Kaiser Insurance Opinions

Just a note to let you know that I've been going to Kaiser for 16 years, and yes they've improved. For the most part, I have had really no noteworthy problems with Kaiser at all in all this time! Good luck! T. H.

I may have a bit of a different light to shine on things. I have a sis in law who works there and she looks into peoples records and has told us about it. It was people we know like the babysitter for the kids that she told us about. So be careful!!

Kim,
I have a friend who has Kaiser. She went through AI to get pregnant and at the time she only had to pay $10 Copay. (That was 9-10 yrs ago.
My father-in-law also has Kaiser. It's a pain in the rump when I need someone right now, but he likes Kaiser because he can go to any facility in any state; ex: California, and they have access to all of his records. Being that he has Kaiser, they have special doctors if he goes to another hospital such as St. Vincent on Sunset Hwy. The same applies, they have access to all of his records, and only Kaiser doctors see Kaiser patients at this hospital.
One great thing is that if a doctor needs to talk to him, he has a signed waiver giving them the ability to speak with me about any medical issues regarding him. The copay has gone up, but well worth it.
Kaiser also has their own group of specialists too, so you don't have to worry about lack of communication between the doctors.
Best wishes to you.

Stick with Regence. You are happy with the Doctors you have and you are getting good care. Don't risk it by switching to a free HMO. We pay 20 percent with our insurance and we would rather pay than have it all free, because you get what you pay for! Go with your gut feeling and it sounds from your email you ll ready know the answer.

Hi Kim,

I was a big skeptic about switching to Kaiser because I had also heard horror stories. I have to say that I have now been with Kaiser for over 5 years and LOVE IT! All of Kaiser is computerized, so if I go to Urgent care, the doctor I see has immediate access to all of my medical records. After each appointment you get a printed out copy summarizing your visit, including the doctors instructions, diagnosis, lab requests, prescriptions, etc, which is great to have, since it is sometimes hard to remember everything they discuss. They also have it set up that you can email your doctor with questions (and they email you back directly)and go online to make appointments and request prescription refills. I had my 2 1/2 year old daughter with Kaiser and ended up having an emergency C-section. I was very happy with the care I received and stayed in the hospital for 4 nights after. We ended up paying just a minimal hospital co-pay and that was it! I had to go to the ER for something else and just had to pay my $5.00 copay! I am now trying to have a baby again (now I have a blocked tube) and am being treated by my Kaiser OB in concert with the specialist from Oregon Reproductive Medicine. In summary, I have been very happy with the care and would recommend it to anyone. It did take me a couple of tries to find a primary care person P.A. Sue Wagner)that I clicked with and we love our OB doctor(Dr.Beth Riley) and pediatrician (Dr. Michelle Ruby). Hope this helps!

Kaiser now offers an option called Added Choice, which allows you to use any doctor outside the Kaiser network, by paying a higher deductible and larger portion of the bill. We have this option, however, I have to say that after being with Kaiser for a year now, we're really happy with them and are using Kaiser's doctors almost exclusively. Our son was a 31-week preemie, and his care was excellent, as has been his followup care since his release from the NICU. Kaiser works with OHSU Doernbecher childrens hospital and Providence St. Vincent's NICU. They also outsource some of their other care, such as pediatric neurosurgery and adult heart surgery. I, too, was afraid to switch to Kaiser, but it's been just fine.

We had kaiser the last five years and we too heard how "horrible" they were. It seems to me that people who were seen there about 12-15 yrs ago had bad experiences but this isn't true for us and I find that most people who have been seen there in the last 8 yrs have had mostly good experiences. All three of my kids were born at Sunnyside hospital and I loved my ob and my pediatrician (also at sunnyside) - the ob doc sat with me at one appt and hugged me and she even cried with me when I was having some serious complications and thought I would miscarry my twins. My pediatrician, when she found out that I was having a challenging pregnancy, called me at home just to encourage me and find out how I was doing! I've never had such wonderful docs! I can give you their names if you like. we liked every doctor and nurse we saw there and all of our experiences were good. The only thing to watch out for is their billing dept. - they are not so good and I would keep track of every statement and just check them to make sure they bill you properly. We made a payment over the phone with our credit card and they "lost" it and then later tried to tell us that we didn't pay ... not a big deal if you catch it right away. Also once they charged us too many copays. This is unfortunate that this dept is lousy, because the medical care was excellent in my opinion. If your able to keep track of your billing and catch mistakes right away then it's not a big deal and I would still recommend them. D.

