Kaiser or CareFirst

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wassabi
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Kaiser or CareFirst

Post by wassabi » Sat Oct 13, 2018 9:51 am

I'm switching jobs in the next few months and taking a federal job in the Washington DC area. I've always had CareFirst and my spouse uses Kaiser. The federal government offers excellent coverage and rates for plans with both providers so we'd like to get on the same plan going forward.

My spouse likes that Kaiser has their own network in which everything is linked. She can email doctors via the app, check test results, schedule appointments, and her doctors are able to review her records prior to any appointments.

I like CareFirst because I don't need a referral to see a specialist and I can choose any doctor I want at any time.

We've both had some minor health issues the past few years but do not anticipate any serious health problems in the near future. We both take one medication each that we will need to continue taking going forward.

With that said, I don't think we can go wrong with either option but I'd be interested to know if any Bogleheads have any opinions for best value health insurance in the DC area.

InvisibleAerobar
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Re: Kaiser or CareFirst

Post by InvisibleAerobar » Sat Oct 13, 2018 10:55 am

I really liked CareFirst. Other than the fact that there's a deductible to hit (minimal), their rates are reasonable, and their annual cap is quite low (~$2k/person last time I checked). Most in the District and surrounding areas accept it as well.

That said, I really wanted to join Kaiser, but their doctors are a good 10 miles away, which, as you know, is DC-parlance for up to 90 minutes one-way. That, and the fact that I can't get prescriptions at local pharmacies, meant that it wasn't as viable a choice. If you do live close enough though, that should probably change your considerations

wassabi
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Re: Kaiser or CareFirst

Post by wassabi » Sat Oct 13, 2018 11:10 am

InvisibleAerobar wrote:
Sat Oct 13, 2018 10:55 am
I really liked CareFirst. Other than the fact that there's a deductible to hit (minimal), their rates are reasonable, and their annual cap is quite low (~$2k/person last time I checked). Most in the District and surrounding areas accept it as well.

That said, I really wanted to join Kaiser, but their doctors are a good 10 miles away, which, as you know, is DC-parlance for up to 90 minutes one-way. That, and the fact that I can't get prescriptions at local pharmacies, meant that it wasn't as viable a choice. If you do live close enough though, that should probably change your considerations
Good point about distance. We are very close to several Kaiser facilities (5 minute drive to one and 10-15 minute drive to another). For CareFirst, most of my doctors are further away and more inconvenient to reach in DC traffic (although not TOO bad).

I'm leaning toward trying Kaiser. There's no deductible (CareFirst is $1,000/yr) and we can always switch during open enrollment next year.

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dm200
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Re: Kaiser or CareFirst

Post by dm200 » Sat Oct 13, 2018 11:29 am

wassabi wrote:
Sat Oct 13, 2018 9:51 am
I'm switching jobs in the next few months and taking a federal job in the Washington DC area. I've always had CareFirst and my spouse uses Kaiser. The federal government offers excellent coverage and rates for plans with both providers so we'd like to get on the same plan going forward.
My spouse likes that Kaiser has their own network in which everything is linked. She can email doctors via the app, check test results, schedule appointments, and her doctors are able to review her records prior to any appointments.
I like CareFirst because I don't need a referral to see a specialist and I can choose any doctor I want at any time.
We've both had some minor health issues the past few years but do not anticipate any serious health problems in the near future. We both take one medication each that we will need to continue taking going forward.
With that said, I don't think we can go wrong with either option but I'd be interested to know if any Bogleheads have any opinions for best value health insurance in the DC area.
Big Kaiser fan, over the decades - also in Washington DC area. Would never have left Kaiser several times except for employer insurance sis not offer it.

You can pick your Primary care Physician at Kaiser from among many choices. Older or younger, male or female, Internal medicine of Family medicine, and from many varied backgrounds. You can also switch at any time for any reason.

Yes - for some specialties, you need a referral. This has never been a problem for me. Once you get the referral and see a specialist, in actual practice you never need another referral to see that specialist or specialty again IF THAT SPECIALIST SO REQUESTS. For example, there are two specialists that I needed a referral for seven years ago - when I returned to Kaiser. Each tells me what I need to do or not do, when to come back, etc. I never needed another referral -- and one specialty is the third doctor (others retired) and the other is the second. There are also two other specialties I see regularly as well - only one referral. Depending on the specialty, sometimes I get the initial referral by email.

I can do about half of what I need to do by email or phone (no charge) with my PCP.

In this area, as well, there are 24x7 Urgent care kaiser facilities that can handle (my opinion) about 99% of what you would go to a hospital ER for.

When your PCP thinks you need a referral, he/she can book the appt on the spot. For example, my wife saw her PCP for a 10 am appt and the PCP said she needed to see a general surgeon for the situation. Her PCP booked the appt on the computer and my wife saw the general surgeon at 12 noon that day!

In addition, today as Kaiser has grown - there are almost always multiple Physicians for every specialty. I have never done this, but I am sure that if you wanted a different specialist for a specialty - it could be done.

Kaiser also has 24x7 (no charge) nurse advice phone line (This was great when child/ren were small) and some things can be done with a "virtual house call" 2 way smart phone. My wife did this on a Sunday afternoon. No charge.

The other, curious to me, thing Kaiser has done here (about ten years ago) is hire more PCP Physicians and eliminate nurses and nurse practitioners from Primary care. Now, the only medical professional I see when I have primary care appointment is the Physician. It is also common that appointments with your PCP are very available - and if your PCP is away (vacation, etc.) you can easily get an appt to see another Physician.

