Kaiser Insurance

Updated on May 07, 2008
R.C. asks from San Jose, CA
26 answers

I have been insuring my family through my employer with a PPO plan. However, I am looking to become a stay-at-home mom and will need to switch insurance coverage to my husband's company. My husband's company only offers the Kaiser health insurance plan. This means that we will need change all of our doctors including our Pediatrician, whom we adore. I looked into private insurance, but our medical history has too many red flags to insurance companies. Can any one tell me if they have Kaiser and if they like it? Also, can you recommend a great Kaiser pediatrician?

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So What Happened?

I want to thank everyone for responding to my request. The feedback has been very helpful. I have been checking out the website with the doctor's profiles and I like that the doctors are available via email. We haven't changed our health care coverage yet, but I definitely feel more comfortable if we do.

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M.J.

answers from San Francisco on

I HAD a great pedi in Milpitas but she left. :( The doctor I chose to replace her has been good so far but I would suggest you go on their website www.kp.org and go through the pedi profiles of the facility closest to you. The profiles tell you how long they've been a doctor, where they graduated from, did their residency, hobbies, etc. You can try them all until you find one you like. Good luck. p.s. Kaiser is just fine by me. I've had all 3 of my kids with them over the last 20 years. ;)

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I.S.

answers from San Francisco on

I have been a Kaiser patient from adolecence and been more than happy about the level of care received over the years. My husband's employer was acquired two years ago and they stopped offering Kaiser so we made the decision to purchase Kaiser insurance directly. What the previous gal said about hospital stays after the birth of a baby is totally true... they literally ask if you'd like to stay another day... we had to Ask to go home... there was no pressure at all... just great care. My OB is Debora Sawyer with Andrea Hutchinson as her alternate. Our Pedi is Ella Reznik... I recommend both of these Santa Clara Kaiser doctors! We also have a Pedi GI specialist and Physical Therapist as well as Allergists... getting access to specialists has not been a problem at all. I truly value the non-profit status of Kaiser because instead of trying to limit referrals to specialists (for quarterly bonuses from the big insurance companies)... they focus on preventative care and are extremely responsive when concerns or issues arise.

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C.S.

answers from San Francisco on

Hi,
I have a 6 year old and a 4 year old. We have had Kaiser for many years. We haven't had any out of the ordinary health problems to deal with. However, I am pleased with Kaiser. Our current Pediatrician is Dr. Navneet Singh at the facility in Campbell. We like him a lot. Prior to Singh, we had a Dr. Tanney. We liked her a lot too.

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S.L.

answers from San Francisco on

My kids were born at a Kaiser hospital and we have had Kaiser for their whole life. They are now almost 11 and 7 1/2. We have a pediatrician that we love at the Campbell Clinic. Dr. Barsky. Not sure where you live but I love the Campbell Clinic located on Hacienda Ave. just off Winchester. It is small and I have received wonderful care from their pediatric clinic. The new Santa Clara facility on Lawrence Expwy and Homestead is wonderful and that is where my niece and nephew go. I don't remember their doctor's name but I can get it. I have had Kaiser insurance for most of my older childhood and adult life and would always opt for Kaiser given a choice. It is a different system from a PPO and you need to learn how to work it but I will give you the bottom line. Keep asking for what you want and you will get it. Some Kaiser info. the medical offices and hospitals are a not for profit organization and the doctors get paid a salary for their services. They don't get dinged for ordering tests or labs or xrays. You can schedule appointments by phone or on the internet and if you need a same day appointment there is always someone available even if it isn't your regular doctor. They have an internal secure computer system that has all the medical history so therefore any doctor you see will know your history and how to help you. I have had doctors I didn't mesh with so I just changed and it is that simple. Just change. No questions or issues or anything.

Good luck and feel free to email me at ____@____.com if you want more information.

FYI - my job is as a Benefits Manager so I work with lots of different types of insurance. I am just giving you my personal experience with Kaiser.

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D.H.

answers from San Francisco on

Kaiser actually has several plans: if your company offers multiple plans, make sure that you review them all. About 10 years ago (back in the mists of time), my employer had an obscure Kaiser plan where it would actually pay (about 70%) for non-Kaiser, out-of-network doctors. It was called "Kaiser Small Business" or "Kaiser PPO" or something. So, not all Kaiser plans are the same.

People who hate Kaiser hate it because, for most plans, Kaiser only pays for doctors who are employed by Kaiser. So, if your doctor leaves Kaiser, you have to change doctors. If you change jobs, lose your job, your employer drops Kaiser or for some other reason you are not in Kaiser anymore, you have to change doctors. But don't be too scared by this. Lots of good doctors spend long periods of their careers at Kaiser and lots of companies have Kaiser plans so you have a good chance of finding and keeping a good Kaiser doctor. You just have to be prepared that, someday, you might have to change doctors.