My friend has been on Kaiser her whole life. She said she has never had any problems with it, until recently. But, she says, she has never really been sick or had to use it until the past couple of years. She and her husband picked up a rare sickness overseas and Kaiser doctors didn't know how to treat it and would ignore the illness or push them off to someone else. They were so sick too. And she just had a baby a year ago and hasn't cared for the treatment she has gotten throughout the pregnancy, etc. So she is now realizing that the heath care isn't great and they are planning to switch insurance providers in the fall when they can (through work policies).

Don't switch. I had Kaiser several years ago, and couldn't wait to leave. But was really turned me against them was working in Hospice as an RN. We had the Kaiser contract in the city I worked. They were awful. I could tell you horror stories.
Maybe they have changed - but I wouldn't bet my life on it.
P.

I am not familiar with Kaiser Insurance. I went online to find out about their plans. The only thing that was listed is how to reach them for billing questions or to change your group plan. I would be looking into what they have changed since your last experience.
Insurance companies and physician offices are in business to make a profit. Insurance Company premiums are high. The regulations on care stop the consumer from receiving the quality of care they deserve. Our economy is not helping, consumers' need to save money where they can to provide for their families.
I am a Medical Billing Manager for a large O.D. office in the Northwest. I have been dealing with insurance for over 5 years now. My enjoyment is providing service to our patients so they receive the quality benefit they have paid for. As well as making sure they are billed only for services they have received. I see both sides!!!
Keep in mind their are many options to medical insurance, that can provide you with superior healthcare at an affordable rate.
I would love to share my knowledge. Contact me is you would still like to research your options. I think this is wise if you are unsure!!
Wishes for quality healthcare and peace of mind.
Take Care.

Kaiser is fine for check-ups or preventive stuff, but if you have a big problem forget about it! For example my husband had a lot of problems with his foot and ankle. They just pushed him around from specialist to specialist. At 15 dollars a pop it started to add up. After a year we got sick of it and switched to Cigna and went to the Vancouver Clinic. They had him in surgery for ankle replacement surgery within a month. That was in November and he was able to run the MS run this last March. It was wonderful. He is walking pain free...no thanks to Kaiser. And this has happened to many of my friends that had similair situations.
Kaiser has great doctors, but their hands are tied on a lot of things. To put it simply...they get paid the same wether they do the surgery or not. They are paid hourly. That is why when you go to a place like the Vancouver Clinic they will do more tests and surgerys and really whatever is necessary, because they are paid for each procdure.
I hope this helps. Don't get me wrong, I miss just having a co-pay, but I would also have a husband still walking around in pain.
If you are in Vancouver I could recomend some great Kaiser doctors, since we have been to most of them over the years.

Good luck.
D.

Not sure which part of town you live in, I am in SE. I have had Kaiser pretty much my whole life and have really enjoyed it over the few times I had other insurance. I would recommend Dr. Ruden at the Division Clinic as a Pediatrician, he has been my kids' doc for 6+ years now and I have enjoyed him. For an Ob/Gyn I would recommend Diane Kintz at the Mt. Talbert Clinic. She has been mine for 8 years now. I had to have some infertility testing done before my son was born and the Dr. at Talbert were good about and willing to go as far as they could before saying it was treatment so that my insurance would cover it.

Good luck

I have always believed-you get what you pay for. Trying to save money on Health Insurance is always a scarry step. By saving $100.00 here or there-are they going to cover most Doctor Visits? Are you going to end up paying less for health insurance, but then get stuck paying $50.00 or more here and there to make up the difference of what your new insurance doesn't cover? My husband and I were self employed and had a terrible insurance ($250.00 that we payed out of pocket), it covered some emergency room visits ($350.00 that we almost always ended up paying out of pocket). We ended up paying more anyways because of what our insurance wasn't paying for. We were almost better off not having insurance-and putting the $500.00 a month that we were paying to health insurance in the savings account and paying everything ourselves.
With health insurance, look at what you have now. Look at what you have had to pay out of pocket now, and then look at what you are thinking about signing up for. Most of the time (not all of the time) you end up paying more later, when trying to save money now.
Thankfully, my husband is now no longer self employed, and we have the best health benifits that we have had in a long time. Health Insurance isn't what it used to be. 12 years ago or so, Group Health was the best health insurance you could get, now, not so much (from what I hear). Things change. But if you are happy with your health insurance NOW-don't change it.

