Which is a better health care provider? Kaiserpermanente or Blue Cross?

[mugupo]

Which is better one? I only had this two option.

[Bizdady]

I have blue cross and my gf has Kaiser. Were you offered HMO or PPO? Kaiser is pretty much like an HMO since you have to go to their hospital doctors and all. We havent had any problems with either insurace. We had a baby and that went under Kaiser without a hitch. I have diabetes and Blue Cross covers my supplies pretty well. I have Blue Cross HMO btw, have to go to my doctor and get authorized visits to see specialist but not something I mind.

[Uniquely]

Honestly, these days all the insurance companies are far more concerned with making as much profit as is possible, than with making sure their clients get the coverage they truly need. I would compare the rates, deductibles, and factors such as freedom to determine your own providers and go from there.

[quirkmanly]

Originally Posted by robinandtami

Honestly, these days all the insurance companies are far more concerned with making as much profit as is possible, than with making sure their clients get the coverage they truly need. I would compare the rates, deductibles, and factors such as freedom to determine your own providers and go from there.

That's not totally true. On average most HMO's run on smaller profit margins than say, for instance, hospitals.

To the OP, take a good look at what coverage you are getting for your money, work out what your total out-of-pocket exposure would be under each plan and, if you have preferences, that your family physicians are participating with the plan. Another consideration to factor in would be disease management programs (cardiac, diabetic, oncology, etc) that are offered.

[mikejet]

I'm happy with Kaiser though I've never tried Blu-cross. I think for Blu-cross you need to pay more out of pocket before the benefits kick in.

[Septimus Prime]

I'll tell you this: they both have terrible, extremely annoying commercials.

I have Aetna PPO myself. I consider PPO superior to HMO.

[cruisyeyes]

It is.

[RustyK94]

I consider a government with the wealthiest economy in the world to tax from the best payer for health care.

This concept might be lost on few ppl it's called social policy and governments that usually implement these work with in a democratic frame work known as social democracy.

You should try at some point.

[jkwest]

I have PacifiCare....its not bad...

I have heard some pretty horrendous stories about Kaiser, though...

[DetroitSportsFan]

I've had Blue Cross for 14 years, and so far so good.

[Ferris]

Of those two mentioned, I've only had a BC/BS PPO. I thought it was fine.

[jsteinhauer]

Originally Posted by quirkmanly

That's not totally true. On average most HMO's run on smaller profit margins than say, for instance, hospitals.

Evidence for this claim, please.

[Moviefan1203]

I've had Blue Cross for a while now, and I have had nothing but good experiences.

[quirkmanly]

Originally Posted by jsteinhauer

Evidence for this claim, please.

I'm quoting FL data, because that is what I am familiar with.

FHA HMO data here - PDF file from the Florida Hospital Association website

Hospital detail here

[STARSCREAM]

I used to have Blue Cross. It was ok.

[jsteinhauer]

Originally Posted by quirkmanly

I'm quoting FL data, because that is what I am familiar with.

FHA HMO data here - PDF file from the Florida Hospital Association website

Hospital detail here

That's not a very good comparison. The hospital data is for the nation's top 100 performing hospitals. That's not many hospitals, and it's the cream of the crop. Such hospitals are usually those that perform a lot of elective procedures, such as orthopedics and plastic surgery or cancer centers that don't have a lot of emergency or trauma services and institutions that don't provide indigent care. Both hospitals in the community in which I work (and many in the state) have struggled to simply be in the black for the past three years, despite layoffs, hiring freezes and mandatory unpaid time off for employees.

It would be more interesting to see a comparison with mean or median profit margins for hospitals in the state of Florida.


As far as the choice, HMO's are usually more restrictive and are usually less expensive. When I was younger with fewer resources, I chose HMO's. When young and healthy, you don't use it anyway. As I got older and the income increased, I chose Blues over HMO's. Now I don't have a choice.

[quirkmanly]

Fair points and I understand what you are saying. If I can dig up some specific regional detail, I'll share it.

In essence, the point of my comment is that it is all too easy to say that insurers are making huge profits and constantly denying care, because that really isn't true. Nearly all of the major carriers now follow CMS guidelines in respect to what is and is not billable, so it really isn't the case of being at the mercy of a particular insurer's policies (instead the goverment's!).

With regards to HMO vs PPO, as stated the restrictive nature of a HMO is an issue, especially with dependent coverage, however it does provide some legal protection (in many states) when balance billing and non contracted provider issues arise.

[camper]

We have blue cross/blue sheild. They're OK, we get sick and pay a co-pay and they pay the bulk of it. Even get some dental out of it, too. Had it during the birth of all 3 kids, and its worth it. They haven't denied anything yet, but we don't have cancer or aids or lukemia or anything horrible. My wife has asthma, they pay for her meds. Non-name brand meds are dirt cheap, I think we paid about $1.32 for a dozen oxycodone's when my wife had her wisdom teeth out.

camper