My wife didn't like Kaiser for various reasons. One, she didn't like having to insist on being given good care; like others have said, if you insist, you'll get it but she got tired and annoyed by always needing to insist on it. Two, she's extremely picky and she's happier to choose from a broad range of doctors out there rather than only Kaiser doctors. Three, she likes knowing that if her current doctor changes employers, she can follow him to a new employer (and will probably still be covered). This actually happened and we easily followed our doctor to his new employer. Four, when our son needs surgery (like now), she wants to be able to pick the best doctor, not the best doctor that works at Kaiser. It is very comforting for her to know that all the doctors, even the ones working out of famous children's hospitals, are covered and available.

That said, if times become tough for us, she'd probably go to Kaiser again.

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M.E.

answers from San Francisco on

Hi R....I have had Kaiser all my life I was born there back in 1980...I have a two year old that was also born there in 2006 I love his pediatrician she is great her name is Dr. Flowers, I also love my OB her name is Dr. Slade....I do believe Kaiser has it's downsides just as everything does but if you find Doctors that you like then it's good...I have no complaints about these Doctors they listen and talk to you, not talk at you....They make sure you understand everything before you leave...I hope I have been some help and these Doctors are at Santa Teresa Kaiser

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E.P.

answers from San Francisco on

We're with kaiser this year (his work stopped offering our previous HMO). I don't like how difficult it is to get an appointment. I do like the pediatricians we have seen in Mountain View, though. You can't just call and get an appt, you have to talk to an advice nurse first, which sometimes is fine (I just want advice) but if I want an appt, it is annoying. They do have a good system so you can send e-messages to the dr, which is quite useful.

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D.S.

answers from San Francisco on

Hi R.,

Our family has been with Kaiser for the past 6 years. I have not complaints. It's no longer like the days of old. You can pick and keep the same doctor. We have a wonderful pediatrician. Her name is Linda Fory. We go to the Kaiser San Jose location. It recently changed it's name to Kaiser San Jose from Kaiser Santa Teresa. My oldest daughter, who is 17, totally feels comfortable with her. At 13, children are allowed to go into their visits without their parents. This bothers me, but it's the law, regardless of whether you're with Kaiser or not. Soon to be 18 she is bummed that she will no longer be able to see Dr. Fory. Dr. Fory, listens and explains. She has a great bedside manner.

I used to be very leary about Kaiser, and of course I hear about some of the horror stories, but now, having been a member for a while, I will do everything in my power to keep this insurance.

Good luck.

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M.S.

answers from San Francisco on

Hi R., My family has been insured by Kaiser for a long time now. We are long past the pediatrics now but I have been pleased with recent care for us, the grandparents. If you don't find yourself comfortable with your doctor there is a pool to choose from. The latest improvement is the ability to use email to make appointments, get test results, renew perscriptions and contact physicians. You can still talk to a real person, the advice nurse and see the doc but sometimes email is all you need and you don't have to wind your way through the phone questions. One downside is that the economy and health care problems has increased membership and wait time is sometimes longer than it used to be. Not impossible but longer than it was. Having waited in private doctor's offices of all kinds for long times I still like Kaiser. Mary Ann Stearns

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A.C.

answers from San Francisco on

Hi R.,
We have been going to Kaiser Santa Clara for 10 years. My kids and I love Dr. Clifford Yee. During flu and cold season it seems like I was taking my kids every other week. We have seen many of Dr. Yee’s associates and have had positive experiences.

My OB is Dr. Michelle Young. I didn’t see her much during my first pregnancy. My second pregnancy was more difficult and I was scheduled to have a c-section. She was there with me every step of the way.

Dr. Eric Mesner is my internal medicine doctor. He is always running behind because he takes a long to time to care for his patients. However, he uses email and phone calls very effectively. Sometimes I can get prescriptions without coming in for an appointment.

Because there are so many doctors it is a good idea to shop around. If you don’t like someone get someone else. Also, try email if you can’t get an appointment. Often the doctors will make exceptions when the nurses/ medical assistants can’t get you in.

Good luck!
Angela

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J.P.

answers from San Francisco on

I was born at a Kaiser hospital and have had Kaiser insurance my whole life. I also had both of my girls there. I love it. We have never had any problems with them. We are seeing Dr. Navneet Singh at the Campbell offices. He is really great and my girls are very confortable with him. They are 3 and 8 months. Good luck!

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C.T.

answers from San Francisco on

We have been with Kaiser for 8 years, and I have no complaints. You do have to be assertive about your health care sometimes, but I think that's the case anywhere these days. I have had several different pediatricians, and I have liked them all. Dr. Tuch in Mountain View, Dr. Fory at Santa Teresa, and currently Dr. Reznik at Santa Clara.

