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I have Aetna POS, and have to change to one of the following.
Kaiser Permanente HMO - CO
United Health Care (Pay now)
United Health Care (Pay later)
I liked the Aetna plan I was on because it allowed for specialist without Referral.
Can any of the medical professionals, or patients that have dealt with these three tell me amongst the three which one they found more beneficial on the patient / consumer side of things.
I use to hate Kaiser for a few reasons. But their model I think is spot on. I had them for a year and the ease of going to the doctor was fantastic. See the doc, go get the x-ray, go to the lab, go get you meds, all in the same building. Ease of use and simplicity are huge in my book. Their care and standards were no different than any other doc I have been to in the past 4 years.
If I could I would go back to Kaiser. I am on my wife's UC Health plan and it sucks donkey dick. I spent 2 hours trying to to even find a place to get an x-ray.
No matter what make sure you get what you want out of your doc. In general I hate doctors, been around them too much in life and have a general low opinion of them. Don't let them throw meds at you and kick you out the door. Make them think and actually treat you, that is why they went to med school.
UHC administers lots of different plans. Employer plans, marketplace plans, etc.
My wife's employer's group is self insured (Centura) and UHC does a good job administering the plan IMHO. My opinion would be limited to that aspect as we enjoy tremendous coverage as long as we stay in (Centura) network. For us, in network doesn't necessary mean in UHC's network, but more often in Centura's network of hospitals and providers. My PCP is not directly affiliated with Centura but is in UHC's provider network so I can see him, but the office visits cost a little more. Not a concern for us because she gets employer paid contributions to an HRA we can use to pay non covered deductibles and copays. In the event we would have to go out of network for some rare specialty, there is still very good coverage and generally low out of pocket costs.
If it's an employer paid plan, that coverage is really going to be based upon what the employer is offering. If it's a marketplace plan, I've offered no help.
We've had UHC for years through my work . . . overall have been very happy with it. Our plan is self-referring and I've never had any hassles with anything. And I've had a few surgeries on it--all very smooth from having very good doctors and facilities to pretty painless on the paperwork and red tape. Obviously depends on what kind of plan and what the options are. But my family and I have had a very good experience with UHC.
I had Kaiser through a different job right out of college and I did NOT like that at all. I had two pretty bad experiences with them. One was a pretty minor wrist fracture where on my follow-up from the cast removal the specialist told me I should give up lifting weights due to the injury and that it would never be the same again. Idiot. And the other was a lump in my forearm that was misdiagnosed as just a "fat lump" and nothing to worry about. Several years later when it had grown and I wanted to have it removed (when I was under UHC) it turned out to be a nerve sheath tumor--benign, fortunately, but it definitely required removal and that could have been pretty bad.
So you couldn't pay me enough to go back to Kaiser if I had other options. But that's just me. I have friends with Kaiser who really like it.
Similar (but worse) experience here, but like all places, Kaiser is made up of people. I put the fault on the people, and not really Kaiser's business model.Quote:
Originally Posted by Ramsker
At least you got a choice, up north we automatically got switched to the not as good UHC, but hey at least the premiums didnt go up.
My wife is a union employee with Kaiser, so we have a pretty sweet deal. But you have to be your own advocate and stand up to the pill pushers, if they can write a prescription and get you out the door they will. If you want more in-depth care you have to insist on it. But I think they're all like that these days.
But I had gastric bypass surgery through Kaiser and I couldn't have asked for any better experience!
We were on Kaiser for 23 years while I was with the State. All in all we were quite happy with it, had a few experiences with knucklehead PA's but nothing major.
Only after they started accepting Medicaid / Medicare did we see a decline and that was mainly appointment times and the pharmacy was always packed.
I have UHC for my Medicare plan and have been very happy with it. Supplies a lot more than the straight Fedicare would.
