no surprises)
-I have a HDHP so sometimes the check-in clerk doesn’t know the right co-pay to collect, but they always refund or reapply any over payment in a timely manner.
-we saw specialists in 4-5 different depts this year. All were excellent, except one who had no bedside manner. I asked to switch from the bad doc and it was no problem.
-the specialization of the supporting medical staff, for example if you need a shot it is administered by the injection clinic staff not the regular nursing staff. No post-shot pain.

What don’t I like:
-as others have said, you do have to advocate for yourself

Good luck!

 

[Scuba]

My problem with Kaiser or any HMO is lack of choice. If DH or I were to be diagnosed with a serious illness, we want the freedom to go to City of Hope, Loma Linda, Cedars Sinai, MD Anderson, or wherever we think we will get the most advanced care with the latest and greatest drugs available. If you are with an HMO, no matter how great the docs are, they are limited to the choices/formulary the HMO has approved. At the end of the day, any “managed care” organization is about managing costs.

Glad those of you with Kaiser are happy, but as long as we can afford it, we will pay our outrageous premium and deductibles to preserve our right to the best possible care available from any source. I am happy to coordinate my care across various docs of my choosing.

 

[bmcgonig]

I'm of the opinion that I don't want to be limited by Kaiser. I want access to whomever I want. That said Kaiser is not the same as was in the 1990s. Back then noone wanted to work for them. Now I'm told by some friends who are docs in the Bay Area that everyone does and it's not easy to get a job there since there are many applicants. Totally different.

Again if you have a weird issue that they can't figure out you want to have the ability to go somewhere else. If you're with ACA you can just switch the next year I guess. But not sure if that's easy or possible with Medicare.

 

[savory]

Thanks for your response. We are still deciding and your input is helpful.