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L.M.

answers from San Francisco on

Hi R.,

I happen to have Kaiser insurance, and I love it! We live in South San Jose, but our children's pediatrician is in the Campbell facility. Any of the physicians in the Campbell office are wonderful doctors. Our doctor's name is Dr. Singh, and we love him! Go online to kaiser's website, look up the Campbell facility, and check out the doctor's web pages. You can learn about all the doctors in that office. My oldest son has heart disease, and we have been taken care of so well by Kaiser doctors, and our plan. I've been with Kaiser for 16 years, and I love it!

I hope this helps!

A little about me:

I am a happily married stay at home mama to 4 boys ages 9,6, and 4 year old twins. We love to cook, hike, camp, play and spend time with family and friends.

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H.P.

answers from San Francisco on

I love Kaiser. i can always get an appointment to see someone even if it is at 9 pm.

The biggest difference is that you need to be proactive. IF you have health issues you should be knowledgeable about them. I went through back issues a few years ago and needed to have surgery. the back specialist that i saw told me that they usually wait until nerve damage starts to show. But the other treatments were not working for me. So i asked for the referral and got it. I did not want to wait anymore. that is the biggest thing with kaiser is you have to be proactive about your health.

My pediatrician is at Santa Teresa Hospital and her name is Mary Beth McNabb. I love her she has been great on educating me about my child's disability and the options that are open to me.

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S.M.

answers from San Francisco on

Hi R.:

My family had to switch to Kaiser about 5 years ago. I have to admit that I was very nervous about it. However, I have had nothing but great reports about it. We go to Santa Clara Kaiser, so this is where all my experience is. In fact our insurance changed a few months before I got pregnant with my daughter, and my pre-natel care was great. When I had my daughter, I fully expected to get "kicked out" of the hospital within 24 hours, but I was there for 2 days - then they asked me if I wanted to stay an extra day! You still have to see your primary care doctor for specialist referrals, but the nice thing is that all your medical records are in one place - not scattered over several different facilities. We have a FAB pediatrician - Elizabeth Copeland - and I absoloutely love her. She is fairly young (with small kids herself), and is very proactive. She also has a great bedside manner with my kids (ages 12 and 4). I'm sure, as with everything, that there are pros and cons, but I truly have yet to have a bad experience there. Good luck!

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D.B.

answers from San Francisco on

Hi R.,

I've had Kaiser insurance for the last 40 years, except for a brief time where one employer didn't offer it. I absolutely love it and would choose it over any other coverage. I go to Kaiser Santa Teresa and have had the same doctors for many years. I happen to have doctors who listen to me and give me whatever tests I ask for. My kids doctor is also wonderful and has been their pediatrician since birth. She knows them well and remebers them even when we run into her at the grocery store! My 11 year-old son has had two surgeries and we received the best care possible. I live in Willow Glen, but choose to stay at Santa Teresa because I want to keep my doctors, but there are excellent facilities in Campbell and Santa Clara also.

In addition to good doctors, Kaiser offers many classes to keep you and your kids updated on the best health practices. We just finished an excellent class with KP Kids on nutrition and exercise.

I would recommend the following doctors:

Pediatrics - Dr. Mina Pai
OB-GYN - Dr. Thomas Lin
Primary Care - Dr. Stanley Otto Yu

I also have a couple of wonderful specialists I've been seeing for the past 14 years. There are, of course, some doctors I'd never see again, but you now have the choice of choosing to keep the ones you like. I think you'd be happy with Kaiser. Good luck.

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M.S.

answers from San Francisco on

My whole family has Kaiser and we love it. I have heard with Kaiser it all depends on the hospital you go to. We go to the Santa Teresa Center in San Jose and it is wonderful. We get appointments very quickly and the staff there is great. My suggestion would be to go check out the Kaiser in your area and talk to the people there before you decide.

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L.C.

answers from San Francisco on

Hi R. ~
I have had Kaiser (Santa Teresa)for many years and have had the greatest doctors! My son is now 13 years old and he has had the best care since birth. His previous doctor is now a stay at home mom (with 4 boys). His current pediatrician is Dr. Sreedevi Menon and he really likes her. He has an ear, nose and throat specialist, Dr. Jon Swedenborg that is the greatest. (My son had 2 ear surgeries and had his tonsils removed by him). I hope this works out for you. Also, you don't have to stay with doctor that you are given when you make your appointment. YOU can always CHOOSE who you want. You'll know when you meet them if it's a match. Good Luck!
Lucy B.

