I work for a small family business. They have Kaiser insurance in California. I was on my husband's Blue Cross insurance policy. He left his job to work at the same small family business that I work at. He did not want to be on Kaiser Insurance so he put us on COBRA through his old employer. The COBRA is exhausted and Blue Cross will not take us and he wants to go on HIPAA (State of CA insurance) instead of the small company's Kaiser insurance.

All along we have been paying part of the insurance premium that is in excess of Kaiser Insurance. Now the HIPAA will be even more.

I do like how with Blue Cross you can go to any doctor anytime and with Kaiser your hands are tied.

I am afraid of going on HIPPA because there is a pre-existing conditions clause for 12 months and the premiums and out of pocket are so high.

I am also afraid that if later down the road we decide to go with Kaiser they won't take us because we were on HIPPA. Then they will know that we were rejected by Blue Cross and they will reject us too.

My husband does not care how much it costs because he is so against Kaiser.

My question is this:

1) Am I stupid not to just go on Kaiser?

2) If I go on HIPPA will Kaiser reject us later on?

Thank you for your views.

Why is your husband so dead set against Kaiser? Did he have a bad experience with them before or is he being adviced against it by others who had bad experiences?

I personally have never had Kaiser but have heard some horror stories and also some pretty typical complaints that you see with any HMO. My Mom is with Blue Cross/Blue Shield of MI and my brother-in-law won't go near that plan even though my Mom has had nothing to complain about in 20+ years. Sometimes one bad story can sway someone to the extreme.

How often do you need to see a physician? If you are relatively healthy and young then an HMO won't be as scary but for someone like me who is a cancer patient, I thank God I'm not with ANY HMO.

I don't believe Kaiser can reject you just because you went with HIPPA. Check with the State to see if they can.

If you've been turned down by BC are you sure Kaiser will accept you? If your husband is so against Kaiser is it realistic that you would apply for them down the road that you need to worry about their rejecting you for going with HIPPA?

Could you take the Kaiser now see how you like it and if it's not working switch to HIPPA?

I know it's scary trying to imagine all the possible scenarios. If there are a lot of Kaiser doctors in you area that you think you might like then it might be worth it to try them out. On the other hand if you have to go out of your way to hunt down a handful of docs that you wouldn't want to see if they were around the corner, then you should probably avoid Kaiser.

My girlfriend has Kaiser here in SoCal and she doesn't like her limited choices but so far I haven't heard any real problems regarding her coverage and her husband had a pacemaker put in. So it's not like they never need to see anyone.

Good luck and let us know how it goes.

Sincerely,
Antoinette

Dear Antionettev3:

My husband has several medical problems and he just goes for yearly visits. He does take various medications every day. I had a cornea transplant three years ago and I take no prescriptions and only go for yearly female checkups. He is worried about the day that something bad happens.

Kaiser in California is not only your medical insurance company but they own the hospital and are the employers for the doctors too. They are all in one. So the Kaiser hospital has floors of medical clinics, labs, pharmacy, etc. Kaiser was known for always taking the least expensive way to try and fix you. They did not have the latest operations, prescription medicine, MRIs, etc. They were not on the cutting edge. In the past you would hear of your friends who were delivering their babies not being given epidurals or spinals. Your diabetic friends wanting an attached insulin pump and Kaiser not offering it.

My husband has heard good things about Kaiser, but the many bad things out weighed them. If we went on Kaiser first, we would not be eligible for the HIPPA.

The beauty about Kaiser is that we wouldn't have to pay anything except our co-pays. With Blue Cross we have to fork out almost $400 a month (after the employer pays $977, plus we have a deductible and pay 30% of every bill.

Blue Cross rejected my daughter (21 years) because she has an ulcer and is taking prevacid. They say that in 2 to 5 years if she is symptom free she can apply again. I guess you have to be totally healthy for the past 10 years since that is what they questioned about in order to become a member.

I wish my DH close friends and family had Kaiser so then maybe someone could convince him. It doesn't help that about 4 times last year you read in the paper about Kaiser accidentally killing a patient with the wrong medicine. Plus they did not clean their colonoscopy equipment correctly for months and had to have hundreds of patients come back and be tested for Hepatitis and HIV. This was not all the same Kaiser hospital since they are a chain. I guess accidents do happen everywhere.

I just hate being stuck like this. Thanks for listening.
Belle

I've had Kaiser in MD for 3+ years. If you told me 5 years ago that I'd love an HMO, I would have thought you were crazy. I really like them. I have a number of complex problems including thyroid, diabetes asthma, GERD and severe short term memory problems. Whenever I've had a problem they have referred me to appropriate specialists. They sent me to a neurologist and she didn't feel she had the expertise and she referred me to a dementia specialist and a neuropsycologist twice. They have sent me for a number of mri's. I like the concept of everything in one building. I know there are folks who hate them, but I've had nothing but positive experiences.

Hope this helps.

As an insurance agent I am familiar with Kaiser and know they are always, now, rated highly. I have friends who have been in the program for years and they are VERY satisfied. If you have pre-exisiting my suggestion would be to grab Kaiser and give it a chance. It is not like the HMOs of several years ago. Good luck.