Hi,
We have Kaiser and I love it!! My ob is Sandra Reed in Beaverton. She is kind of hard to get into so Dr. Beth Riley is also very good. As for a ped. We use Dr. Wu in the Tualatin office and I love him. THe best thing for us right now is the option to talk with the dr. via email! I love being able to ask quick questions without waiting on hold for an advice nurse! Also the email saves me time in driving to the dr. I am not sure where you are located, but if you are in Vanc. I began Kaiser there and have a few dr. suggestions for that area also! I would recommend Kaiser. Also when I had my son it was FREE! and our daughter was $200. Total for expenses we had to pay! Cannot beat the coverage!
Good luck with insurance and on becoming pregnant again!
K.

Hi Kim! I too was worried about joining Kaiser, but we had to for financial reasons too. It has actually been a great experience, and we haven't had any issues with them, it's all been easy, and the doctors have been great. We have a great pediatrician out at the Orchards offices in Vancouver. It is Dr. John Lassater. As far as an OB/GYN, I haven't seen one with Kasier yet. But they have worked with us as we were unable to pay for a large medical bill, and we got their financial assistance, and we haven't had to pay anything for co-pay or pharmacy for the last year! A great benefit...if you qualify! Don't be scared, it will be okay!

HI Kim,
I do love some of their dr.s at kaiser, but I hate there system. I have had nothing but problems with anything I have tried to do with them. I would personaly avoid them. I am just one opinion though. When I was pregnant, they switched me from dr to dr, I have had to fight about everything I ever have needed to do with them. You always have to fight for the things you need to get done. If you think yoiu need to been seen asap, they will only get you in when it is convenient, but if you start sobbing and telling them how much you hate how rude they are, how awful their service is they will get you an appointment the very next day. And then your charts read that you are really moody! I like a lot of the people there, their are good and bad everywhere, but I hate Kaiser..

I had Kaiser years ago and would NEVER have it again.
D.

Kaiser is now a partner of Group Health Cooperative. There is no guarantee if your physicians will stay with Regence, they, the docs, have to sign new contracts with that insurance company whenever their existing ones expire, this may or may not coincide with your open enrollment period. Personally, having played the insurance shuffle for many years, as to what plan covers what physician, the one thing that was critical to me and my family was our continuity of care. We made the decision to always stick with our doctors, especially the pediatrician, regardless of the insurance. Look at what it's going to cost you out of pocket for the monthly insurance premium and what the office call premiums will be. Not all procedures (fertility) are covered expenses with Kaiser/Group Health, you still could have a higher co-pay for these services and you would have a new doctor. Kaiser/Group Health is not available in all areas, so when you travel this could be problematic. There are some things you can't put a price on, and the relationships with your physicians, especially pediatricians and ob-gyn's are so critical. I wish you well.

We had Kaiser when we lived in CA and I liked it. My daughter was born through them and we had no issues. They are a true HMO in the sense that most likely your child would be delivered by whichever Dr. is on staff. I actually chose a facility that did 85% mid-wife delivery so I didn't actually see a Dr. during my delivery, but that is all up to your comfort level and I had a choice to have a mid-wife deliver or a Dr. based on the facility I chose.

We liked all the docs (ped, family, and OB) we had through them!

I was with Kaiser I like the sunset kaiser in hillsboro. My pediatrician was Dr. Nash. I absolutely loved him. He is very thorough and listens well. My OBGYN was Dr trainer. I also loved him. He was at Mt talbert at Sunnyside. So its a drive, but I thought he was totally worth it.I worked with him for endometriosis and laperoscopies. He could probably give you a good recommendation for a specialist. ER is still pretty slow,but the interstate one isn't too bad. Never go to Sunnyside ER they are always crowded and can take hours just to get you in a room.
I have had tons of health issues and from experience I have learned to ask my old docs to give me a good recommendation to a kaiser doc. Most can give you a few. Thats how I found most of my good docs.

Good luck!

My husband and daughter are on Kiaser but I am not so I cannot say about OB and delivery... but as far as my daughteer and husband we have loved every minute of it! We see Dr. Davis at Division and we love her to death. They have treated us and seen us for any little thing and we have never been turned away or told we can't get care. We have been through many many illnesse, tubes, even a 3 day hospital stay at dornbecker and all at a very low deductible to us. I have never felt as though we don't get good care. Maybe it is the size of the city and system... but we are very happy.

Kim,
I have had both insurances, so I feel I have a pretty objective opinion. My husband was actually an employee of Kaiser for a couple years. Kaiser is very affordable, and offers great coverage, if you are & remain healthy. Their approach truly is preventative, however when you become ill (especially something serious), they lose money to treat you-- so their attention/treatment is far less agressive than an PPO. PPO's such as Regence make money to treat you. It's important that you understand the difference.

