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+--- Thread: Kaiser vs HMSA (/showthread.php?tid=11516)
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Kaiser vs HMSA - hawaiideborah - 09-25-2013
Hi all,
Yes, I have read the older pumatalk posts on this topic.
I am wanting to get a current perspective on how folks feel about HMSA vs. Kaiser.
My partner is on Kaiser and I am on HMSA. We are going to switch to a family plan during this coming open season. For us, Kaiser is cheaper.
HMSA has worked for me, but it has seemed like it is hard to find a primary provider. However, once one has a primary, one can get referred to all types of specialists. It has seemed like I can have choices with specialists with the HMSA, but I have to do a lot of the work to research and refer myself.
Kaiser it seems sends you to specialists on Oahu or has you schedule appt. when the specialist comes here. My partner has been happy with Kaiser, but she doesn't have many health concerns and hasn't needed specialists.
How is Kaiser for chronic conditions or for more complex conditions?
Also, if you need medical attention when traveling on mainland, how does Kaiser deal with that? Can you go to an urgent care clinic on the mainland and get covered by Kaiser? I know you can with HMSA.
Thank you in advance for any opinions.
RE: Kaiser vs HMSA - coastal - 09-25-2013
I'm on HMSA since moving here from mainland in 2012. You're right, it's hard to find an HMSA provider. On the mainland, I used to have Kaiser, and when I would visit HI, I would be able to use the Kaiser facilities here in HI due to their reciprocity agreement (and I did a few times). It all worked very well. Honestly, if I had a choice at this time (and I don't due to my employer only offering HMSA), I'd return to Kaiser in a heartbeat! I also have several neighbors who are with Kaiser, they haven't said one bad thing about them (and I've asked). With HMSA, if you go to the mainland and need care, you can use the blue cross/blue shield system as well.
RE: Kaiser vs HMSA - csgray - 09-25-2013
I think we will switch to Kaiser during the next open enrollment period. After 8 years of unsuccessfully trying to get certain durable medical needs met for my husband here on the Big Island, we are giving up to try a system that promises to provide access to the specialists that we need. The breaking point was when I had hernia surgery through HSMA, and my coworker had the same surgery through Kaiser; I paid hundreds and hundreds of dollars more than he did.
Carol
RE: Kaiser vs HMSA - Lee M-S - 09-25-2013
I've used Kaiser in California--just went to a Kaiser there. They pretend it's a separate organization, but they made it easy to get healthcare. I think that if you go to another facility, like in an area without Kaiser, you have to pay but Kaiser will reimburse some or all of the costs.
It can take several weeks to get an appointment with a specialist in Hilo, and some of the specialists are terrific, others are a little second rate. If you don't like the specialist they send to Hilo, you can pay your own airfare to see one on Oahu. If that kind of specialist doesn't come to Hilo, Kaiser pays airfare and ground transportation on Oahu. They also pay transportation if you go for tests like CTs and MRIs... Oh, and you can get Hawaiian miles for your trip.
As I understand it, some of this may change on October 1 when Obamacare kicks in. Friends with Kaiser said they got a letter from Kaiser offering help in figuring out their options. We didn't get the letter, maybe because I'm always getting CTs and MRIs...
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RE: Kaiser vs HMSA - shave_ice - 09-25-2013
I've had HMSA and Kaiser here on the Big Island and Kaiser on Oahu. I will take Kaiser hands down. When I was on HMSA I had trouble finding a doctor that would take new patients. I also had to pay a copay plus I would get a large (for me) bill later on. It was very frustrating for me since I'm on a very tight income.
With Kaiser, you pay a $15 copay. That's it. No separate bill comes in the mail later on. When Kaiser didn't have the type of doctor I needed to see, they referred me to someone else and Kaiser fits the bill (minus a $15 copay each visit).
RE: Kaiser vs HMSA - birdmove - 09-25-2013
We have had Kaiser. My wife had a lady doctor, and I had a male doctor. Both of them quit. They don't have a suitable doctor available to be my doctor. They do a good job if they have to send you to Oahu for something. They arrange and pay for the flights, and have a van to pick you up and deliver you to the airport. One time my wife had to do that, and they wanted me with her just in case. They paid for my ticket and hers.