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dm200
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Re: Kaiser or CareFirst

Post by dm200 » Sat Oct 13, 2018 12:05 pm

wassabi wrote:
Sat Oct 13, 2018 11:10 am
InvisibleAerobar wrote:
Sat Oct 13, 2018 10:55 am
I really liked CareFirst. Other than the fact that there's a deductible to hit (minimal), their rates are reasonable, and their annual cap is quite low (~$2k/person last time I checked). Most in the District and surrounding areas accept it as well.
That said, I really wanted to join Kaiser, but their doctors are a good 10 miles away, which, as you know, is DC-parlance for up to 90 minutes one-way. That, and the fact that I can't get prescriptions at local pharmacies, meant that it wasn't as viable a choice. If you do live close enough though, that should probably change your considerations
Good point about distance. We are very close to several Kaiser facilities (5 minute drive to one and 10-15 minute drive to another). For CareFirst, most of my doctors are further away and more inconvenient to reach in DC traffic (although not TOO bad).
I'm leaning toward trying Kaiser. There's no deductible (CareFirst is $1,000/yr) and we can always switch during open enrollment next year.
Kaiser is opening new medical centers (in 2019) in Alexandria, Stafford and Haymarket.

texasdiver
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Re: Kaiser or CareFirst

Post by texasdiver » Sat Oct 13, 2018 12:29 pm

We are currently with Kaiser in the Pacific Northwest. Personally I can't say enough good things about it after many years of various PPOs I had when working as a Fed and in education (Blue Cross, Aetna, and I don't remember who all else). Also have family working for Kaiser so I get to see both sides.

Bottom line? Kaiser is fabulous for ordinary health maintenance and wellness. Everything is integrated and seamless and you never again have to worry about medical billing issues or that sort of hassle. Prescriptions can be filled entirely online and come in the mail for free the next day. Appointments can be easily scheduled online and you can switch doctors at any time for any reason as long as the new doctor is taking patients. And all your medical records, billing records, pharmacy prescriptions and everything else is online at a convenenient one-stop portal.

Where Kaiser sometimes falls short is in accute care for rare and complicated sorts of problems. You basically have to work your way up through the primary care physician into their specialists. So the system can be slow to escalate up to narrow specialists and the top outside facilities if you get struck with some kind of one-in-a-million sort of condition that requires highly unique outside expertise and care. Not saying you won't eventually get the care you need. Just that Kaiser's system of making the primary care physician the gateway and their understandable bias towards keeping all their patients "in-house" in the Kaiser system means they are going to be slow do do things like send you off to the Mayo Clinic or whatever other world class facility is where you need to go to see some specialist outside the Kaiser system.

For the ordinary family who just needs basic primary care, Kaiser is great. If you have rare and unusual conditions that require lots of outside consultation and care that goes beyond what Kaiser has to offer in your area then a PPO option may be better. Likewise if you require lots of hospitalization and the nearest Kaiser hospital is a long ways away then another option might be better that lets you more easily use the hospital of your choice in your own neighborhood.

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dm200
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Re: Kaiser or CareFirst

Post by dm200 » Sat Oct 13, 2018 12:33 pm

texasdiver wrote:
Sat Oct 13, 2018 12:29 pm
We are currently with Kaiser in the Pacific Northwest. Personally I can't say enough good things about it after many years of various PPOs I had when working as a Fed and in education (Blue Cross, Aetna, and I don't remember who all else). Also have family working for Kaiser so I get to see both sides.
Bottom line? Kaiser is fabulous for ordinary health maintenance and wellness. Everything is integrated and seamless and you never again have to worry about medical billing issues or that sort of hassle. Prescriptions can be filled entirely online and come in the mail for free the next day. Appointments can be easily scheduled online and you can switch doctors at any time for any reason as long as the new doctor is taking patients. And all your medical records, billing records, pharmacy prescriptions and everything else is online at a convenenient one-stop portal.
Where Kaiser sometimes falls short is in accute care for rare and complicated sorts of problems. You basically have to work your way up through the primary care physician into their specialists. So the system can be slow to escalate up to narrow specialists and the top outside facilities if you get struck with some kind of one-in-a-million sort of condition that requires highly unique outside expertise and care. Not saying you won't eventually get the care you need. Just that Kaiser's system of making the primary care physician the gateway and their understandable bias towards keeping all their patients "in-house" in the Kaiser system means they are going to be slow do do things like send you off to the Mayo Clinic or whatever other world class facility is where you need to go to see some specialist outside the Kaiser system.
For the ordinary family who just needs basic primary care, Kaiser is great. If you have rare and unusual conditions that require lots of outside consultation and care that goes beyond what Kaiser has to offer in your area then a PPO option may be better. Likewise if you require lots of hospitalization and the nearest Kaiser hospital is a long ways away then another option might be better that lets you more easily use the hospital of your choice in your own neighborhood.
From what I understand, some of these things vary from one kaiser area to another. Many decades ago, when Kaiser was much smaller here, I was even referred outside for a colonoscopy. Now, they do these all the time with in house folks. We are fortunate to not have any of these one in a million serious conditions.

texasdiver
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Re: Kaiser or CareFirst

Post by texasdiver » Sat Oct 13, 2018 12:34 pm

InvisibleAerobar wrote:
Sat Oct 13, 2018 10:55 am
I really liked CareFirst. Other than the fact that there's a deductible to hit (minimal), their rates are reasonable, and their annual cap is quite low (~$2k/person last time I checked). Most in the District and surrounding areas accept it as well.

