Kaiser HMO vs Cigna HMO Decision Time
I've had Kaiser for over a decade now. In the beginning I chose it because the US medical insurance system seemed incredibly complex and I had no idea what to do. I liked the idea of "just going to one building". Coming from many other countries where healthcare is a much simpler affair, it took me a while to learn the ropes. However, since then, I've had kids, moved to a different location in SoCal, etc. and I'm reevaluating my choice. I promised to do this last year, but I was lazy and left it for this time around.
My family is generally healthy and we rarely need to go to the doctor. However, when we do because something weird came up, I just basically go to Urgent Care to be seen on that day and get what I need. I rarely see my main doctor, but need to communicate with him to order blood tests, random medication, etc.
My main complaints with Kaiser are three:
Doctors always seem to be in a rush and they have no idea who you are without looking at a chart unless you see them frequently. It seems like they're always understaffed and doctors are overworked. I don't forget how atrocius KP was during the pandemic and shortly after the pandemic. I'd go to Urgent Care with a sick 6 months old baby and they would tell me that the wait time was 2 hours. I had to yell at people to get prioritized and that is something I don't enjoy doing. According to KP registration desk associates, a 2 hour wait time for urgent care is normal and I can't stomach that. Appointment availability; shortly after the pandemic appointment availability with my doctor was scarce. In some cases, wait times were over 5 weeks which is absolutely insane to me. This has gotten better, but I'm still sour about it.
My employer offers a few options, but frankly it seems like Cigna HMO is the only real alternative to KP. Here is what I'd like to gain:
A real relationship with my doctor. One where he or she knows me, has a general idea of my history and things we've discussed in the past without having to look at a damn computer every single time. A way to get directly in touch with my doctor when I need to (phone, email), instead of having an army of nurses respond to my messages via the standard KP messaging system. Not being "rushed" through the system so that there is actually time to discuss what is happening. Less urgent care waiting time (not sure if this is even possible)
Am I dreaming or is the above possible at all with Cigna HMO?
Lastly, I have a couple of general questions, mostly about definitions:
What is the definition of "deductible"? Is this a per-occurance thing? Is it a per-symptom thing? Is it per patient/family member? Currently with KP this is at $0. With Cigna HMO I'd be looking at $600. Cigna's "Out-of-pocket Maximum" is $7,000 and KP is $3,000. WHat kinds of things fall under this category and how is it different from "deductible"? What is "Comprehensive Care"? Cigna has a 10% after the deductible and KP is at $250 per inpatient admission. Am I to understand that this is basically hospitalization? If so, 10% after deductible seems like a lot of money, especially with those $300,000 hospital bills that I've seen online. How is this competitive vs the $250 that KP asks for? How is urgent care handled? KP has its facilities; does Signa offer basically any urgent care I want to go to?
I realize this became a wall of text. I'm sorry for that; just trying to get information to make sure I'm making an informed decision should I decide to switch.
submitted by /u/Hologram555
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