I had thyroid issues when I was first under Kaiser. They failed to diagnose it. I later found out it was cancer, and was under Regence, and they did everything possible to get me healthy. Last year, I was pregnant while on Kaiser, and I feel because of their lack of attention, ended up having a late term miscarriage. I'm now back with Regence, healthily pregnant, and you could not pay me to go back to Kaiser!
I strongly agree with previous posters-- You get what you pay for!

Kaiser is much different now. My sister has been in and out of kaiser with several surgeries and gave birth there. It was a good hospital. Back in the day I truely believed the service was awful(now 36)and that was our insurance. My mother-in-law has worked for Kaiser for over 20 years in the administration. If that says anything. The insurance is affordable. You can always try it out for a year or two. Good luck.

Kim~
Go for it! You will love Kaiser. I have always been a Kaiser patient, since I was a child, and I'm 50 now. Both my children were born Kaiser. They are much improved from their nightmare story days. The only problem is if you move from a Kaiser area you'll miss them. Give them a try, you can always change back if you just don't get along.
Good luck to you and God be with you and yours.
Mandy

Please don't change. I had Kaiser and had numerous problems with them. I had an ingrown toenail operation that had to be redone because the "doctor" was incompetent. I had to wait 3 months for an appointment with a doctor about difficulty walking - a running injury - and then they had given me the wrong date (I NEVER make mistakes about dates - I run my own private business with 35+ clients and have never mixed up their appointments), so I had to wait even longer, limping all the time. I had a work injury while with them, and the doctors were completely unhelpful. I switched to a non-HMO option after two years with them and will never, ever go back to an HMO. I know too many close friends who have almost died under incompetent care from them. PLEASE DON'T CHANGE! If you were a young, healthy, male, I'd say go with Kaiser & save the $$. However, having kids & trying for more, you're not in a position to never use your insurance - you need to be able to rely on good competent doctors. You can't afford to switch. Your health, and your family's health, is worth the money.

Hi Kim, We made the change to Kaiser almost 2 years ago. Not only did we change insurance, my husband changed jobs to Kaiser. I love it! I was so worried and like you I loved our non Kaiser doctors and didn' want to change. I have found new and better doctors. I have 3 kids so between all of us we are almost regulars. I am not sure if we just found good docs that take speical care of us or if they are all like that. I did have one gyn I was not to excited about so guess what, I chose a different one for next visit, no big deal. It does take a little figuring out the system but once you get that it is as easy as pie! Contact me if you would like the name of the docs we see. Take care, L.

My other 1/2 & I grew up on Kaiser. In fact, we were both born there!
We always loved it - never had any problems.

We moved out of state & he was able to keep his coverage & get meds sent by mail. We see his doctors once a year & can get specialist referrals anytime we need them! Your OB might be on their referral list!

I wish I would have been able to keep it!

I have Kaiser insurance and have been very happy with the care I have received from them. I delivered early and was sent to St Vincent's just a a precaution since they have NICU. My son's pediatrician is great - Dr Vigil at Division and I just took my son to the pediatric dentist for the first time and that was great as well. They have been making a lot of improvements recently in their service.

Although I think Kaiser would be fine, Some things are NOT worth saving a few dollars. If you have blue cross, I'd stick with that until you are done having babies. GOOD doctors are hard to find. If you are happy with the ones you have, I'd hold out, especially with the circumstances you mentioned. I went oh 8-10 years with out a DR I liked, fortunately I don't have to go very often, but interviewing them can be a hassle.

Blessings, Ang

I don't have personal experience with kaiser but I do work in medical billing and we always have huge problems with any hmo plan. Most people know what type of care they want or need and it seems to take many, MANY months to get a referral. You'd probably make up for the premium savings by paying the PCP a few copays first then finally getting to the specialist and paying them too.

We are adults and paying good money for coverage, why should we have to ask someone else's permission to do what we want to do? They say they're saving you money with lower premiums but what they're really doing is saving themselves money by withholding referrals and putting off necessary and reasonable claims.

In addition, I just read another post and saw that kaiser is now a part of group health, if that's true I would never choose them! I have seen nothing but bad things from group health, they are referred to as group wealth or group death. Someone mentioned they lose money for treating you, so of course they don't do so called unnnecessary testing, because they lose money! You lose health because they want to save money. I'd go through any number of tests to figure out what was wrong with me.

I'd always go with aetna, blue cross, or blue shield coverage over any other. In fact we passed on my husband's group health coverage and choose to pay more for an individual blue cross plan. It's just not worth it when you need it!

Hi Kim,

We had blue cross/blue shield and switched to Kaiser to save money as well.

We have been with Kaiser for one year and have loved it. The doctors and nurses have been great and we have always been able to get an appointment for the same day, if needed. While we haven't had such serious things as heart surgery, we have had some emergencies, including my first miscarriage, and I felt they handled these very well.