That said, I really wanted to join Kaiser, but their doctors are a good 10 miles away, which, as you know, is DC-parlance for up to 90 minutes one-way. That, and the fact that I can't get prescriptions at local pharmacies, meant that it wasn't as viable a choice. If you do live close enough though, that should probably change your considerations
Here in the Pacific Northwest Kaiser does free mail order prescriptions that usually come the next day or in 2 days at the latest. Free as in free shipping, you still have co-pays sometimes. It's all online. I log into my Kaiser account, all my prescriptions are right there and I can fill them with a couple of clicks and entry of a credit card if there is a co-pay. I'm 5 minutes away from the nearest Kaiser pharmacy but I never bother to go wait in line, I just fill them all online.

texasdiver
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Re: Kaiser or CareFirst

Post by texasdiver » Sat Oct 13, 2018 12:39 pm

dm200 wrote:
Sat Oct 13, 2018 12:33 pm
texasdiver wrote:
Sat Oct 13, 2018 12:29 pm
We are currently with Kaiser in the Pacific Northwest. Personally I can't say enough good things about it after many years of various PPOs I had when working as a Fed and in education (Blue Cross, Aetna, and I don't remember who all else). Also have family working for Kaiser so I get to see both sides.
Bottom line? Kaiser is fabulous for ordinary health maintenance and wellness. Everything is integrated and seamless and you never again have to worry about medical billing issues or that sort of hassle. Prescriptions can be filled entirely online and come in the mail for free the next day. Appointments can be easily scheduled online and you can switch doctors at any time for any reason as long as the new doctor is taking patients. And all your medical records, billing records, pharmacy prescriptions and everything else is online at a convenenient one-stop portal.
Where Kaiser sometimes falls short is in accute care for rare and complicated sorts of problems. You basically have to work your way up through the primary care physician into their specialists. So the system can be slow to escalate up to narrow specialists and the top outside facilities if you get struck with some kind of one-in-a-million sort of condition that requires highly unique outside expertise and care. Not saying you won't eventually get the care you need. Just that Kaiser's system of making the primary care physician the gateway and their understandable bias towards keeping all their patients "in-house" in the Kaiser system means they are going to be slow do do things like send you off to the Mayo Clinic or whatever other world class facility is where you need to go to see some specialist outside the Kaiser system.
For the ordinary family who just needs basic primary care, Kaiser is great. If you have rare and unusual conditions that require lots of outside consultation and care that goes beyond what Kaiser has to offer in your area then a PPO option may be better. Likewise if you require lots of hospitalization and the nearest Kaiser hospital is a long ways away then another option might be better that lets you more easily use the hospital of your choice in your own neighborhood.
From what I understand, some of these things vary from one kaiser area to another. Many decades ago, when Kaiser was much smaller here, I was even referred outside for a colonoscopy. Now, they do these all the time with in house folks. We are fortunate to not have any of these one in a million serious conditions.
Yes, they do know what they are doing and here in the Northwest where Kaiser is big they still do have agreements with other outside hospitals and specialists for emergency care and so forth. So you aren't necessarily locked into Kaiser if they don't have what you need. I'm just pointing out that there can be a fairly bureaucratic process to get referred to specialists outside the Kaiser system. Which frankly is understandable because a tremendous number of Kaiser patients, especially those new to Kaiser, walk into the door expecting to be able to use their Kaiser card to see whatever doctor or specialist they want regardless of circumstance. And that's just not how Kaiser works. Everyone thinks they are a "special case" when usually they are not.
Last edited by texasdiver on Sat Oct 13, 2018 1:19 pm, edited 1 time in total.

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dm200
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Re: Kaiser or CareFirst

Post by dm200 » Sat Oct 13, 2018 1:05 pm

Yes, they do know what they are doing and here in the Northwest where Kaiser is big they still do have agreements with other outside hospitals and specialists for emergency care and so forth. So you aren't necessarily locked into Kaiser if they don't have what you need. I'm just pointing out that there can be a fairly bureaucratic process to get referred to specialists outside the Kaiser system. Which frankly is understandable because a tremendous number of Kaiser patients, especially those new to Kaiser walk into the door expecting to be able to use their Kaiser card to see whatever doctor of specialist they want regardless of circumstance. And that's just not how Kaiser works. Everyone things they are a "special case" when usually they are not.
A friend of mine (when he was on Kaiser) needed some kind of eyelid surgery - and Kaiser sent him to an outside eye surgeon that specialized in that sort of surgery.

Depending on the specialty (Cardiology and Hematology are ones I have had experience with), Kaiser PCPs will deal with specialists "behind the scenes" without the patient having to see the specialist in person. I find that very convenient. My PCP seems to always copy me on the feedback she gets from such specialists. It also happens very promptly. For some bureaucratic reason, my PCP received conflicting guidance from two cardiologists about me. After my PCP discussed this with me by phone, we solved the conflict by my seeing a Cardiologist in person - and the cardiologist resolved the issue to my satisfaction. I am a bit unusual in that I always review every test result, medication, office visit information, feedback from specialists, etc. If I do not understand or agree with anything, I ask (usually my PCP) and she is very responsive to my emails.

Back when we were with other health insurance plans, I recall that while we could pick almost any specialist, there was almost always a wait/delay to get an appointment. Our experience with Kaiser, however, is that we get the appointments with the specialists very promptly. Last year, for example. I emailed my PCP about a symptom on a Wednesday afternoon. She responded that I should see her if I believed I had an infection, but she would refer me to a Kaiser specialist if I did not. I replied that I did not have an infection -- and had the specialist appointment the next day (Thursday).

carruthers209
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Re: Kaiser or CareFirst

Post by carruthers209 » Sat Oct 13, 2018 1:58 pm

Kaiser's also has been an amazing resource when we vacationed in Hawaii and my husband ran out of his Parkinson's meds-big no-no-on a Sunday afternoon and no refills left on his prescription. We live in northern California and have had Kaiser's for almost 50 years. The Honolulu Kaiser's hospital gave him a new membership number to input him in their computer system, made a doctor's appointment that afternoon and after seeing the doctor, he walked over to the pharmacy department to pick up his necessary meds. So if you have a chronic disease or disability-and there's a Kaiser's facility where you are going to vacation, it could be an amazing benefit. The scary piece would have been an "out-of-network" hospital visit/doctor's visit/and pharmacy charge. Kaiser's is pretty much a one-shop-stop and we don't need to worry that some member of the emergency medical team at their hospital is out-of-network. (I read a lot of horror stories about that one where people have other medical coverage) I love Kaiser's and I hear about people who use fake addresses (relatives or whatever) to be in a covered zip code so that they can have Kaiser's medical services.

