I just took a new job in San Fran. and have the alternative to choose either a KP HMO strategy or a Blue Cross PPO plan. I had never had a HMO option prior to.
Some required context: I am a 31 year old healthy and fit male BUT based upon my case history I am high risk for both MS and liver issues, and while barely a guarantee that I will establish either, being secured against more serious diseases from a treatment and financial perspective is even more essential for me than it would be for another healthy 30 year old without my medical history. I know its essential for everyone, however you get my point …
The factor I discuss the above is to ideally assist you to trust me when I state I have done A LOT of research on the difference in between these two plans over the past week. I feel I have a bit more reliability on this specific question than the typical bear.
I focused not on those lame HMO vs. PPO short articles that are all over the internet that all state the very same thing (” Well it depends on which is a better fit for you.” Yeah. No shit it depends. Useless.) Focused more on what real clients faced when going through this procedure with both types of insurance and I believe I identified some extremely consistent takeaways:
i.) Seriously sick people dislike HMOs, be it Kaiser’s or whomever’s, with the strength of a thousand suns.
Based upon reports of clients, if you develop an unique and/or serious illness, you better pray to God you are on PPO. Clients dealing with persistent disorders that required long term and substantial healthcare and surgeries, to a one, railed against Kaiser’s HMO and HMOs in general with an extremely intense ferocity. You could truly feel their frustration through their posts. Constantly rejected requests for treatment/drugs/referrals/ diagnostics/physical treatment, numerous hours on the phone, countless dead ends, etc, and a general bafflement at the reality that their insurance provider would not assist them.
” Back injures? You need to drop weight. Go see this nutritional expert.” 6 months later you lastly get identified with broken vertebrates. Lots of stories like that and worse. It was apparent that the were being screwed economically in addition to emotionally. I actually felt bad for them.
ii.) Healthy people like Kaiser. Individuals who love Kaiser HMO, also to a one, never pointed out severe health problems. They were usually really healthy individuals (and helpful for them!). The ailments they discussed were rashes and twisted knees and minor cuts/burns – things that frankly are nothing compared to cancer, blown discs, paralysis, and other problems that would need long term treatment and/or surgical treatments. The favorable things they mentioned all seemed rather shallow to me when framed against whether or not this choice could end up eliminating or bankrupting them or triggering them substantial quantities of discomfort. They talked about things such as how great it was that they might get their meds in the exact same building as their doctor, the hassle-free parking, etc. If you believe I would mind walking a few blocks to a Walgreens to pick up my meds in order to avoid some of the exceptionally unreasonable and undesirable horror stories I check out you would be really wrong.
The large bulk of people who review Kaiser HMO evaluate it really favorably. Based upon what Ive learned this past week I believe this is since most of that client population (similar to the majority of the basic population) aren’t that sick, hence get to this kind of insurance through rose colored glasses.
So I guess it boils down to your viewpoint on insurance coverage (if you even have one). A lot of individuals either think they are bulletproof so will n ever have to worry about getting actually sick OR are too terrified to face the reality that they definitely are not bulletproof and very well might get extremely ill OR, having never been really sick themselves have a really mild and incorrect perception of what “really sick” even is.
I believe insurance’s biggest benefit is assisting you when something truly devastating occurs. No one believes it will occur to them and its hard to challenge the truth that regular people like you and me go to the physician all the time and get extremely problem. Im not trying to terrify you however its an empirical truth. It takes place.
So would you rather pay an additional $200 on a PPO strategy when your kid requires stitches or pay numerous more in money/time/physical pain/frustration/futility when something truly severe happens to yourself or someone you enjoy?
Appears Like a no brainer to me.