11 answers

Anthem Blue Cross Vs. Kaiser

In a few weeks I have to choose between these two insurances. We have (and have always had) Blue Cross. Love love love our doctors. Can't stand the referral process (took three weeks to get a neurology referral after my daughter seemed to have a seizure... and then when the referral arrived, it had the doctor's name, but no contact info whatsoever. UGH!) or the prescription benefits (we're supposed to pay a set price for retail or a better set price for mail order, yet my son's three meds have three completely different charges, one of which is more than double what our "max cost" is supposed to be).

It used to be that I only heard bad things about Kaiser, but that seems to be old news. These days the "Kaiser people" I know love it. Except for the mental health services. This is relevant because my son has serious psychiatric needs. I talked with a rep and she explained how it is possible to see a doctor more frequently than just monthly as I've heard (my son currently goes weekly with one doctor and about every six weeks with another). I'm wondering if that every really happens, or if it's just "possible."

Also, we do a modified vaccination schedule. Are there Kaiser peds who are willing to see parents more often instead of jamming everything into one visit?

If you have used Kaiser in the past five years, could you please give me an idea of what you like or don't like? If you're in the Inland Empire or High Desert, I'd especially love to hear from you.

In case anyone is curious, yes, cost is a factor. We will spend less overall for Kaiser, both in terms of monthly premiums and prescriptions. However, the difference isn't enough to automatically make the jump. Any input you have will be appreciated.

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More Answers

I too really like Kaiser... have been on it most of my whole life in So and N. Cal and my son who is now 11 diagnosed with failure to thrive, ADHD etc. has received good care... he has had MRI as a baby when they thought he had a neurological issue, has had 8 surgeries through kaiser for palate surgeries, hernia, ear cyst, ear tubes, G tube placed when he was 1 yr, removed when he was 7, etc. broken arm, all for the cost of co pays. Sure there are dr.'s that you wont agree with everywhere... but that is where you trust your mom's gut feeling and get another opinion if needed. When we moved from N to S Cal... all his records were transferred so his history came with him... He now does see a Psych. every 3 months... but also all the Dr.s he has ( peditrian, ENT, Endocrine dr., psych) are also super accessible by email... a great new thing they have implemented... and if I have a question about new behaviors or concerns... I can send an email and usually get an answer back FAST often before 24 hours. I know some folks say bad things about kaiser... but I have been overall really satisfied... Good luck!

2 moms found this helpful

I have been with Kaiser most of my life and love it! The time we were with another HMO (Western Health Advantage) was a nightmare, so bad my husband got his employer to add Kaiser so we could return.

Our son has a long list of mental health conditions (ADHD, OCD, depression and more) and I've been happy with the services. It can take a while to get in with the psychiatrist, but I found they make every effort to help you. Once you're established with a psychiatrist, it's quicker than getting that initial appt.

When our son's behavior took a turn for the worse this week, I was able to call his therapist personally (direct number) and he fit us in next week. I am also able to contact our son's psychiatrist's nurse directly whenever I have questions or concerns.

I love that everything is coordinated. I often ran in circles with the other health plan trying to get referrals or dealing with billing mistakes. It was also a pain finding doctors accepting new patients. None of that with Kaiser.

My only complaint is our local pharmacy. They moved it to the hospital a couple years ago and now it's a real hassle. They're swamped and it can take up to a week to fill our son's ADHD med prescriptions, which is a big deal since we have to go every month for those. However, for the meds that don't require an in-person pick-up, I use Kaiser's mail order pharmacy (free delivery) and it's quick and efficient.

Can't say on the vaccination schedule. We follow the guidelines so we don't have experience challenging them at all.

One of the things I really like about Kaiser is their website profiles of all of their doctors. So, when you're choosing yours, you can read all about those on staff and choose the one you feel is the best match. Our son's pediatrician noted a special interest in ADHD, so I chose him when we started suspecting that could be what was wrong with our son.

2 moms found this helpful

I've had Kaiser for the past 6 years and I live in the High Desert. My hubby's health plan doesn't charge anything for any Pre-natal care or the regular visits until my kids are 2. I bounce between Fontana and Riverside, you just have to know which departments in either areas have better doctors. They are building a new hospital in Ontario and expanding the Fontana one too. Granted the HD offices are only Peds, Family and lab work, but Fontana isn't that far for urgent care or emergency (and Kaiser is connected with St. Mary's for easy billing issues). The Riverisde offices are where my mom goes for mental health issues, and she likes them. My sons doctor is up for anything we want to do for their shots (and I have bounced around trying to find one that we liked). And when my Hubby was diagnosed with Diabetes, he was hospalitized for the weekend and they were very helpful on trying to figure out why.
If you are hesitant, sign up for Kaiser first. Try it out and see if you like it. If not, when your Open Enrollment comes up, switch to Anthem and try them for a year (or vice versa). It might be a hassel, but then you will see which one you like better.