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dm200
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Re: Kaiser or CareFirst

Post by dm200 » Sat Oct 13, 2018 2:07 pm

carruthers209 wrote:
Sat Oct 13, 2018 1:58 pm
Kaiser's also has been an amazing resource when we vacationed in Hawaii and my husband ran out of his Parkinson's meds-big no-no-on a Sunday afternoon and no refills left on his prescription. We live in northern California and have had Kaiser's for almost 50 years. The Honolulu Kaiser's hospital gave him a new membership number to input him in their computer system, made a doctor's appointment that afternoon and after seeing the doctor, he walked over to the pharmacy department to pick up his necessary meds. So if you have a chronic disease or disability-and there's a Kaiser's facility where you are going to vacation, it could be an amazing benefit. The scary piece would have been an "out-of-network" hospital visit/doctor's visit/and pharmacy charge. Kaiser's is pretty much a one-shop-stop and we don't need to worry that some member of the emergency medical team at their hospital is out-of-network. (I read a lot of horror stories about that one where people have other medical coverage) I love Kaiser's and I hear about people who use fake addresses (relatives or whatever) to be in a covered zip code so that they can have Kaiser's medical services.
Wow! Great story. Unfortunately, Kaiser is only present in a few areas of the country.

Kaiser does, however, cover emergency and urgent care out of their areas - so maybe it would have worked out OK.

Big Dog
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Re: Kaiser or CareFirst

Post by Big Dog » Sat Oct 13, 2018 2:33 pm

We are very close to several Kaiser facilities (5 minute drive to one and 10-15 minute drive to another).
How close is the nearest Kaiser hospital? If within reasonable driving distance, Kaiser can be excellent.

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dm200
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Re: Kaiser or CareFirst

Post by dm200 » Sat Oct 13, 2018 2:36 pm

Big Dog wrote:
Sat Oct 13, 2018 2:33 pm
We are very close to several Kaiser facilities (5 minute drive to one and 10-15 minute drive to another).
How close is the nearest Kaiser hospital? If within reasonable driving distance, Kaiser can be excellent.
In this area (Washington DC) Kaiser does not have its own hospitals, but rather makes agreements with hospitals around the area -- and then puts Kaiser physicians there at such hospitals. Usually, Kaiser patients are in their own Kaiser wing/floor. As far as I know all such hospitals are in reasonable driving distance of most Kaiser participants.

wassabi
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Re: Kaiser or CareFirst

Post by wassabi » Sat Oct 13, 2018 4:26 pm

Thanks very much to everyone for all the great input. We decided to give Kaiser a shot. Your comments definitely helped us make the decision. :thumbsup :thumbsup

rxtra8
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Re: Kaiser or CareFirst

Post by rxtra8 » Sat Oct 13, 2018 4:36 pm

Also a Kaiser fan. I am in SCAL and Kaiser is everywhere here. I worked for them in pharmacy for 25 years and now have Kaiser in retirement. I would recommend Kaiser. What I really like is one stop shopping; see your MD, get blood test, X-ray, etc. plus RX if needed all in one place! Also per the good story when on vacation in Hawaii, I know that Kaiser will usually do what it takes to make the member happy. I have never had any issues using their services (and they did not know I also worked for them).
“The eye sees only what the mind is prepared to comprehend.” | — Robertson Davies

madbrain
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Re: Kaiser or CareFirst

Post by madbrain » Sat Oct 13, 2018 4:40 pm

dm200 wrote:
Sat Oct 13, 2018 2:07 pm
Wow! Great story. Unfortunately, Kaiser is only present in a few areas of the country.

Kaiser does, however, cover emergency and urgent care out of their areas - so maybe it would have worked out OK.
I can confirm that . I have been on vacation in other states and other countries where Kaiser is not present. I had to pay out of pocket, but Kaiser reimbursed me. The process did take some months, though. Medical care in other countries is a lot cheaper, though. For example, 2 nights in one of the best hospitals in Bangkok cost me about $1900 last year.

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dm200
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Re: Kaiser or CareFirst

Post by dm200 » Sat Oct 13, 2018 4:48 pm

wassabi wrote:
Sat Oct 13, 2018 4:26 pm
Thanks very much to everyone for all the great input. We decided to give Kaiser a shot. Your comments definitely helped us make the decision. :thumbsup :thumbsup
Good Luck! Hope you find a Primary Care Physician who works out.

My experience and opinion is that I almost never rely on patient experiences related to me. I am very, very happy with my Kaiser PCP for the last 7 years. However, if I search online - I find terrible reviews and I personally know two folks who cannot stand her and switched away. I am very glad I picked her seven years ago and glad I have paid no attention to folks who cannot stand her. Remember also, you can switch PCPs at any time for any (or no) reason - just a few mouse clicks when logged in.

I also encourage you to take full advantage of online services, virtual house-calls, advice lines, urgent care, telephone appointments, etc.

You might be different, but I almost always want a different Physician than my wife. She and I seem to have very different tastes in Primary care physicians. I have concluded that my PCP has a certain "demeanor" that my wife might interpret as not paying attention to her situation. In out 40+ years of marriage, there has only been a one year period when we had the same PCP.

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dm200
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Re: Kaiser or CareFirst

Post by dm200 » Sat Oct 13, 2018 4:50 pm

madbrain wrote:
Sat Oct 13, 2018 4:40 pm
dm200 wrote:
Sat Oct 13, 2018 2:07 pm
Wow! Great story. Unfortunately, Kaiser is only present in a few areas of the country.

Kaiser does, however, cover emergency and urgent care out of their areas - so maybe it would have worked out OK.
I can confirm that . I have been on vacation in other states and other countries where Kaiser is not present. I had to pay out of pocket, but Kaiser reimbursed me. The process did take some months, though. Medical care in other countries is a lot cheaper, though. For example, 2 nights in one of the best hospitals in Bangkok cost me about $1900 last year.
Wow! That is very, very good news that Kaiser paid.

madbrain
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Re: Kaiser or CareFirst

Post by madbrain » Sat Oct 13, 2018 4:58 pm

dm200 wrote:
Sat Oct 13, 2018 4:50 pm
Wow! That is very, very good news that Kaiser paid.
Not the first time, sadly. I get sick to various degrees on about 50% on my vacations. Never had a 2-day hospitalization until last year, though. This was food a serious case of food poisoning . There is one international clinic in Saigon that I have been to 3 times, for various reasons.
Kaiser never denied any of my international claims. Foreign claims are in general much cheaper than in the US for the same service.

