Which Gold HMO: LA Care, Blue Shield or Kaiser?
I just got my green card (became a U.S. Permanent Resident) last week, and now that I qualify for Covered California, I’m trying to pick between two insurance plans.
I am 40, in Los Angeles (91106), self-employed, and currently pay $460/month for Kaiser Gold HMO. Spouse has insurance through employment. Before Kaiser I had HealthNet. While Kaiser’s vertical integration is amazing, the feeling of “nice, I can walk from the doctor’s office directly to the pharmacy” is kinda wearing off and I feel the doctors can’t address my health problems anyways. (I am having worsening sleep apnea problems for 5+ years and Kaiser is sending me on a “talk to primary doctor -> refer to sleep department -> do a take-home sleep study -> prescribe CPAP” treadmill.) I feel Kaiser’s sleep department really doesn’t give a damn about listening to me describe my symptoms, and the sleep doctor I visited 7 years ago while I had HealthNet was miles better than what I’m getting at Kaiser. If my doctor can’t solve my problems, I might at least pay less.
I am looking at a $340/month LA Care Gold HMO and a $410/month Blue Shield 80 Trio Gold HMO. I don’t qualify for Covered California subsidy because our household income of 2 people is over 100k. The idea of jumping over to a PPO is tempting (more access to psychologist/acupuncturist/etc) but the cheapest PPO is Blue Shield Silver 70 at $525/month which feels a pretty crazy price tag.
From what I’ve seen tangentially around, it’s easier to go find a psychologist from other HMOs like Blue Shield (Kaiser tries to cram you into remote group exercises), and it also seems easier to find specialists – even though the specialist may be 5 miles away from the PCP.
Since me getting a green card is a qualifying life event, I can choose a plan now, try it out for 2 months, and then if it’s shitty, I could switch to something else during the December open enrollment period. I’m just not sure which one to choose though.
Does this.. make sense? Also does anyone have information on LA Care HMO? Is their operations reliable, etc. I google “LA Care HMO” to find reviews but all I get is information about their Medi-Cal program, which probably is a much bigger portion of their operations than their HMO.