2 moms found this helpful

I loved Kaiser. My hubby's job changed and we had to switch to a different plan. I wish I still had it. Everything is super coordinated there. All your records are on computer so everyone has access and there isn' t over-medicating, etc. My pediatrician was very open. My OB was great. Never experienced any of the mental health services. You can switch doctors if you don't like one. It was never a problem gettting a referral and because it is all in one system, I never waited for approval. Try it out!

2 moms found this helpful

I like Kaiser a lot. I paid nothing but the hospital night stay and that was it. Mental sevices are great, they try new approaches to things and are pretty understanding. I think their prescriptions are cheaper than other places too and I think you will like that you can order by mail and look at all your families visits on line. It's great you can e-mail your doctor, look up other doctors, even look at lab results.

2 moms found this helpful

We are a Kaiser family. I was reluctant to join at first, but based on my personal experiences (member since 2006), I would highly recommend it. The electronic medical records, email access to your medical team, and the many options to find a doctor that meets YOUR needs and interests is great. I had my first child at Kaiser West LA. I'm totally happy with her pediatrician. I did spread out one group of shots, but ultimately decided it was harder for her to have to go back and experience the pain and trauma again and again. Good luck!

1 mom found this helpful

Hi S.,

This has been a question I'd been grappling with for the past 2 years. I've also been hearing better things about Kaiser, but in then end, my hubby who is a chiropractor still doesn't trust Kaiser. So, we've stayed with Anthem Blue Cross - although we did upgrade to HMO Plus which is better. I've heard some Kaiser facilities are better than others. Not consistent. You'll make the right choice for your family. With my company, we can change providers every year around November. So, if that's the case with you, you can always try it out for a year and decide.

Good luck!

1 mom found this helpful

Well we like Kaiser, though our plan recently changed and we spend more money, but I love the convenience.

1 mom found this helpful

I'm not on Kaiser, but I have a dear friend who is, and they are definitely doing a modified vaccination schedule. She hasn't mentioned anything about it being an issue. It shouldn't matter, because those "extra" visits for the spread out vaccinations can be nurses visits. Just wanted to give you a little encouragement there. :)

1 mom found this helpful

we had kaiser past 10 yrs (northern CA) & I am very glad with their services & docs . (though not all the docs but few in my experiences were excellent.)

This yr we changed to PPO so kinda missing the smooth path of visiting doc/specialists/lab, now we r paying more out of pocket/deductibles/worst is the documentations/wasting my time making calls to Ins & facilities ....but then we get to see the docs in excellent medical facilities thru the PPO is the only consolation (my kids have medical issues so we now take them to standford)...but as u mentioned for us its just hell as we r in PPO since we got used to the smooth & fast services from Kaiser. If we had not opted for stanford Univ services then we would never had left Kaiser.

Incase of mental health they do have counselling covered but not the therapies for which u need to file a case & win (easy but a long process).

1 mom found this helpful

Can't tell you a lot on the psych stuff, but we've enjoyed Kaiser since our kids were babes. With our youngest I did find a Kaiser Pedi that would go along with my wish to modifiy the vaccinations (I just lengthen the times as i could so there's never more then two injects at a time, and the I held off on polio vaccinations on the youngest until he was over a year and is was apparent that WHO wouldn't be able to totally eradicate it back in 05. They were close, but there was a huge setback).

I'm in OC cali and my son's Developmental Pedi sees him strictly for ADHD and we are given three month supplies of my son's meds and able to call in for more as needed. Although we usually see that dr. every 3-6 months anyways.

We usually always get referrals easily, sometimes its even just simply handing me a phone number or once when one of my kids had a rash the pedi walked over to the other side of the offices to get a specialist to come look as part of a consult! The other nice thing with Kaiser is that you really don't need an office visit to get a referal for a specialist. When we were "returning" to kaiser after a couple years of having to choose blue cross, I easily made an appointment to have my daughter be seen by an opthmologist (eye surgeon) for her vision issues - i simply let the appointment people know that she had to see the pedi opthmologist for her vision issues and they made the appointment. Of course it probably helped that I knew who i was asking for and that dr had seen her before we lost the kaiser coverage. I know that when we were using blue cross it took me nearly 3 months to get her seen by one of their drs of the same sort.

I will say that we've had some "bad" doctors (including a pedi to tried to convince me that i should stop nursing when my oldest was a year so she wouldn't get "dependent" -ugh!- and the OB who wanted me to not nurse during my pregnancy although that was standard advice) but every time I run into one I didn't like or didn't feel comfortable with, it was easy enough to change to a different dr. I didn't find that to be true with blue cross (for the couple of years we HAD to use that insurance)

in the end... If you like where you are, I'd stay put if you are able to.
Best wishes.

1 mom found this helpful

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