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Re: Kaiser or CareFirst

Post by pamcnm » Sun Oct 14, 2018 9:33 am

As a Kaiser midwife in NorCal, I'm happy to see all these great recommendations for Kaiser!

I needed to undergo cancer treatment 6 years ago and I can't say enough good things about how wonderful it was to everything "integrated."

I need of orthopedic surgery in early 2019 and Kaiser will pay for me to have PT outside of KP, in the town where I live (about 35 miles from the hospital).

As a clinician, I have never been told not do something for a patient because it costs too much, and the inside messages from our management are very patient-centered.

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dm200
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Re: Kaiser or CareFirst

Post by dm200 » Sun Oct 14, 2018 3:32 pm

pamcnm wrote:
Sun Oct 14, 2018 9:33 am
As a Kaiser midwife in NorCal, I'm happy to see all these great recommendations for Kaiser!
I needed to undergo cancer treatment 6 years ago and I can't say enough good things about how wonderful it was to everything "integrated."
I need of orthopedic surgery in early 2019 and Kaiser will pay for me to have PT outside of KP, in the town where I live (about 35 miles from the hospital).
As a clinician, I have never been told not do something for a patient because it costs too much, and the inside messages from our management are very patient-centered.
Fortunately, I have not encountered these particular medical challenges, but my wife and I are very pleased with the ones we have encountered - from pancreatitis (hospitalization required) to gallbladder surgery to hernia surgery to hand surgery - etc.

Very good to know - certainly my perception -- as a patient. On several occasions, kaiser's response to my situations has been much more "aggressive" than what I (as a layperson) thought necessary.

texasdiver
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Re: Kaiser or CareFirst

Post by texasdiver » Sun Oct 14, 2018 10:25 pm

pamcnm wrote:
Sun Oct 14, 2018 9:33 am
As a Kaiser midwife in NorCal, I'm happy to see all these great recommendations for Kaiser!

I needed to undergo cancer treatment 6 years ago and I can't say enough good things about how wonderful it was to everything "integrated."

I need of orthopedic surgery in early 2019 and Kaiser will pay for me to have PT outside of KP, in the town where I live (about 35 miles from the hospital).

As a clinician, I have never been told not do something for a patient because it costs too much, and the inside messages from our management are very patient-centered.
My wife is a Kaiser clinician and out here in the kooky west she occasionally gets requests for referrals to some patient's favorite naturopath, homeopath, crystal healer, horse therapist, alternative vaccine therapist or whatever. Also lots of requests for emotional support animals. So yeah, they aren't going to pay for that. But normal medically-indicated referrals? Obviously.

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dm200
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Re: Kaiser or CareFirst

Post by dm200 » Mon Oct 15, 2018 11:52 am

texasdiver wrote:
Sun Oct 14, 2018 10:25 pm
pamcnm wrote:
Sun Oct 14, 2018 9:33 am
As a Kaiser midwife in NorCal, I'm happy to see all these great recommendations for Kaiser!
I needed to undergo cancer treatment 6 years ago and I can't say enough good things about how wonderful it was to everything "integrated."
I need of orthopedic surgery in early 2019 and Kaiser will pay for me to have PT outside of KP, in the town where I live (about 35 miles from the hospital).
As a clinician, I have never been told not do something for a patient because it costs too much, and the inside messages from our management are very patient-centered.
My wife is a Kaiser clinician and out here in the kooky west she occasionally gets requests for referrals to some patient's favorite naturopath, homeopath, crystal healer, horse therapist, alternative vaccine therapist or whatever. Also lots of requests for emotional support animals. So yeah, they aren't going to pay for that. But normal medically-indicated referrals? Obviously.
Yes - amazing what some folks desire for health/medical care.

In this area (Washington DC), Kaiser has grown so much over the years that they now have almost every type of specialty covered by Kaiser Physicians.

jalbert
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Re: Kaiser or CareFirst

Post by jalbert » Mon Oct 15, 2018 11:55 am

wassabi wrote:
Sat Oct 13, 2018 9:51 am
I'm switching jobs in the next few months and taking a federal job in the Washington DC area. I've always had CareFirst and my spouse uses Kaiser. The federal government offers excellent coverage and rates for plans with both providers so we'd like to get on the same plan going forward.

My spouse likes that Kaiser has their own network in which everything is linked. She can email doctors via the app, check test results, schedule appointments, and her doctors are able to review her records prior to any appointments.

I like CareFirst because I don't need a referral to see a specialist and I can choose any doctor I want at any time.

We've both had some minor health issues the past few years but do not anticipate any serious health problems in the near future. We both take one medication each that we will need to continue taking going forward.

With that said, I don't think we can go wrong with either option but I'd be interested to know if any Bogleheads have any opinions for best value health insurance in the DC area.
What problem is being solved by having one of you move to the provider that is not the first choice of that person?
Risk is not a guarantor of return.

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dm200
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Re: Kaiser or CareFirst

Post by dm200 » Mon Oct 15, 2018 12:11 pm

wassabi wrote:
Sat Oct 13, 2018 4:26 pm
Thanks very much to everyone for all the great input. We decided to give Kaiser a shot. Your comments definitely helped us make the decision. :thumbsup :thumbsup
Good Luck! Maybe we will cross paths sometime at a Kaiser facility. :happy

I would go online and pick a Primary Care Physician. Remember that if you do not like him/her - you can always switch to another PCP (who is available) at any time for any reason. There is a wide variety of PCPs and backgrounds.