I've had Kaiser most of my life and had UHC for a few years in there. I like how everything is all together for Kaiser. We had our second son this year and the whole thing cost me $250 total. Good coverage and really good care. I liked the flexibility of going about anywhere with UHC but with the kids Kaiser has been excellent.
its really apples to oranges. it all depends on your medical history, how you like to use money, dependents, etc.
kaiser is having some pretty major financial problems right now and have been doing large hiring freezes. so its possible they may be even more understaffed than normal. a prescription can sometimes have a VERY long wait time, like 4-5 hours. we have people come to our pharmacy and pay out of pocket that are kaiser members because they don't want to wait and sometimes our cash prices are lower than kaisers covered prices. thats not ALWAYS the case though. my wife had kaiser for our first kid. we didn't have to pay a lot of out pocket, but she was a teacher and had a pretty good individual deal, had she needed to cover me as well it would have been super expensive.
i have UHC. i like it because it is a high deductible, HSA plan. in my opinion unless you KNOW you are going to have some fairly expensive medical costs, this is by far the best way to go. my company pays 1000 in each year, it always carries over, i can stop paying into the hsa when i want, its tax free and can be used as a 401k once you retire. it always goes with you if you leave a company. my deductible is 4500 for my family, so not chump change but even if i didn't have the hsa it wouldn't bankrupt me. right now i have 9000 in my hsa as i pay in the max per month so i am fully covered for at least two years. if i wanted i could stop paying in and my total health care up front cost for the year for a family of 3 would be about 1100. the nice thing with the high deductible hsa plans is your premiums are generally quite low so you really only pay for what you need. however, if you have a major accident before you had time to put into your hsa it can be tough.
kaiser isn't all bad, but it can be slow, and they don't let you go anywhere. when my wife was pregnant we had two hospitals as options and neither was closer than 30 minutes. with UHC we have been able to basically go anywhere. i feel the uhc high deductible hsa plan is the best for a young, healthy family with low medical costs. you are covered for catastrophes and the hsa lets you have some tax deductions and another form of savings. but if you are going to constantly run through your hsa account or have a really high out of pocket max, kaiser might be a better option.
Same here. I had a deviated septum and had surgery last year on it. Zero complaints. Was very easy and no issues. I actually really like my doctor too. They go out of their way to check EVERYTHING if something is wrong. Maybe that's because my wife works there? I dunno. But their "one stop shop" model is great for men. Lol. Simplicity is beautiful.Quote:
Originally Posted by rondog
Thanks for the info, guys! My company is switching from Cigna to UHC next year.
We switched from UHC to Cigna last year. When we swapped to Cigna we opted for the HSA. We also had UHC at my old job for several years. Never had a problem with either. This year our Cigna premiums went up, but not by much.
My mom and dad are with kaiser and they are always happy and impressed with their service and care. My father is a retired medical malpractice lawyer, so he's pretty damn picky.
I have had Kaiser Health Insurance for many years now. I don't have any major complains about the healthcare service they offer. With any HMO you need to be comfortable with being treated like a "Number" and be ok with getting service from whatever resource is available at the time. Sure, I have a primary care doctor that I would prefer to work with all the time. But the way I see it, my health record is clearly documented in my chart and anyone within Kaiser providing me service can reference the same chart. So I really don't care if Doctor X or Y ends up fixing me. In the end YOU the patient need to take ownership in understanding your healthcare needs and objectively assessing any treatments offed. The more educated you are about YOUR healthcare situation the better treatment you will get because you can call bullshit when needed.
I've had United for many years now... no complaints. I know one thing, the wife is not bitching all night long trying to figure out the entire screwed up billing of some service we had somewhere. Previous insurance providers have always jacked up the billing I believe on purpose to get extra $'s. United has paid for my services properly. Unknown from me if Kaiser billing is accurate or not?
Kaiser, people love em, people hate em. I believe in the medical professionals, I know some of them, they do good work. It's the system that some dislike. One location, One stop shopping. Great, but if it takes me 8 hours of vacation time away from work in one sitting, that doesn't help me much. United, I go see who I think is best, spend a hour or two away, plan for the next visit or specialist if required. If I also look at it this way, not all of the Kaiser locations can actually handle everything at that time. Not all of them have an MRI available or a specialist. They will have to refer you out to another location or Doctor anyways. (Kaiser or other)
A family member works for Kaiser on the business side of things. The place has issues, but I'd also assume United or any other provider does too, we just don't see it unless you're involved with it.
