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Are you happy with your Insurance? Need advice in California

Discussion in 'ME/CFS Doctors' started by laura, Mar 22, 2011.

  1. WillowJ

    WillowJ Senior Member

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    WA, USA
    oh, I wish you had not told your PCP about the CFS. I actually got my CFS diagnosis from a Kaiser neuro who was a decent fellow (unlike one of his colleagues who wanted my cousin to go to counseling for migraines), but in Urgent Care, primary care, and ER they absolutely patronized, ignored, and abused me because of the CFS label.

    Kaiser's electronic records can be very helpful when accurate and when your disease is not used as an insult, but not at all useful when you want anyone to ignore a label they will use as deragatory.
  2. Mya Symons

    Mya Symons Mya Symons

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    Laura, if I had my choice of insurance, I would go with Blue Cross. At one time, my family was insured through Blue Cross. I never had trouble getting anything covered, even regarding the FMS and CFS. And this was several years ago. Make sure, however, that you pick the plan that allows you to choose which doctor YOU want to see. Also, ask for a booklet to read before you buy. I know it can get complicated (and tedious), but it is worth going through the reading material to make sure you get what you want. Further, if there are agents available, ask lots of questions.

    One more thing--do not get CIGNA insurance. They once denied me coverage because my mother and sister had Hashimoto's disease before I did. They said it was a pre-existing condition. I fought it and eventually got the coverage. However, denying everything seems to be their MO. I know of many people who have had trouble with them.
  3. laura

    laura Senior Member

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    Southern California
    WillowJ and SaraM, your Kaiser experiences sound awful! We seriously need to continue to battle the mountain of ignorance that is out there. If only we had more energy... :)

    I'm starting to think of Kaiser as an "in-the-box" healthcare provider. Meaning, if a person has a well-etablished, clear cut, clearly understood illness then they are great. But anything complicated, without a straightforward treatment protocol, they can't handle it. Does that sound right?

    Mya, I'll be sure to avoid Cigna. Any knowledge of Aetna? Or Healthnet?
    I've had Blue Cross but lately they have been messing up my paperwork, I've had to call many people to clear things up, their departments don't seem to talk to one another.
  4. SaraM

    SaraM Senior Member

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    Willow,
    I had so many bad experiences with Kaiser specialists that when my doc wanted to send me to a reumatologsit for a cfs diagnosis, I refused to see him. I had to tell my doc about my cfs because I needed him to order some tests through Kaiser. He is also willing to support my disability claim in case I want to apply for it.

    Laura,
    Yes, you got my point right.I am with Kaiser because I cannot afford any thing else. I had Blue Cross before but it was costly.Blue Cross PPO is excellent if money is not an object.
  5. WillowJ

    WillowJ Senior Member

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    SaraM, I'm sorry you've had such bad experiences. I hope one day you can escape from Kaiser's abuse also and have the freedom to choose your own doctors from anywhere.

    I actually had better experiences with many of my Kaiser specialists than I did with non-specialists. My Kaiser rheum was one of the few docs I could count on to know I was sick with something (she didn't have the faintest idea what, nor could she provide any help or treatment, but she knew I wasn't making things up or anything like that).

    I understand now why you needed to tell about your CFS. (Terrible when I want to hide an important condition from my doctors and advise other patients to consider the same, isn't it?? One day, the world will be different--I believe that). I'm glad your PCP is providing tests and disability support.

    Laura, in my area, Kaiser too often does not even know how to diagnose standard in-the-box health problems unless you are lucky enough to get one of the competant or semi-competent doctors (you can tell who they are because they are not accepting new patients, lol). However I think in CA it may be like you describe.

    Thanks for the sympathy regarding my experiences there. I have major trust issues with doctors now, which I'm starting to get beyond thanks to some competent and kind doctors I have met since dumping Kaiser (but which I had not met any like for my own care, even outside of Kaiser, in past years).


    @all
    The prescription coverage actually works out a lot better on our current plan because Kaiser charges the full copay even if the medicine is cheap, and Providence charges a percent or some such calculation but never more than the copay, so some of our meds are less than the copay (and some are only $4 because the pharmacy has a list of common meds for affordable prices, but you do not need any particular insurance to get this deal--just check at CVS, Target, whatever pharmacy, and ask if your med is on their $4 plan).
  6. laura

    laura Senior Member

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    Southern California
    I can so relate to having difficulty with doctors! With my current doc, I often feel I am being "humored," i.e., the unspoken subtext is, "you're a hysterical female, so I'll order the test you requested just to quiet you down..." Even non-CFS related, like when I fell down a flight of stairs and injured my foot. My doctor only sent me to get an x-ray because I kept pushing, saying that it really hurt -- he didn't think I really injured anything, said it was "nothing serious," "just bruised." He was shocked when it turned out my foot actually was broken...!

    And thus, here I am, on the hunt for a new doctor, new insurance, new new new. And hopefully better.

    Hearing that you have gone through some bad doctors, but have found some good ones, gives me hope that down here in SoCal I can find them too!
  7. Oldvine

    Oldvine

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    I'm happy with my insurance...Medicare and United Health and I'm also in California. So far, I see any doctor I want to see and only pay co-pay on pharmacy.
  8. lartista

    lartista Senior Member

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    I am going at it with Colorado's DORA Insurance Commission's at my side against KAISER PERMANENTE ROCKY MOUNTAIN. The fight is still on and they are under investigation for what they have done to me with this illness and trying to intimidate me while I am sick. They are trying to cancel my health insurance after I won a drug appeal for VALTREX... You can follow the story here:http://www.youtube.com/user/kaiserMECFS?feature=mhee and
    http://kaisermecfs.blogspot.com/. I am keeping the story low till we get a little further....

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