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S.S.

answers from San Francisco on

I have had Kaiser for a long time now. My son is 13 months and we Love our Pediatrician. Dr. Tuch is great with him. She is in the Mt. View office. It is smaller so there is more familiarity. I also love my Ob/Gyn, Dr. Rao. Also in the Mt.View office. The other doctors in both the Ped and ob/gyn offices are all great but we like our primary ones the best.

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V.L.

answers from San Francisco on

Please ignore this message.

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N.M.

answers from San Francisco on

We have used Kaiser for more than 10 years. We like it very much as they have covered everything we've needed. They kept track of all our well-baby visits and needed immunizations so I never had to wonder about when to get which vaccination. (My kids are 6 and almost 5.) We've had two different pediatricians (the first one transferred to a different department) and have loved them both.

Many times we've had a sickness "emergency" and needed an appointment right away, and they've been able to schedule one that day (often within a couple hours) with our pediatrician (and on the rare occasion that our pedi is not there, they'll have another available doctor) which has saved us many trips to the emergency room or urgent care. We've needed the emergency room twice, and we definitely didn't have to wait around for help nearly as long as all my non-Kaiser friends have talked about.

Oh, by the way, you can request which doctors you want to be your primary physicians, but if for some reason you have to take a doctor that they assign to you, don't worry. We let them pick ours for us and they have been great. And if you don't hit it off well with your doctor, you can ask to change. Our pediatrician is Dr. Irene Moff in Santa Clara. She's knowledgeable, easy to talk to, and the kids like her. Hope you have a good experience with Kaiser also.

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H.W.

answers from San Francisco on

Hello R.,
I have Kaiser Insurance and the only thing I can say is that if you're pretty healthy, they are excellent. We have a daughter who has bilateral anophthalmia (no eyes) and 4 severe heart defects. It has been a battle getting what we need for her. Her last heart surgery was in October and at that time her esophogus started growing scar tissue after the trach tube came out. It almost killed her. We were at Stanford for this surgery because the only guy who could do the surgery she needed was there. Anyway, since her surgery in October, she now will not take water or anything liquidy without choking on it. My husband took her to a gastrointerologist last Wednesday and that lady said she should have been in there months ago. We will now be going to someone in Fremont to take a look at her and do a swallow study. We informed the pediatrician of our concerns and she had said not to worry about it. She said our daughter would get enough fluids from her baby food until she started taking liquids. We really became concerned because summer is approaching and we did not want her to become dehydrated. We even told them about a swallow study and she still did nothing.
If you end up going with Kaiser, I would just say to make sure and do your own research and PUSH for what you want. Don't always take NO for an answer. If you push for long enough, you end up getting what you need in the long run. It just takes a while sometimes.
Hope this helps!
H. mom to 2 wonderful boys ages 12 and 8 and a beautiful daughter who is 16 months and blind!

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P.S.

answers from San Francisco on

Our family (three kids) has had Kaiser coverage for over 30 years. We have had only 1 or 2 not great experiences. Kaiser now encourages you to choose a personal physician; if you don't like the first doctor, you can see a different doctor the next visit. A co-worker has had Kaiser for many years and recently switched to another insurance; she now wishes she still had Kaiser again. My oldest daughter's employer doesn't offer Kaiser coverage and she also wishes she still had it. We've had surgeries, emergencies, babies, etc. and have been totally satisfied with the care. Unfortunately, my girls are in their 20's now, so I'm sure their pediatrician has retired. However, there are all types of doctors available; those who prefer not to give prescriptions at the drop of a hat and those who will. Make several visits until you find the doctor for you --- there are lots of choices. And you can't beat the 24-hour advise line PLUS you can now email your doctor and actually get an answer.

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B.E.

answers from San Francisco on

I've had Kaiser most of my life and haven't had any problems. It is really convenient not to have to worry about insurance forms and who's covered and who's not.

I recommend our pediatrician at Campbell Medical Office-Dr. Keith Fabisiak.
Good Luck.

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T.B.

answers from San Francisco on

Hi R.,

We switched to Kaiser because the Blue Shield PPO was getting WAY too expensive and this was the next best offer through my husband's work--I'm a SAHM. I was very leary of it because of the history and I'd had my own drs already all my life (almost 40 years).

We switched about 1.5 years ago and I LOVE it. Granted, none of has has really been sick during that time, but when we have needed to see someone, we've gotten in right away. My kids see Dr. Cindy Ying at Santa Teresa and LOVE her. My daughter was 9.5 at the time and wanted to switch to a female dr and my boys don't seem to care either way.

My husband and I see Dr. Robert Doll and love him, but he is more difficult to get into. I'm prone to sinus infections and if they can't get me in to see him, they always call a prescription in for me, so I do get the care I need pretty quickly anyway.

Good luck!!

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S.S.

answers from San Francisco on

Dr. Elouise Joseph in Mt. View is wonderful.

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