+- 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: Kaiser turned us down - need broker maybe? (/showthread.php?tid=6148)
RE: Kaiser turned us down - need broker maybe? - Sandra A. - 09-15-2009
Kaiser is my insurance. I left them for a several months and then tried to come back on an "individual" plan (no employer involved). I applied and ooops...Denied...oh it was my previous back problems. Being self-employed they have that right to deny. I filed an appeal, it took 2 months but I am back on! They have one year to monitor me, my health has to remain the same during that year. Whatever...no problem, it will! I have had Kaiser for over 10 years. For living here, Kaiser is my choice. A clue for dealing with Kaiser is this: they will give you what you want, it's just that you may have to push it. The thing about them is that if you really get ill, they will fly you anywhere for the best treatment without any cap-out limitations.
RE: Kaiser turned us down - need broker maybe? - Carey - 09-15-2009
Glen - HAVE to take classes???? at my age, it is a privilege to take classes (and if you are taking classes for the insurance, you really can have a lot of fun with it....). Added plus: I am seeing more of my O.F. friends on campus, and all of us are getting a great vibe just being on the campus!
DTisme, For what you are paying a month, you could enroll in the university and pay for the insurance and still save money! (and if you qualify, you could even get scholarships to cover some, or all, of it!)
RE: Kaiser turned us down - need broker maybe? - kani-lehua - 09-15-2009
the only thing is though, it's hard to find a doctor accepting new patients. with kaiser, someone has to see you.
"chaos reigns within.
reflect, repent and reboot.
order shall return."
microsoft error message with haiku poetry
RE: Kaiser turned us down - need broker maybe? - Carey - 09-15-2009
We just started with HMSA - the same that the university uses - with Jimbos new job. There were a handful of Drs. listed on each side of the island that were taking new patients. I selected one (board certified) in Hilo, though there was even one in Keaau, and Jimbo selected one on the OTHER side.
So far pleased with each, but it has only been a few uneventful months :~)
ETA: We did have Kaiser, & I liked the Dr I had (she was a diver) but she moved back mainland & Jim's retirement health plan no longer had Kaiser in Hawaii (everywhere else it did!) We cannot complain, as now we are in the position of having 2 coverage policies, both covered by work.
RE: Kaiser turned us down - need broker maybe? - kani-lehua - 09-15-2009
you lucked out! i wanted to continue with summerlin (same kind of plan as hmsa), but when i was told that the doc i was referred to on this island wasn't accepting new patients, i opted for kaiser. it's okay and i do like my doctor.
"chaos reigns within.
reflect, repent and reboot.
order shall return."
microsoft error message with haiku poetry
RE: Kaiser turned us down - need broker maybe? - Kelena - 09-16-2009
Absolutely right -- I fully plan on taking some classes when I come over. Looking forward to it. If you aren't learning, your languishing. But I do think it is sad that we have to go to such lengths to get health care coverage.
RE: Kaiser turned us down - need broker maybe? - csgray - 09-16-2009
I think more practices are taking new patients now. The doctors at the practice I use all are accepting new patients, a few years ago none of them were. The mass migration from the mainland has eased and it seems to be easier to find a doctor. Specialists, on the other hand, are still tough to get into.
Carol
RE: Kaiser turned us down - need broker maybe? - wyatt - 09-16-2009
Hey DEtisme, The plan I got Is KPIF HIPAA Platinum Plan,
I pay $282.00 at 47 years of age
No preexisting exclusion, Drug coverage, %50 of labs and tests. Only 5 visit per year with 20 copay,you pay after 5.
Before being turned down.I was quoted $218.00 on there regular individual plan.
One of the reasons the turned down my HIPAA at first was the online application goes to California. It did not hit the Hawaii desk tell after the 63 day limit. I was denied because of their mistake. I saved a copy of my application that had the date filed. I sent all relevant info with my complaint. After the state contacted Kaiser. They wrote saying they were mistaken about the date filed and I was covered.
"Yearn to understand first and to be understood second."
-- Beca Lewis Allen
RE: Kaiser turned us down - need broker maybe? - Devany - 09-16-2009
The basic HIPPA HSMA option for both of us is $526 per month and the high option is $1,060 per month. Neither includes dental or prescriptions. The basic option has a $500 per person annual deductible versus $300 per year for the high option. Also the basic option covers only 70% of surgery and hospital costs, while the high option covers 80% of surgery expense and 90% of hospital charges. We have to wait until Cobra expires and then we have 30 days to do the conversion, which is retroactive to the end of the Cobra period.
Kaiser's HIPAA medical and drug coverage under their gold plan for $747 per month; lab/x-rays are covered at 50% and hospital costs are $250 per day – max of five doctor visits per year. Their silver plan for $840 per month provides medical, drug coverage and vision care (also chiropractors and acupuncture); lab/x-rays are covered at 50% and hospital costs are $200 per day – max of five doctor visits per year.
Comparing apples to apples is not easy because these policies are crap compared to their standard plans. Kaiser is an HMO, so you have very little choice in where you go for care.
Keep in mimd that a simple test like a colonoscopy can cost $3500 and up, A CT scan is around $1500 for a basic scan.
quote:
Originally posted by DTisme
Thanks all for your help - we'll know more how to handle this once we get their letter w/the specifics in it. I didn't know we even had the 63 days from end of COBRA - that at least makes me feel a little better. How much more is the HIPAA plan than the regular Kaiser plan I wonder. Wyatt, did you end up with that one when you got covered? Is it much more expensive? We're paying like $1300 now a month for the both of us thru COBRA (PPO) - which is crazy. We were looking forward to saving some money. Maybe that wont' happen now. Getting old sucks.
Aloha au i Hawai`i,
devany
www.myhawaiianhome.blogspot.com
www.eastbaypotters.blogspot.com
RE: Kaiser turned us down - need broker maybe? - DTisme - 09-17-2009
Devany, thanks for posting some numbers - greatly appreciated. Am still a little confused though. When you say, "a simple test like a colonoscopy can cost $3500 and up," are you saying "will cost YOU" bc it's way above their max coverage or are you saying costs can add up quick with simple tests like that being so expensive? Sorry, not quite clear on all this. The $200, $250/day hospital coverage makes little sense to me, either, as that's like the price of an aspirin in the hospital, yes? I've never seen a med. plan with max # of dr. visits per year. I guess I've been spoiled!