Kaiser HMO vs. United PPO??

moreno_d2005 · October 2010

Hello, this is my first post! My husband and I are not pregnant yet, but we're currently trying to conceive. It's just about the Open Enrollment time of the year again at my workplace so we're currently evaluating our insurance options. We've always had Kaiser, it?s been a bit inconvenient but the cost has been an attractive option to us but now that we're thinking of having a baby I'm not sure I want to stick with Kaiser. I would really appreciate opinions!

Kaiser Pros: Seems more cost effective, Kaiser plan includes a Fertility coverage (which the PPO does not) if we end up needing to go the route if we end up having trouble conceiving
Kaiser Cons: Inconvenient location (the closest birthing center is 45 min. away), Seems impersonal, Lack of flexibility, Customer Service not always the best
United Cons: potential higher cost
United Pros: more flexibility and freedom to choose my own doctor, more convienient location for both doctor and pharmacies (Kasier pharmacy is inconvientient to get to), brand new state of the art birthing center just completed only 15 minutes away from my home with some great doctors who are part of the United Network

Any feedback, especially if you have personal experiences with one or both would be VERY much appreciated.

Thanks!

Mama_v2.0 · October 2010

I think at the end of the day you have to go with cost. If you have at least $5k-10k extra you can budget for health care (for the birth of a child...fertility treatment would be extra) than go for United and make sure you max out flex spending account. If you have debt (then than a mortgage) I would probably just stay with Kaiser. 90-95% of doctors & offices just want your money and don't care about you personally...so that really doesn't play a factor.....however convenience does.

Mrs.K&C · October 2010

I would consider the convenience, especially if infertility treatment is something you need. However I have Kaiser and the closest hospital for me to deliver at is 45 minutes away and it wasn't a problem for me at all. I had a very difficult pregnancy with my first, and a very difficult delivery with my second and the nurses and doctors at Kaiser were far from impersonal. My son had a 10 day stay in the NICU and everyone was very caring. Personally I have had great experiences with Kaiser. You can choose your doctor at Kaiser, there are many to choose from even in the smaller OB locations. Also, my Kaiser plan for childbirth was one (relatively small) co-pay, while if I had the PPO through my employer, I would have had to pay a percentage of everything (anesthesia billed separately from the doc, doc billed separately from hospital, hospital it's own bill) and that would have added up quickly. Financially the out of pocket for my delivery with our PPO would have been a few thousand. I also utilized fertility services through Kaiser up until IVF, and their coverage was very helpful. IF treatment is very expensive and adds up fast as well.

m&m818 · October 2010

For us cost was a huge factor, and ended up choosing Kaiser again this open enrollment because of that.

Our hospital options were 20-40 minutes away, and our Dr's office was 10-15 minutes away. That said, we received wonderful attentive care from our OB during my high risk pregnancy and from the nurses & midwives who delivered my DD. We love our pediatrician as well and even with a recent trip to the ER with my DD, we have been nothing but satisfied customers of Kaiser. As a bonus, their advice nurse line rocks.

The only areas I've seen they need significant improvement are the nursing/feeding services. I was not happy with the LC's we saw or the BF'ing classes in the east bay. Next time I'll go outside of Kaiser for support.

The convienence of location and more options may be enticing but for us the costs for birth alone would have ended up at $3-7k for a normal vaginal delivery vs. $250 at Kaiser out the door no matter what type of birth (c-section, NICU, etc)

kpv · November 2010

I have been very happy with Kaiser so far this pregnancy.

I didn't need any fertility treatments so I can't speak to that. My doctor has been very attentive and personal. I chose this doctor after I didn't like the first one I picked (so you can pick your own doctor w/Kaiser, it just has to be a Kaiser doctor). The biggest thing for me though is that I only have to pay $100 for delivery - that includes everything even if I have complications. With a PPO, you have to pay a % of the total cost. If you have an expensive delivery, that could be thousands of dollars.

Kaiser HMO vs. United PPO??

Re: Kaiser HMO vs. United PPO??

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