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dm200
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Re: Kaiser or CareFirst

Post by dm200 » Mon Oct 15, 2018 2:31 pm

jalbert wrote:
Mon Oct 15, 2018 11:55 am
wassabi wrote:
Sat Oct 13, 2018 9:51 am
I'm switching jobs in the next few months and taking a federal job in the Washington DC area. I've always had CareFirst and my spouse uses Kaiser. The federal government offers excellent coverage and rates for plans with both providers so we'd like to get on the same plan going forward.
My spouse likes that Kaiser has their own network in which everything is linked. She can email doctors via the app, check test results, schedule appointments, and her doctors are able to review her records prior to any appointments.
I like CareFirst because I don't need a referral to see a specialist and I can choose any doctor I want at any time.
We've both had some minor health issues the past few years but do not anticipate any serious health problems in the near future. We both take one medication each that we will need to continue taking going forward.
With that said, I don't think we can go wrong with either option but I'd be interested to know if any Bogleheads have any opinions for best value health insurance in the DC area.
What problem is being solved by having one of you move to the provider that is not the first choice of that person?
A married couple on the same employer plan will spend less on premiums than if one is on Kaiser and the other on CareFirst. The OP did post that and, based on information here, he will try Kaiser.

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dm200
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Re: Kaiser or CareFirst

Post by dm200 » Mon Oct 15, 2018 3:57 pm

Some married folks like to have the same Primary Care Physician -- and some do not. My wife and I, 40+ years of marriage, have only had the same PCP for a brief one year period.

We have very different interpretations and perceptions of the various types of Physicians - not sure why exactly.

Perhaps completely unwarranted, but I sometimes think if we had the same physician - my wife and the physician would get together and give me a hard time. :)

Based on knowing my wife and looking at online profiles of available physicians (primary care) - I made a recommendation to my wife and my wife picked that PCP. My wife is very happy. I am also near certain that my PCP's "demeanor" would not be at all satisfactory to my wife. I have been very, very happy with my PCP for the last almost 8 years.

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Re: Kaiser or CareFirst

Post by texasdiver » Mon Oct 15, 2018 5:30 pm

dm200 wrote:
Mon Oct 15, 2018 2:31 pm
jalbert wrote:
Mon Oct 15, 2018 11:55 am
wassabi wrote:
Sat Oct 13, 2018 9:51 am
I'm switching jobs in the next few months and taking a federal job in the Washington DC area. I've always had CareFirst and my spouse uses Kaiser. The federal government offers excellent coverage and rates for plans with both providers so we'd like to get on the same plan going forward.
My spouse likes that Kaiser has their own network in which everything is linked. She can email doctors via the app, check test results, schedule appointments, and her doctors are able to review her records prior to any appointments.
I like CareFirst because I don't need a referral to see a specialist and I can choose any doctor I want at any time.
We've both had some minor health issues the past few years but do not anticipate any serious health problems in the near future. We both take one medication each that we will need to continue taking going forward.
With that said, I don't think we can go wrong with either option but I'd be interested to know if any Bogleheads have any opinions for best value health insurance in the DC area.
What problem is being solved by having one of you move to the provider that is not the first choice of that person?
A married couple on the same employer plan will spend less on premiums than if one is on Kaiser and the other on CareFirst. The OP did post that and, based on information here, he will try Kaiser.
That may be the case in the OP's situation but it isn't always the case. At one point in time, both my wife and I had our own employer-provided health coverages. Each employer set aside X-dollars per month (about $500) for each of us to use towards purchasing group coverage. If we went on a family plan with one employer we would have gotten just one $500 subsidy and given up the other. We chose to have separate plans from each employer and got the full subsidy from each employer. My wife was on an individual plan with her employer and I was on an employer and children plan with my employer (excluding the spouse). It ended up saving about $500/month in premiums. In the end it may not have actually saved quite that much because we ended up with two separate deductibles. But since we were basically just doing annual checkups and nothing more it ended up being substantially cheaper to go with two separate individual plans. At the time I calculated we were saving about $6000 per year to do it that way.

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Re: Kaiser or CareFirst

Post by dm200 » Mon Oct 15, 2018 5:36 pm

texasdiver wrote:
Mon Oct 15, 2018 5:30 pm
dm200 wrote:
Mon Oct 15, 2018 2:31 pm
jalbert wrote:
Mon Oct 15, 2018 11:55 am
wassabi wrote:
Sat Oct 13, 2018 9:51 am
I'm switching jobs in the next few months and taking a federal job in the Washington DC area. I've always had CareFirst and my spouse uses Kaiser. The federal government offers excellent coverage and rates for plans with both providers so we'd like to get on the same plan going forward.
My spouse likes that Kaiser has their own network in which everything is linked. She can email doctors via the app, check test results, schedule appointments, and her doctors are able to review her records prior to any appointments.
I like CareFirst because I don't need a referral to see a specialist and I can choose any doctor I want at any time.
We've both had some minor health issues the past few years but do not anticipate any serious health problems in the near future. We both take one medication each that we will need to continue taking going forward.
With that said, I don't think we can go wrong with either option but I'd be interested to know if any Bogleheads have any opinions for best value health insurance in the DC area.
What problem is being solved by having one of you move to the provider that is not the first choice of that person?
A married couple on the same employer plan will spend less on premiums than if one is on Kaiser and the other on CareFirst. The OP did post that and, based on information here, he will try Kaiser.
That may be the case in the OP's situation but it isn't always the case. At one point in time, both my wife and I had our own employer-provided health coverages. Each employer set aside X-dollars per month (about $500) for each of us to use towards purchasing group coverage. If we went on a family plan with one employer we would have gotten just one $500 subsidy and given up the other. We chose to have separate plans from each employer and got the full subsidy from each employer. My wife was on an individual plan with her employer and I was on an employer and children plan with my employer (excluding the spouse). It ended up saving about $500/month in premiums. In the end it may not have actually saved quite that much because we ended up with two separate deductibles. But since we were basically just doing annual checkups and nothing more it ended up being substantially cheaper to go with two separate individual plans. At the time I calculated we were saving about $6000 per year to do it that way.
Yes - always check out the choices and net costs.

