From: "Gregg Strom/BRYX Int'l" 

I've generally been happy with the level of care at Kaiser.

(But I've generally been UNHAPPY with the quality of care provided by their
contracted provider here in the desert....)

gs

"Bill Lucy"  wrote in message
news:MPG.138d6f202b910cec9898db{at}news.barkto.com...
> In article , greggstrom{at}earthlink.net says...
> > "Bill Lucy"  wrote in message
> > news:MPG.138cf57e6ecd14259898cd{at}news.barkto.com...
> > > In article ,
greggstrom{at}earthlink.net says...
> > >
> > > > > I think that existing health insurance and
government programs
have
> > > > > gone a long way toward elevating prices payed by
the uninsured who
> > > > > don't qualify for government programs.
> > > >
> > > > A very good point.  When I told Markus about the rates at Kaiser
> > (including
> > > > the co-pay), he said, "Is THAT all it is? Then why
this big deal
about
> > > > health care?" (I believe I've mentioned that here
before....)
> > >
> > > Does he have a pre-existing condition which may prevent or impide
> > coverage?
> >
> > No.
> >
> > > Does his job permit him to enter into that particular program? Does he
> > travel?
> > > Does the contract disallow him from anything but emergency services
> > outside the
> > > normal coverage area? Is he limited to certain clinics? Are referrals
easy
> > or
> > > difficult to get under the contract?
> >
> > My understanding is that this is a standard contract: Kaiser
> > clinics/hospitals for normal coverage, ANY facility for out-of-area
> > emergencies, urgent care at Kaiser facilities when available, or any
> > facility if Kaiser not available.
>
> The "any facility in an emergency" is pretty standard,
although many HMOs
> hassle people who do so (it happened to my boss after a skiing accident to
one
> of her kids this year). The urgent care at Kaiser facilities is expected
> (although it's not universal). The urgent care at any facility if Kaiser
is
> unavailable is not expected. That's highly unusual, in fact.
>
> > I don't know if Kaiser has coverage for out-of-country, because I only
had
> > minor problems when traveling, so simply paid cash to a local doctor (as
> > referred by American Express).
>
> In almost any situation out of country, most HMOs don't cover anything
other
> than life-threatening situations.
>
> > Referrals are getting expotentially easier. (The Kaiser doctors did a
job
> > action forcing that: "Work to rule.")
>
> The State of Illinois just passed a law that requires easier referrals. As
an
> example, now only one referral is necessary to a specialty care physician
for
> that physician to treat a patient over a period of time. Before, it might
be
> necessary that a person see their PCP everytime they needed to see the
SCP.
>

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