Kaiser (and HMOs in general) have a number of downsides:
1) You are only allowed to deal with their doctors / hospitals / approved people, this becomes problematic if you travel a fair amount.
2) Much higher out of pocket expenses if you go outside of Kaiser for anything
3) According to friends who have had them their billing is a giant mess, and apparently you get hit with a co-pay for each department you end up seeing.
Generally speaking, ask Brian about Kaiser and why he's not on it anymore.
I've generally gone with PPOs (preferred provider organization) which instead of having giant scary complexes like Kaiser, they contract with a list of doctors, specialists, etc to create an "in network".
Upsides:
- You can see anyone if they are in network, the options available all have nationwide coverage. For example, doctors in Iowa cost me the same as doctors in California.
Downsides:
- co-pays can be slightly higher
- there's in-network vs. out-of-network nonsense to deal with. You can still see out of network people with PPOs but they cost you more.
Both Brian and my general rule of thumb is go PPO (blue cross or blue shield in California since they are separate, though I think one of them is now Anthem) if your employer pays all of the costs, get the most expensive plan. If they don't cover the most expensive plan fully take a look at the differences between the most expensive they will fully cover and any other options. It will usually come down to co-pays and various maximums, but if your ok with the most expensive one your employer will pay - take that. If not take the more expensive one and accept some monthly payment for that.
Vision and Dental are separate from medical, though the rule of thumb generally holds.
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timeasmymeasure
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Date: January 4th, 2011 07:13 pm (UTC)1) You are only allowed to deal with their doctors / hospitals / approved people, this becomes problematic if you travel a fair amount.
2) Much higher out of pocket expenses if you go outside of Kaiser for anything
3) According to friends who have had them their billing is a giant mess, and apparently you get hit with a co-pay for each department you end up seeing.
Generally speaking, ask Brian about Kaiser and why he's not on it anymore.
I've generally gone with PPOs (preferred provider organization) which instead of having giant scary complexes like Kaiser, they contract with a list of doctors, specialists, etc to create an "in network".
Upsides:
- You can see anyone if they are in network, the options available all have nationwide coverage. For example, doctors in Iowa cost me the same as doctors in California.
Downsides:
- co-pays can be slightly higher
- there's in-network vs. out-of-network nonsense to deal with. You can still see out of network people with PPOs but they cost you more.
Both Brian and my general rule of thumb is go PPO (blue cross or blue shield in California since they are separate, though I think one of them is now Anthem) if your employer pays all of the costs, get the most expensive plan. If they don't cover the most expensive plan fully take a look at the differences between the most expensive they will fully cover and any other options. It will usually come down to co-pays and various maximums, but if your ok with the most expensive one your employer will pay - take that. If not take the more expensive one and accept some monthly payment for that.
Vision and Dental are separate from medical, though the rule of thumb generally holds.