Just have to make the best guess on what care you need for the cost $. If it doesn't work out for you, change when the time comes up. I'm not happy at the moment because of our United Plan doesn't cover the medications until we've met the out of pocket. This hasn't happened yet, and my most recent medications purchase was $1700 for 90 days. F*CK. o'well. might have to make a change on something next time around. Decide where I want to pay, monthly, up front, in the back.. still going to pay, just figure out where it feels less painful. lol
It's not hard to do as you might think. I have 2 scripts that cost me over $600 per month.Quote:
Originally Posted by gnihcraes
Ouch.
...
Bump for knowledgeable people. Wife finally let me make some choices with her healthcare stuff as she doesn't do well figuring it out. Already got her from highest to medium plan last year. Now working on dumping premium dental plan when she doesnt even go but somehow thinks 360/yr for that is trivial to pay.
Anywho, wondering about out of pocket maximum. Seems too good to be true. On her cheap plan under ACA it was added. To boot it is also the lowest out of pocket of the 3 plans. If we are going to have a kid c-sect. We know cost would be over any plans out of pocket, why would you not do the cheap plan? No way carrier can force us into family plan since we are married if I'm doing my own companies ins. right?
Cheap plan 73/month, 1700 deductible, 5,100 out of pocket.
Mid grade plan, 170/m, 1250 deductible, 6,250 out of pocket.
I don't believe anyone can "force" you into a family plan as long as everyone has coverage meeting ACA minimum requirements.Quote:
Originally Posted by fitz19d
I figured it was some kinda I provided the baby batter therefore I'm involved kinda thing. Actually at the borderline of needing to bug my company about info since I should be getting close to the 6 month mark.
No shit. Prescriptions cost us $5, so far no matter what it is. Thank God neither of us need anything really exotic yet.Quote:
Originally Posted by Dave_L
Yeah, spot on. I left KP as an employee this past summer after years, my wife still is employed there, and I kept my own insurance through them. They priced their product wrong and are trying to make operations make up the difference, which is difficult. The ACA has been negative margin for them, and by diluting out the membership without hiring, they've really pushed out access which I see in so many posts here. It is sad. I do think KP is the correct model, but while everyone is trying to look like KP, KP is busy trying to look like one of the big 5, and failing.Quote:
Originally Posted by tmckay2
But, they cured my cancer - so nothing but love. I would go back and work there if the circumstances were right.
The question is, with UHC pulling out of ACA. What happens next ?
The differential pooling of risks by insurance companies was there for a reason. The ACA threw that baby out with the bath water. The ACA is unsustainable and has led to overall higher healthcare costs. The government doesn't comprehend "efficiency".Quote:
Originally Posted by Great-Kazoo
I / we're well aware of that. The question should have been how bad do you think everyone's gonna take a hit. I know the spouse has been trying to get any info on line. According to the "help desk" the number of people who lost their carrier, have been overwhelming the system. Again...............Quote:
Originally Posted by Gman
There are at least two companies locally in town going out of that business not counting UHC. Maybe more.Quote:
Originally Posted by Great-Kazoo
Anthem and Aetna are claiming stability, but I'm as skeptical as you both.
I'll go out on a limb and state that I think there will be more uninsured under the ACA than there were prior to it. I have doctors that are bailing on their practices, so I know my access to medical care was better before the ACA. I also know that I'm spending more than ever for the same level of care...or worse.
My doctor bailed, closed his practice and went to work for a bigger group. The practice he was partnered with is still limping along, but I'm not sure how long they are going to survive either.
Quote:
Originally Posted by Gman
Oh yeah, completely. Access is worse. Lots of folks have health insurance, not as many can get health care, and the consolidation and forming up of ACOs is dramatically accelerating.Quote:
Originally Posted by brutal
As some may know here, I just moved from CO to Fl and my company only offers UH here. Kaiser - which I have had for the last two years was SPECTACULAR! Paid for everything. My had a complete anterior hip replacement in July this year - cost me $200 TOTAL! I had UH before and it was a total waste of money so I am hating that I have it again. KAISER ROCKS!
My wife..
Kaiser rocks your wife?