You know you are old when employer plans did not have an annual "deductible" ;)

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Re: Kaiser or CareFirst

Post by Jazztonight » Tue Oct 16, 2018 11:02 am

Glad to hear the OP is giving Kaiser a try. My DW and I have been happy with the care we've received there since 1983.

My PCP is great, and DW feels the same about hers. We have always gotten referrals to excellent specialists. Some of my own colleagues have worked at Kaiser (I did not) and have had good careers. Their medical records systems are high tech, and most services are under one roof (or in one campus), which means less hassles. Often a doctor will send you down for a lab test or Xray, and then you'll come back up with the results. It's really a good system.

They even have a very organized volunteer system; I was a volunteer musician at Kaiser for about 10 years.

Good luck!
"What does not destroy me, makes me stronger." Nietzsche

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Re: Kaiser or CareFirst

Post by dm200 » Tue Oct 16, 2018 4:24 pm

Jazztonight wrote:
Tue Oct 16, 2018 11:02 am
Glad to hear the OP is giving Kaiser a try. My DW and I have been happy with the care we've received there since 1983.
My PCP is great, and DW feels the same about hers. We have always gotten referrals to excellent specialists. Some of my own colleagues have worked at Kaiser (I did not) and have had good careers. Their medical records systems are high tech, and most services are under one roof (or in one campus), which means less hassles. Often a doctor will send you down for a lab test or Xray, and then you'll come back up with the results. It's really a good system.
They even have a very organized volunteer system; I was a volunteer musician at Kaiser for about 10 years.
Good luck!
In this area, though, some specialties have moved to a different facility than my PCP - a very minor "inconvenience"

BUT - you can get lab tests done at any facility and use any pharmacy.

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Re: Kaiser or CareFirst

Post by Jazztonight » Tue Oct 16, 2018 5:20 pm

dm200 wrote:
Tue Oct 16, 2018 4:24 pm
Jazztonight wrote:
Tue Oct 16, 2018 11:02 am
Glad to hear the OP is giving Kaiser a try. My DW and I have been happy with the care we've received there since 1983.
My PCP is great, and DW feels the same about hers. We have always gotten referrals to excellent specialists. Some of my own colleagues have worked at Kaiser (I did not) and have had good careers. Their medical records systems are high tech, and most services are under one roof (or in one campus), which means less hassles. Often a doctor will send you down for a lab test or Xray, and then you'll come back up with the results. It's really a good system.
They even have a very organized volunteer system; I was a volunteer musician at Kaiser for about 10 years.
Good luck!
In this area, though, some specialties have moved to a different facility than my PCP - a very minor "inconvenience"

BUT - you can get lab tests done at any facility and use any pharmacy.
Yes, true. Even at our facility, which is big, we occasionally have to go to other locations for a particular service or treatment.
"What does not destroy me, makes me stronger." Nietzsche

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Re: Kaiser or CareFirst

Post by dm200 » Tue Oct 16, 2018 6:12 pm

Jazztonight wrote:
Tue Oct 16, 2018 5:20 pm
dm200 wrote:
Tue Oct 16, 2018 4:24 pm
Jazztonight wrote:
Tue Oct 16, 2018 11:02 am
Glad to hear the OP is giving Kaiser a try. My DW and I have been happy with the care we've received there since 1983.
My PCP is great, and DW feels the same about hers. We have always gotten referrals to excellent specialists. Some of my own colleagues have worked at Kaiser (I did not) and have had good careers. Their medical records systems are high tech, and most services are under one roof (or in one campus), which means less hassles. Often a doctor will send you down for a lab test or Xray, and then you'll come back up with the results. It's really a good system.
They even have a very organized volunteer system; I was a volunteer musician at Kaiser for about 10 years.
Good luck!
In this area, though, some specialties have moved to a different facility than my PCP - a very minor "inconvenience"
BUT - you can get lab tests done at any facility and use any pharmacy.
Yes, true. Even at our facility, which is big, we occasionally have to go to other locations for a particular service or treatment.
Before electronic records at Kaiser, if I had an appointment with a specialist -- I had to wait 2-3 days so that my paper records folder could be shipped from my "home" center to the center where the specialist was located. Now, all of the Kaiser providers have instant access to my records online. :)

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Re: Kaiser or CareFirst

Post by madbrain » Tue Oct 16, 2018 8:09 pm

dm200 wrote:
Mon Oct 15, 2018 5:36 pm
You know you are old when employer plans did not have an annual "deductible" ;)
I have never had a deductible on any Kaiser employer plan so far in over 20 years.
Other plans usually do have deductibles.

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Re: Kaiser or CareFirst

Post by dm200 » Wed Oct 17, 2018 1:42 pm

madbrain wrote:
Tue Oct 16, 2018 8:09 pm
dm200 wrote:
Mon Oct 15, 2018 5:36 pm
You know you are old when employer plans did not have an annual "deductible" ;)
I have never had a deductible on any Kaiser employer plan so far in over 20 years.
Other plans usually do have deductibles.
Yes - never had a deductible with Kaiser employer plan either.

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Re: Kaiser or CareFirst

Post by texasdiver » Wed Oct 17, 2018 2:23 pm

dm200 wrote:
Wed Oct 17, 2018 1:42 pm
madbrain wrote:
Tue Oct 16, 2018 8:09 pm
dm200 wrote:
Mon Oct 15, 2018 5:36 pm
You know you are old when employer plans did not have an annual "deductible" ;)
I have never had a deductible on any Kaiser employer plan so far in over 20 years.
Other plans usually do have deductibles.
Yes - never had a deductible with Kaiser employer plan either.
We have a deductible with our Kaiser employee plan but that's because we choose to. We have a choice between the Kaiser Core Plan with no (or very low) deductibles that costs $47.54 every bi-weekly pay period. Or the Kaiser HD plan that costs $0 per pay period and comes with an HSA account that Kaiser puts $2000 in per year. We have been coming out way ahead with the HD plan, pocketing the $2000 HSA contribution every year and saving about $1200 per year on savings on premiums (and another $1500 or so on tax deduction with our own HSA contributions) since we barely ever spend any money on healthcare and all the annual well child checkup and vaccinations are covered anyway. We'd need to be spending $5000/year on heathcare just to break even and we don't come close to that.