My only complaint is the waiting time when you call them for advice or to set up an appointment. In hindsight, it's never THAT long, but it seems like forever when your child has a fever and you're a nervous mom.

Their advice nurses are fantastic, though. I have talked to a LOT of them over the past year and they have been consistenly good.

I hope this helps. The hardest part was having to let go of my child's pediatrician under Blue Cross - we loved him, too. However, financially, we didn't have much choice at this time in our lives.

Best of luck. M.

I don't know anything about Kaiser, but I would read any new insurance carriers policies very carefully before switching. I would be very explicit about what kind of care you think you might need in order to get pregnant again and make sure that it is covered and that you aren't going to have to wait a long time. I see that you and your husband are teachers, so I am assuming that these are plans that are offered by the school district you work for. I would start by calling the HR department and asking them. This is a much better time than in September when everyone is switching! Give them scenarios like: If I need this type of intervention then what would be covered, what would be the process of getting into a specialist, ect. When we were looking to switch, my school district's HR department was great about that. We ended up switching from Premera to Regence. Regence is a lot less a month than the Premera plan, but I am going to pay $2,000 - 3,000 to have the baby I am pregnant with now instead of the $400 I paid with my daughter! (Believe it or not the monthly premium difference still made Regence cheaper!) It would really be important to know all the facts for your expected situation before you make the change. Good Luck!

I had Kaiser for many years and although there are some downfalls there are huge advantages. My Mom was diafnosed with Cancer and had a one in ten chance of survival. Living in CA at the time they sent us immediatedly to SF and got us the best Dr's. The spared no cost for my Mom's survival and numerous surgeries, chemo, radiation, and LONG hospital stays later my Mom is alive and we are not poor. My mom has been cancer free for over 10 years. As a kid I had them and I liked my pediatrician and my mom liked the convenience of not dragging kids to ten places, having it all in one place. Hope this helps.
Kat

I am a very happy Kaiser member. Have had Kaiser insurance for almost 7 years and feel as though I have received nothing but excellent care. I had a high risk pregnancy and got the most incredible services from the Kaiser OB department, pre term labor department and perinatology. I really like my now 6 month old's primary care physician. My baby has had pnemonia and bronchitis and the services from the primary care physician and the urgent care have been exceptional. When I first called with her symptoms that resulted in a diagnosis of Bronchitis, we were able to get an appointment within 2 hours of my call. When the baby had pnemonia the doctor called us every day and gave us her home phone number in the event the baby's symtpoms got worse. The primary care physician is in the Mt Scott Clinic, OB at east Interstate and perinatologist at the Kaiser clinic located at ST.Vincent. I would be happy to give you any and all of their names if you are interested. A.

My parents had kaiser (after I moved out) and had BIG issues with their dental. They were so relieved when their group insurance changed.
For me, it is very important that I have the option of going where I want when I want. I pay a bit more, but if I want a second opinion or am out of town I dont have to worry about seeing someone. Kaiser, I have heard, can be incompitent when complications occur, as long as you are txt book though you are ok.

Hi Kim~
For what its worth, I have worked for Kaiser and have been a patient, and in both respects, they are truly a "machine"--meaning VERY organized, and thoughtful about how they give healthcare and how they treat their employees. They believe in a "healthy intervention", so, they will hold off on things like pain meds, and unnecessary exams that will cost YOU more money. That is a big deal, because most "machines' will give pain meds like candy to just get you out of there, and they will add on more exams than you need for their own income. SO, it depends on your state of mind. Also, all you have to do is ask, and you will be set up with a specialist--of course, you have to go throught he proper channels, so you would have to see your primary care provider FIRST,(there ARE reasons for this)and after that, you will be all set up! (MAKE SURE that specialized care is part of your insurance program--or you might be in for huge cost in the future) Just do your homework--Kaiser has sooo many options for insurance, so you need to make sure they they have what YOU WANT. Good luck!!

Hello,

You have had a ton of responses, so I will keep this short. I love kaiser medical. It is quick, easy, and painless. I have given birth 3 times with kaiser, and each time, it was a great experience. They listened, and took great care of me. After having a miscarriage with one of my pregnancies, the next one, they watched me very closely. My youngest had a high fever, for no reason when she was young, and they sent us to doernbecher, just to be safe. Same cost as my kaiser hospital copay. My oldest broke her arm, they sent us to doernbecher then too. I've personally had heart surgery since being with Kaiser, paying only my hospital copay. It has been a life saver for my family, and I love all of the doctors I have had.