+- Punaweb Forum (http://punaweb.org/forum)
+-- Forum: Punaweb Forums (http://punaweb.org/forum/forumdisplay.php?fid=3)
+--- Forum: Punatalk (http://punaweb.org/forum/forumdisplay.php?fid=10)
+--- Thread: Health Insurance (/showthread.php?tid=1770)
RE: Health Insurance - Les C - 01-19-2008
Kaiser can be very picky about who they allow into their program. I was a former member and they rejected me because of a pre-existing condition which was diagnosed whilst under their care.
HMSA has a conversion plan that guarantees(?) enrollment as long as you are still covered or within a certain timeframe of the end of your previous coverage; pre-existing conditions don't seem to matter. I think this is what Nalu descibed; it's an individual plan. There is no prescription coverage. The person (in Honolulu) with whom we arranged for our conversion over the phone was very, very nice, helpful, and understanding! She did an exceptional job of explaining our options to us. I don't know if this was just this person, or if it's how HMSA trains its staff to conduct business.
Getting HMSA through an employer can make a significant difference, especially with the prescription coverage. For HMSA, you will need to tell them what doctor/plan area you want, which means that you may have to check with the doctor first to see if they are taking new patients. You will get a book of plan participants to choose from when you ask for information on their coverage. You will see that most of the participants are not taking new patients. Some physicians will have stopped taking new patients since the printing of the book. But don't despair, you should be able to find someone. You may have to widen your selection criteria. HMSA's magazine has an article that talks about what they are doing to improve and increase service to neighbor islands.
We found decent care at Kea'au Family Health Center which is part of the Bay Clinic group. The Bay Clinic recently has been raked over the coals in the media, probably because they deserved it. But they have apparently gone through some changes in administration and have been improving their operation.
On a side note, in an interview in the HMSA member magazine with the organization's CFO, he states that since the group's inception, (1908?, 1930's?) their financial model has been to not make a profit. He says that 93% of their budget is spent on patient care and 7% on operating costs. I don't know if these figures are typical or unusual. I like that philosophy!
RE: Health Insurance - Kelena - 01-19-2008
This is why it is very important that we have a national health care system in America. We simply cannot afford to continue with this hodge podge nightmare that passes for a system. Children can have insurance in some states, but not others; we hold walk-a-thons when someone in the community is hit with a catastrophic illness; you have to sign up for classes to get health insurance; keiki covered here, not covered there. In the meantime, citizens in Canada, Germany, Britain, France get health care without having to walk through a labyrinth. What a national embarrassment.
By the way, there is a bill before Congress that would provide inducements for new doctors to serve rural areas (forgiveness of loans). Hawaii needs to support that bill.
And you know what to do in November.
RE: Health Insurance - Nalu - 01-19-2008
We had a choice to do the PPPO conversion plan, and that meant guaranteed acceptance and no one year waiting period, but the monthly fees for a family were $658., so we took our chances and did the indiviual care plan and jumped through the hoops. I agree, definately make sure there are drs. taking new patients first, I would call HMSA and ask them directly for a list, that's what I did, rather than trying to sift through pages of "NO's". Our plan is here:
http://hmsa.com/healthplans/individual/icp/default.aspx
Aloha, Angela
RE: Health Insurance - Carolann R - 01-19-2008
The State plan we will be covered under soon will cost us about $350 per month for Health, Prescription, Eye and Dental (I think Chiropractic as well)...it's just for Tony and myself. We're gonna go with the HMSA - coverage is actually a little better than what we'd get wtih Kaiser. The good thing about working for the State is that pre-existing conditions don't matter if you are a State employee.
Carrie
http://www.carrierojo.etsy.com
http://www.vintageandvelvet.blogspot.com
http://thedb.com/vintageandvelvet
"Freedom has a scent like the top of a newborn baby's head..." U2
RE: Health Insurance - macuu222 - 01-19-2008
I realize this is alittle bit off topic but we had an emergency today that required to doctor in a hurry. So we drove to Urgent Care in Hilo on Kinoole. Guess what ? They are closed on weekends. Never heard of an urgent care facility that didn't do weekends! So we went to the other Urgent Care facility...but they don't accept Blue Cross/Blue Shield of Hawaii. So we then had to go to the ER. Took approx 4 hours to see the doctor.
I talked briefly about it with Dr. King from the ER and he said it really doesn't matter how great your insurance is. The whole island is severely understaffed of doctors and that translates to LIMITED HOURS to the public, NO NEW PATIENT's and limited insurance options.
RE: Health Insurance - Carey - 01-19-2008
Hopefully, having Hilo as an extension teaching hospital for UH med school will bring some new doctors on island, and hopefully some will 'stick'. (everyone remember to be REALLY nice to the newbies so they WANT to stay here...) Also, with the pharmacology college opeing at UH HIlo, hipefully we will also have more locally trained pharmacists.
