<p>Pharmacy - easy to work with if you mail order, otherwise go to one of their med centers to drop off or fill. </p>
<p>Cancer diagnosis? I have no idea. </p>
<p>From start to finish, the surgery my family member needed for chronic pain, well about 18 months. The first 8-9 months wasn’t really listened to, told previous surgery was “failed x surgery syndrome.” </p>
<p>The surgery itself, excellent. In hospital service, great. </p>
<p>In home aftercare, kind of sucky. Their contracted provider would make appointments and not show up, show up hours earlier or later than scheduled.</p>
<p>I always check for board certification and where the doctor trained before any appointment with a new doctor. I cannot imagine anyone signing up for a health plan before they know exactly which physicians are in it, and then doing the homework on those physicians. You’re trusting them with your life.</p>
<p>As far as the hospitals considered excellent in my area, “as of Jan 1, almost all individual coverage policies have to cover “costs and petition to be seen at speciality hospitals”, including Seattle Cancer Care Alliance, Swedish, and The Childrens Hospital. If they are not approved,and who knows how long that takes, the family is responsible for all the costs." That doesn’t sound good for people who have cancer, or want their children to go to The Children’s Hospital.</p>
<p>AIUI, Barnes Hospital in St. Louis has not signed up with any of the Missouri ACA plans. That’s the hospital affiliated with Washington University. It’s a regional center and one of the top hospitals in the country. My dad went there when he had a pancreatic tumor. Too bad for the people of St. Louis and the surrounding area who have to sign up on ACA.</p>
<p>Well tatinG, one of my daughter’s doctors at Kaiser graduated from Wash U. The surgeon taught in Rhode Island and he has a great record. The neurologist worked at UCSF and is nationally known. The oncologist worked at UCSF and had a great career at MD Anderson.</p>
<p>I am not as negative as Samurai, but the place isnt perfect. I am in Nor Cal which may make a difference. I think bluebayou thinks it does.</p>
<p>A friend came down with lung cancer. The insurance company wanted to approve each test. After about 4 weeks, Stanford came into the picture as a second opinion. Stanford said to other doctors, “Wth are you guys doing? Finish the tests now.This guy is going into surgery in a few days. No more of this nonsense.” Okay. Maybe Stanford was a little more mannerly. The surgery was done at Stanford. Looks good so far. My friend had employer based health insurance.</p>
<p>The problem with Kaiser (which I do not hate) is that it may take a ridiculously long time to get that diagnosis. It’s difficult to explain their process and I doubt that anyone there could which is part of the problem but one hand never seems to know what the other is doing or has done and the patient really has to figure out how to get the attention and care they need. Once that happens, it’s great. But I can easily see someone falling through the cracks at that place. </p>
<p>It’s a little like the DMV. But once you get through the line it’s all good.</p>
<p>We are in Socal Kaiser. All the docs have excellent certifications and if our kids got into any of the schools they attended here at CC, we would all be pretty happy. Well respected med schools for every one of our docs. </p>
<p>I actually didn’t think I was being negative, just pointing out good and bad about it. I actually prefer the all in one model on one level - but then, our care has not involved hearts or cancer or brain - just broken or dislocated limbs, spinal issues, bronchial/asthma stuff, migraines and other minor things over whole family. </p>
<p>Actually my sister’s family practice doc since college was in private practice and moved to Kaiser. She was lucky enough to have her own doc when going through Kaiser. I think her care was better, because she had long term relationship with doc. I kind of miss that since going to Kaiser - haven’t had that. </p>
<p>When we did have a heart issue in my family many years ago, had PPO.</p>
<p>That is just it, Flossy. You have to advocate for your care, or you could fall through the cracks. </p>
<p>The DMV analogy is dead on. </p>
<p>I am not worried about my docs not knowing what they are doing. It is more about getting face time with them in a reasonable time limit. </p>
<p>When we were PPO, waiting a few days for an appointment for urgent matter was rare, whereas it is more norm with Kaiser. </p>
<p>If I were an elderly patient, I am not sure I would like Kaiser. Huge medical complexes, scary to navigate parking garages and just the giant monolith is confusing for an able bodied person without chronic health or physical problems.</p>
<p>I wonder if the Kaiser model is the one we are all going to be stuck with in the future. By narrowing PPO’s and your choice of doctors, we could be looking at a de facto HMO-like network, not all that dissimilar to Kaiser. Waiting an interminable time to see a specialist could become the norm.</p>
<p>I just set up an account. I kept saying to the help rep (my state’s) that I wish this were like financial aid, where you can click something and get explanations for terms that don’t make easy sense. Considering how much I hated the CSS Profile, that’s sad. Maybe it’s my state (which otherwise had seemed pretty organized.) </p>
<p>Extremely confusing because various data points changed in 2013, for us. I wanted to enroll with legit income expectations for 2014 (similar to calmom originally trying to decide what income number is cost-effective in the long run; not to be hit with later excess charges.) But something in the eligibility verification didn’t like that. </p>
<p>I also find some discrepancies- pretty obvious ones. In one spot, plan X is noted 0% coinsurance, in a more detailed spot, it says deductible doesn’t apply to inpatient- and in the bcbs site’s benefits summary document, it says a % applies after ded is met. (a higher %, in fact, than the next lower priced plan.)</p>
<p>I still need this; don’t think I’m so aggravated that I’d opt out or stay with my current plan, at 3 times this price. I’m calling bcbs tomorrow and probably the marketplace folks again, too. if I am overlooking some explanation, by all means send ideas.</p>
<p>If this thing ends up working, I think the waiting times will be more normed. For some that will be longer and for others shorter.</p>
<p>By which I mean, those with better insurance and those with less better will all have a similar wait. I don’t think your wait time should be based on how rich you are or whether or not you are in a union, anyway. </p>
<p>My parents, who are in their 80’s are at Cleveland Clinic and they love it. All their doctors are there and the hospital is on the same campus. All their care is very coordinated. They don’t even mind that they have to drive 30 miles in south Florida traffic to get there.</p>
<p>Yep. I hear ya. Once you figure out that you have no other options, you have to just fall into line with grim acceptance of the whole thing. I imagine it’s much like the acceptance that was required to survive mentally in the old Soviet Union. I mean, if you walk into an ice cream shop and are told that the only flavor is vanilla and a single scoop cone is $20, there’s not much point in holding your breath and stomping your feet and wanting chocolate. You either buy the $20 vanilla cone or you don’t.</p>
<p>The upshot here in NH is that 10 of the state’s 26 hospitals will either go out of business or be forced to sell to one of the approved provider hospitals. Anthem BCBS didn’t cut them out because of fee structures. They cut them out because the promised higher volume to the hospitals in the network.</p>