I'm so tired of Pacificare and I haven't had the need to deal with them with a serious problem (thank god). Everything sucks down to their billing. Not to mention I answered a tobacco question honestly like a jackass and they increased my rate. I haven't dipped for 3 years now.

So now that i've been married for almost a year I figured I'd look into a family HMO instead of paying for two seperate plans.

Which insurance company do you have and would you reccomend them?

 

www.bluecrossca.com enjoy

 

blue cross is probably the best.

 

I'm the only insurance you'll ever need



<----ninja warlord/gangster wizard with incredible abilities in healing

 

check out:
www.ehealthinsurance.com

i've heard good things about bluecross, but i personally like kaiser....

 

I have Kaiser and with all things considered, I find them the best choice. They are super-convenient, 'usually' have good doctors, and you can get in quick if you don't "have to" see the same doctor over and over. Plus, they cover ambulance rides, have 24 hr emergency rooms, and they are all over the place.

You want to check out their advantage plans... family advantage or something... if you get in on that the rates aren't as high.

The reason I also like Kaiser, is that if you get a cold, you pay $5 co-pay. If you go in with a gunshot wound, it's still $5.... etc....etc.

With Kaiser, you get good treatment (my bro got a skin-draft from a stanford doctor through kaiser), and you never get a bill (other than your usual monthly).

 

HMO is a way to go. With set monthly payments and some copayments as HellaDumb has mentioned, you/your family is pretty much covered. IMO Kaiser is excellent since I work there. hehehe...Now, don't try to come to ER with a gunshot wound because it would only cost you $5, doing chest compressions makes me tire...As our ads says "THRIVE". We don't like seeing our clients in pain you know...at least I do. Go check out the Kaiser website, it would give your a free quote according to the plan. I better stop - I start sounding like a sales person.

 

Lots of people hate Kaiser but they have been good to my wife and I. I was with them when I was a kid and went back after the marines. Like HellaDumb said they send you to other places if they feel others can do a better job or have better facilities. My dad has had Kaiser since I was a kid. He had cancer about 10 years ago and they sent him to stanford hospital. If you get really sick Kaiser is a good deal. For minor injuries you can make an appt and go to the minor injuries clinic up to 7pm. After that you have to sit through a horrible emergency room depending on location and type of injury. I pay $10 a visit and $5 for prescriptions. A co worker is on blue cross through his wife and pays lots of money out of his pocket since she had a baby. over 10k uncovered after labor. I'm sure he'll get some back after taxes next year, but damn thats a big bill. He pays $25 a visit and $20 for prescriptions because she hates Kaiser.

 

+1 on kaiser....

remember how kaiser started as a hospital... lol...

anyways, talking with a coworker who's mom is on blue this, and that.

she has to do all the paperwork and then rebill blue cross/medicade to get reimbursement for everything.

headache city for me...

kaiser maybe big and "unhumanly" to some, but to me, i'm lazy and heck and glad i can call in prescription via phone and do lazy things like that...

 

im all for kaiser


2 surgeries (one emergency surgery), multiple ambulance rides and who knows how many visits to my surgeon(s)


and i dont' pay a dime

 

used to have pacificare care also but ended up ditchin it and switching to blue/cross/blue shield. i always thought the ppo was way better than the hmo ?

 

i used to have Kaiser and the service was pretty dang good. i now have Healthnet and go to a Sutter doctor.

 

This is what I want to do. Problem is, Blue Cross is in negotiations with Sutter. So it's pretty much Healthnet or Blue Shield.

I've had too many bad experiences with kaiser. Especially with the countless surgeries my retarded brother has had. I used to spend 6 months at a time visiting him. He’s 14 now. I once had to pull teeth to get them to change his bed pan. So I did the next best thing and threw the bed pan into the hallway like a frisbee. They seemed to listen to me and my father from that point on. Their nursing dept is absolutely awful. I have enough horror stories of that place to write a book. There's always one or two highspeed Filipino nurses pulling everyone else slack. Do business for some of them.

I also personally know the chief of surgery at Kaiser South. I'm surprised he knows his left from right. He’s the most undecided person I have ever dealt with. I wouldn’t let him get withing 30ft of me with a scalpel.

I'll give them credit for some things though. They do seem to access to some great surgeons. Had one of the best pediatric surgeons in the world work one my brother once. Flew him in from John Hopkins IIRC.