Although the HMSA policy through the university is fairly expensive, if you add their tuition to the insurance, you are still paying less than most students pay for tuition alone at most state schools, and UH-Hilo has some top rated instructors (it blows me away when I meet students from other institutions. When they hear that I am taking a class taught by the author of the textbook they are using at a more 'prestigious' school, and then they hear what the class sizes are at UH-H - more like a private school than a state university, oh the green eyes I get! Like anything on this island, the university is small enough that you really get to know everyone, of course this is not good if you want to 'dissolve' into the backdrop of a big school)
RE: Health Insurance - missydog1 - 01-19-2008
yes, the "not taking new patients" situation is serious. None of the doctors who take my insurance are taking new patients. And I have asked every one I meet working at a health care facility if they can suggest anyone, and they all say no.
People are moving here in droves but doctors are moving away. The population is getting older. Do the math.
I read that Hawai`i's malpractice laws are causing doctors to move away, that and the relative cost of living in proportion to income. It's all very well for the state to help out with insurance coverage, but it's an empty assistance if no one takes the insurance.
Then the ER can't function properly either because people have to go there for problems that could easily be dealt with in office visits, if people could get appointments.
Then there's the specialist issue... wait til you get told you have to fly to Oahu to see someone. The Big Island no longer has either a neurologist or a rheumatologist, I know for sure. The rheumatologist comes here periodically, but only sees new patients in Oahu.
I had a hand injury that needed surgery. There is a hand surgeon who comes here, Dr. Singer, but I couldn't wait a month until his next visit, so I had to fly to Queen's, pay over $100 for a room the night before, plus an inter-island ticket, none of which was covered, plus the co-pay of $600 or so. (Including $250 for two scripts they handed me while I was still woozy, not covered by my insurance because the hospital dispensed them)
I met one young woman with a chronic sinus infection who got referred to an ENT specialist here on the island. She was referred last summer and the first appointment they could give her was MAY 2008. That is just beyond my tolerance.
My little grandson has now been medivaced to Oahu at least a half dozen times because pediatric crises here are handled at Kapiolani on Oahu, not here on island. Same with pregnancy complications and preemies.
Don't kid yourself. This is not paradise when it comes to medical. It is brutal.
If I do move away from the islands, it will be because the medical system sucks.
ed to add --
if you've been here for awhile and are nicely established with a physician, you may well not have any idea what it's like trying to get established, here and now. My doctor cut his practice ... yes, they can do that, and close their doors, and leave you in the cold. Five years ago when I moved here I got a primary care physician without much looking, but due to the practice trimming, here I am, looking ...
I found one doctor taking new patients, but I had to answer a series of questions, like a job application. If he likes the answers he may accept you. Among the "no's" were -- no back pain, no neck pain, no one on any kind of pain medication. It sounded like he was screening for drug users, and I get that drug seekers are a pain. But the questions weren't designed to separate drug addicts from non addicts. A lot of people have some kind of chronic pain, and it's kind or rough that a doctor won't see you if you hurt ...
As it happens I'm not on pain medication, and assured them I'm not looking for any, but they still didn't call me back. Sigh.
RE: Health Insurance - gtill - 01-21-2008
I'll have 2 years of very high payments with Kaiser till my meicare kicks in, as a continuation of a policy we've had at my work.
Otherwise we couldn't come back and I couldn't retire.
But for the Canadian System, nationalised health care. My aunt died of stomach cancer, waiting for an appointment, diagnosed after 2 years of tests, they scheduled her a 3 month wait, she died before 2! A close uncle nearly same thing. US facilities get a lot of private business from Canada.
Previously, there were a lot of docs here who loved the isles, but they said back then the red tape here is terrible, then came the malpractice,today they,re mostly gone.
Forbes magazine is read by a lot of people. Then we refuse a multi million navy offer for a research program, but too militant. Even require you to keep military secrets. Now no superferry!
But help us anyway!
RE: Health Insurance - Kelena - 01-21-2008
We stayed at a motel on Vancouver Island, in Nanaimo. Very clean, pristine renovated motel with a view of the bay. The innkeeper was very friendly and knowledgeable. He had a wife and a daughter about 7. At the time, we were considering relocating to British Columbia. I noticed that a lot of people spoke French (I have a B.A. in French and attended the Sorbonne, in Paris). He said yeah, my daughter goes to an immersion school. "Private?" I asked. He said no, it's public school. Then I asked about health care. He was a vigorous guy in his 40's, but he told me he had had a HIP replacement (genetic predisposition). He said it was really easy and cost him -- I remember this clearly-- $40. He had it done in Vancouver (about two hours away by ferry). There was a little wait but no one had to hold a telethon. His neighbors did not have to march in front of the hospital begging for services. No one had to hold a pancake breakfast. He and his wife just drove on to the Ferry, crossed the sound, drove down to Vancouver, checked in, they did the operation. He stayed in the hospital until he healed, and then he came home the same way he got there.
Do they give something up? You betcha. But all of our taxes go to support a $15 billion a month war in Iraq.
What amazed me is that the island (Vancouver Island) had no trouble attracting doctors, he told me.
Health care in America is....oh, what's the word I am looking for......starts with an "f"....has a "u" in it....I can't remember, but the French, who have Universal Health Care, would say that health care in America is "foutu".
RE: Health Insurance - Johnnycake - 01-21-2008
Wow! I better start making some friends with physicians as soon as I get there! But, seriously..sounds like the health care situation, or lack there of is alot more serious of a problem than the mainland.
Thank you all for opening my eyes and helping me and others I'm sure, be as prepared as one can be on this issue.
Mahalo.