I have a beef with them over an online bill pay service, which is how we have paid our premium for two years now. I won't bother anyone with the whole story, but we have dropped my medical insurance due to tthis being a big pain in the butt, and am waiting for the Obabacare to kick in. It's a gamble, and I'll be 60 on Nov. 1st, but have been a primo customer for them. One simple checkup in two years (before my doctor quit), and two years worth of payments of my premium.
You have to be a bit careful if you don't have an assigned doctor, and you make an appointment to see whoever is available. You have to specify that you don't want a quick consultation with them, but want to discuss more than one problem. If you don't do this, then when you go in, they will literally tell you that they will not discuss more than one issue.
They do have some Oahu based specialists that come to this island on a regular basis, so you can make an appointment to see them when they come.
Jon in Keaau/HPP
RE: Kaiser vs HMSA - hawaiideborah - 09-25-2013
I just love punaweb posters!
Whenever I need suggestions and help for resources you never fail me.
Thank you all for taking the time to answer. So glad I asked.
After reading your posts, I feel reassured that switching to Kaiser will be ok for me. It is cheaper for me to switch to Kaiser rather than for my partner to switch to HMSA, and even tho I have a good primary provider, it will be hard for my partner to find a good one.
Thank you
RE: Kaiser vs HMSA - Kelena - 09-26-2013
Just a note: Comparing HMSA as it was to Kaiser will be apples to oranges as of Jan 1 2014. For example, HMSA did not formerly offer a prescription drug benefit under plans of the sort suitable to my circumstances. Under the Affordable Care Act, it now must offer one and will. I chose not to go with Kaiser for several reasons, but I will rethink that as I knew I would on October 1 when the Hawaii Health Connector insurance exchange posts rates for both Kaiser and HMSA (those who have an interest in both plans may have already seen the rates and it sounds like you have). I have friends that rave about Kaiser. I also have friends that rant about it. Those who favor Kaiser often cite the fact that you sometimes "get" to go to Honolulu and all your records are in one place. The detractors claim that doctors seem to pass through, you don't see the same one twice, there is a gender imbalance with female doctors predominating and you have to go to their pharmacy for pharmaceuticals.
I like the idea of going to Honolulu very much. But when I had surgery recently. I would have been in no condition to fly home from Honolulu that day, or the next day, or even the day after that. I don't think I would have enjoyed Waikiki very much. If I were just seeing a specialist, I might feel differently -- depending on what the specialist had to say!
By the way, if you are packed off to Honolulu by Kaiser, tell them you want to stay in the "old building". If they look puzzled, just remind them that the current Waikiki Prince Hotel is the old Kaiser building and location.
RE: Kaiser vs HMSA - hawaiideborah - 09-26-2013
My coverage is for federal plans. Same as all current fed govt workers have. My HMSA currently covers perscriptions. Fed plans won't change much.
Thanks for your thoughts. Healthcare here is hard to chose. Not great choices either way.
RE: Kaiser vs HMSA - Chunkster - 09-27-2013
I've had Kaiser since transferring here for work about 12 years ago. Kelena did a good job summing up the pros and cons, by the way. I will add my experience even though it might not be pertinent to hawaiideborah, who I think is female. My original (male) doctor left about three years after I started, and I have had a succession of mostly young and nearly all female primary care docs since. All but one of these (who lasted about four months) did not like to do two basic exams that should be part of every adult male's physical. I should not have to ask my doctor to do these and then have to deal with the "icky" look that results when I do. I am not a dirty old man, and I try not to be gender biased, but I have never experienced this elsewhere. Also, they have never, not once, called me back when they told me they will schedule me for a follow-up in six months or whatever. You have to call them and insist.
EDITED to add: I try to schedule these dermatology follow-ups when leaving the clinic, but they always tell me, "We'll put you on the waiting list and call you." I say back, "Yeah, right." I mentioned this to best dermatologist I ever saw at Kaiser, and asked if all the other people who weren't pushy like me ended up with melanomas. To my surprise, he said, "Yes, it's actually a real problem." He quit six weeks later. I could switch to HMSA, but they never seem to have good doctors taking new patients.