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Kathy, HMSA is the Hawaii version of Blue Cross, IIRC. Kaiser screens for pre-existing conditions, but I don't know how they would deal with any specific illness. I suppose it would depend on what it was and its severity. They took me without any problems, but my only pre-existing issue was very, very far from life threatening and cheap to treat with a generic maintenance med.
I have noticed some tightening at Kaiser that I mentioned earlier in this thread, but I should add that I hear a lot more horror stories about HMSA. In my circle of acquaintances, Carol's sort of experience is fairly common.
Having said all that, the issues with pre-existing conditions, bean counters dictating treatment, and generally poor service from insurance companies are not unique to the Big Island. What compounds those issues are the very limited on-island treatment options. With such a small pool of medical resources, the limitations that are common to insurance companies everywhere become horror stories.
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Kathy,
My husband had already been in the hospital for 5 days, none of the antibiotics they had tried had worked (including vanco) so the Dr.s wanted to try what was truly a last ditch effort with a really expensive newer drug. It was hanging on the IV pole waiting to be hooked up while his temp skyrocketed and the hospital waited for HMSA to OK it. Our issues with HMSA are rooted in literally every interaction we have had since being changed over last July. It doesn't matter if it is a tiny issue or a big one, they are totally obstructionist every step of the way. I have yet to meet a provider or customer who is at all satisfied with this insurance company.
Steve went into the hospital the first day after starting the plan, and right away we saw the difference from a prior stay for a similar infection. The only real difference was the insurance. We hit our max out of pocket the first day so are stuck until next summer, even though my employer/union back pedaled and has now restored access to HMA, because people couldn't find care providers to accept it. We will be switching to Kaiser or back to HMA during the next enrollment period in July.
Carol
Carol
Every time you feel yourself getting pulled into other people's nonsense, repeat these words: Not my circus, not my monkeys.
Polish Proverb
oh my, my sympathies for what you guys went through. That is horrible. I'm just glad he's OK. I remember you mentioned an infection on that "foot fungus" topic. You said life-threatening. It makes me ill to think of how insurance companies let people die. ( I know it's not just in Hawai'i.)
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we've had kaiser, summerlin and hmsa over the years depending on what was offered by employers and what we could afford as being self-employed. in my experience, kaiser ranks lowest on the totem poll. we have kaiser now--renee through her employer (again, she likes kaiser) and me because the premiums are what we can afford. no trouble acquiring coverage even with prexisting (sp) conditions (high blood pressure and high cholesterol) and no problem selecting a primary care physician.
"a great many people think they are thinking when they are merely rearranging their prejudices."
w. james
"a great many people think they are thinking when they are merely rearranging their prejudices."
w. james
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Will you stay, Monte? Is Hawai'i (The Big Island) for you? I've had clients who took to Hawai'i as the proverbial duck to water, like myself, and others who scheduled themselves for 10 days and left after three. It's such a small town, with small town services, infrastructure - and friendliness and helpfulness. You'll just have to see for yourself! Be sensitive when you come; people either get a good feeling or a bad one. If you don't get the warm fuzzies, drive around a bit, it just might be the wrong spot. If you still are doubtful, you might as well save yourself the relocation costs; trust us, you will leave after a year or two! I have a friend we're betting will go "home", (they still refer to the Mainland as "home") though that person is definately going through the expensive motions of "nesting" now. No blame, just a poor fit for them.
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To: Peter Epperson
Michelle Mitchell, M.D is at 933- 2399 - sorry it took so long to get back to you! Mention my name - won't get you any bonus points, but what the hey!
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Joined: Feb 2010
My insurance is a "PPO" with Blue Cross Blue Shield. It is a State of South Carolina Plan. I have now been living in Georgia for 2 years and I have been getting the same benefits and co-pays as when I used it in South Carolina. I am praying and hoping that Hawaii is considered as a mainland state for health care coverage. Do insurance companies now deny coverage for "pre-existing states" too?
What area of the Big Island would be perfect for 5-6 hours of sunshine and daytime temperatures in the 70's. (I realize that elevation impacts the temperature) But I got to have sunshine. Lush landscaping is a must. I would die with just rocks to look at.
Night time temperatures can fall to the 50's for all I care. I can pile on the blankets.
Since my house burned down, I now own a better view of the rising moon.
"Since my house burned down, I now own a better view of the rising moon"
Posts: 19
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Kathy, Thanks
I will call my insurance company.
Since my house burned down, I now own a better view of the rising moon.
"Since my house burned down, I now own a better view of the rising moon"
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"Hawaii is a state of many firsts. It has the nation’s only single, statewide school district — which now boasts the lowest number of instructional days per year and terrible test scores, as well as little flexibility. It is the only state in the nation to have a general excise tax on every transaction involving goods and services — resulting the equivalent of an 18 percent sales-tax rate. It has the highest personal income tax rates and the third-highest overall tax burden. And Hawaii has the mandatory Prepaid Health Care Act, with its high costs, little choice, and lack of flexibility."
Hawaii is the only state in the nation to "tax" medical charges.!!!!
Doctor visits, hospital stays, major surgery, and lab and x-ray are all taxed at 4% which is to be payed by you on top of your co-pay amount because almost all medical insurers will not cover Hawaii's state tax on medical treatment. And god help you if you need major surgery! Just the tax alone could bankrupt you....
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The Puna Community Medical Center in the Pahoa Marketplace is not a primary care provider, but can see patients for acute care on a walk-in basis, 7 days a week. They take most insurances. Kaiser won't do referrals to them. If your primary care provider (PCP)is not available when you need to see a doctor, if they issue the referral after-the-fact, then PCMC will receive the insurance payment. If there is no referral you can pay yourself (they are very reasonable)and try to collect from your insurer. For those with no insurance and no money, or with no PCP, they will treat you anyway. If you do not have a PCP and are a senior, you may be able to become a patient of Dr. Hart Miller there. You can get more info by calling them at 930-6001.
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