I used to have Sutter when I was a child. They seemed very good and I would like to have them again.

 

the healthnet plan i'm on is pretty cheap. regardless of the healthcare provider you go with, co-pays are $20 and prescriptions are $7.

just a warning if you do go the healthnet route... there's a window at the begining where they assign you a doctor and you have 30 days to change it. if you go beyond that 30 days (like i waited 6 months for some dumb reason) to change, it's a major PITA.

 

I have used almost everyone over the past 10-12 years:

I find United Health Care PPO to be much better than any HMO I have ever had.

Health Net was really good when it first came out about 10 years ago, but has equalized with BlueCross.

I'm just one person, but I can't believe I am the only one having trouble with HMO's. They all do pretty well with emergency care, they don't do well with non emergency care.

I hated Kaiser until I got Sutter, now I just don't like Kaiser but I still hate Sutter.

Kaiser example: I needed a physical with appropriate shots signed by a doctor in order to take a temporary job overseas. Kaiser gave me an appt for 90 days in the future, nothing sooner they told me. I was seen by a PA - he said I needed a shot, which they didn't have in stock and suggested I call back in another month! I called HR and told them what happened and they told me no exception - and that a PA isn't a physican and I'll need a physicians sig. On my own dollar I got another appt with another doctor and got both the shot and the sig in about 1 day. Kaiser is not good with non emergencies.

Sutter example: I had trouble walking, lots of foot pain. Foot pain that wouldn't go away, I was thinking about just cutting it off, because it couldn't hurt worse than it does now. Sutter gave me an appt right away, saw me and gave me some Ibuprofin and told me to make a regular appt next week, this was on a Friday, not an "emergency" appt. I called back Monday and got an appt for about 3 months in the future...Seriously, I could not walk or drive my car and they want me to come in 3 months later? I told this to them and they told me it is gout, and that is a non emergency. So I asked what is the treatment and they told me it is pills. So I asked if you know I have gout, and you know it is pills, then can I get some pills? NO, you have to be seen and tracked by your primary provider, gout is a long term illness and you might have some kind of associated liver damage. So I was supposed to wait for 3 months for an appt when a) They knew what I had, b) knew the treatment and c) are my health insurance company? d) I'm in so much pain, I can't do anything but sit in a chair with my foot in ice water. I ended up going to two other doctors, at my cost, to find one that would give me the perscription.

Bluecross Example: My knee hurt, it has hurt for many years, but it's getting worse. I go to my Primary doctor, got a non emergency appt after a 2 day wait. He saw me and a gave me a referal to a specialists. So far so good. I called the specialist and was told the waiting list for new patients is 1 year. No kidding. Went back to my doctors office they gave me the whole list of referals, nobody had anything free for more than 6 months....gad, switched insurance to Healthnet.

Healthnet example: My primary care doctor for Bluecross is also covered under Healthnet, so he gave me a referral right away. Had to wait about 2 weeks to see a specialist. He scheduled surgery for me about 2 weeks after that. Surgery was messy, my knee was worse off than anyone thought - all good so far. Now post surgery, I need some more meds, becuase without the meds, I get lots of pain in both my back and my knee. I call the specialist - he tells me that he can't see me without another referal, so I go to my primary care provider who writes me another referal to the same speicalist, but that guy isn't taking any new patients, how did I become a new patient again? so his office refers me to someone else who agrees to see me right away. He says that the medication that I'm taking isn't one he uses and gives me another perscription. The insurance rejects the new perscription and I get billed for it. Call the insurance company and they tell me what is covered and what isn't. I find out that the new medicine is covered, but under another grouping than what they were looking at. They agree to pay - I got meds for about 1 year, and never heard anything else about it. I eventually get billed for all the new medication the second specialst perscribed for me as soon as I switched insurance companies. I spent about one year trying to get reinbursed for the cost, approx $2000 and I was refused every time.

I have used several other insurance companies too, with varying problems but nothing touches UHC. I can't even recall the name of the worst health care I got...it's was terrible, it is the one that police, fire and drug dealers get in Contra Costa County - really bad and none of the doctors like it because they don't pay the full reimbursment ammount.

I went to United Healthcare after that and I haven't left. I have gotten excellent service with no referells required to see a spcialist and the Dr. offices like it too because they get fully reimbursed for expenses. It does cost more than and HMO but it's worth it IMHO.