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Re: Kaiser or CareFirst

Post by dm200 » Wed Oct 17, 2018 2:27 pm

texasdiver wrote:
Wed Oct 17, 2018 2:23 pm
dm200 wrote:
Wed Oct 17, 2018 1:42 pm
madbrain wrote:
Tue Oct 16, 2018 8:09 pm
dm200 wrote:
Mon Oct 15, 2018 5:36 pm
You know you are old when employer plans did not have an annual "deductible" ;)
I have never had a deductible on any Kaiser employer plan so far in over 20 years.
Other plans usually do have deductibles.
Yes - never had a deductible with Kaiser employer plan either.
We have a deductible with our Kaiser employee plan but that's because we choose to. We have a choice between the Kaiser Core Plan with no (or very low) deductibles that costs $47.54 every bi-weekly pay period. Or the Kaiser HD plan that costs $0 per pay period and comes with an HSA account that Kaiser puts $2000 in per year. We have been coming out way ahead with the HD plan, pocketing the $2000 HSA contribution every year and saving about $1200 per year on savings on premiums (and another $1500 or so on tax deduction with our own HSA contributions) since we barely ever spend any money on healthcare and all the annual well child checkup and vaccinations are covered anyway. We'd need to be spending $5000/year on heathcare just to break even and we don't come close to that.
Interesting.

So, if you have a condition where you see your Kaiser Physician, you would pay "full price" for the office visit until the deductible is met for the year?

What about the, normally, free things like email with doctors, telephone appointments, virtual housecalls?

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Re: Kaiser or CareFirst

Post by texasdiver » Wed Oct 17, 2018 4:24 pm

dm200 wrote:
Wed Oct 17, 2018 2:27 pm
texasdiver wrote:
Wed Oct 17, 2018 2:23 pm
dm200 wrote:
Wed Oct 17, 2018 1:42 pm
madbrain wrote:
Tue Oct 16, 2018 8:09 pm
dm200 wrote:
Mon Oct 15, 2018 5:36 pm
You know you are old when employer plans did not have an annual "deductible" ;)
I have never had a deductible on any Kaiser employer plan so far in over 20 years.
Other plans usually do have deductibles.
Yes - never had a deductible with Kaiser employer plan either.
We have a deductible with our Kaiser employee plan but that's because we choose to. We have a choice between the Kaiser Core Plan with no (or very low) deductibles that costs $47.54 every bi-weekly pay period. Or the Kaiser HD plan that costs $0 per pay period and comes with an HSA account that Kaiser puts $2000 in per year. We have been coming out way ahead with the HD plan, pocketing the $2000 HSA contribution every year and saving about $1200 per year on savings on premiums (and another $1500 or so on tax deduction with our own HSA contributions) since we barely ever spend any money on healthcare and all the annual well child checkup and vaccinations are covered anyway. We'd need to be spending $5000/year on heathcare just to break even and we don't come close to that.
Interesting.

So, if you have a condition where you see your Kaiser Physician, you would pay "full price" for the office visit until the deductible is met for the year?

What about the, normally, free things like email with doctors, telephone appointments, virtual housecalls?
All the preventative care is free (annual checkups, vaccinations, etc) as are all the virtual visits via email or phone. Also preventitive care prescriptions like my statin for cholesterol are free. What you pay for is any non-preventative care visits, prescriptions, and labs until the deductible is met. We've only had a small handful of out of pocket charges in the past 3 years. An acne care dermatology visit by one of the teens and some blood-in-urine related lab work and ultrasound I had done. But with Kaiser, the "full price" isn't some ridiculous out-of-network exhorbitant charge you might see at a private hospital. They were reasonable fees in the $150 range each time. No ridiculous $1000 bills for some out of network lab or quick office procedure or anything like that.

So we've probably had well less than $500 in out of pocket costs per year in the past 3 years and have never gotten remotely close to our $4000 family deductible. And even if we do hit our $4000 deductible we still come out ahead. We start out the year $3300 ahead due to the lower premium and employer HSA contribution. And we get well over $700 in tax deductions from our own HSA contributions. At this point we have built up such a high balance in our HSA that we could go for many years paying the entire $4000 deductible out of the HSA each year and never deplete the balance. In fact it would continue to grow. So what's not to like?

Kaiser has clearly designed their system to incentivize employees to go with the HD plan with the companion HSA account because it probably minimizes a lot of ticky-tack office visits by some frequent flyer types who like to run to the clinic every time they or one of their kids gets the sniffles.

NOTE: This is our experience with the Kaiser plan that my wife receives as a Kaiser employee here in the Pacific Northwest. The Kaiser plans that are offered through non-Kaiser employers are likely different and come in different flavors. For example, I had a Kaiser option through my school district that was completely different (with different deductibles and such) which I declined because I was already on my wife's plan. It was still a decent plan, it was just redundant so I didn't pay for it and I honestly don't know how different it was because I didn't bother to cross-compare each line item. I'm not sure how may different flavors of Kaiser coverage exist out there. I know that my teacher's union was negotiating all kinds of different aspects of the coverage and costs with Kaiser and the district so I imagine the same thing is happening elsewhere and one employer's Kaiser plan may be different from another's.

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dm200
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Re: Kaiser or CareFirst

Post by dm200 » Wed Oct 17, 2018 6:30 pm

Yes - like so many different types of insurance and providers, I suspect that if there are ten Kaiser patients in the waiting room with you, each one may have a different plan and charges related to the visit.

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