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  • Health Insurance...Kaiser or HMSA

    Aloha,

    Which coverage is better living in Kailua-Kona?

    Mahalo?

  • #2
    Re: Health Insurance...Kaiser or HMSA

    Kaiser has only 3 clinics on the Big Island, one in Hilo, Kona and Waimea. HMSA you can see just about any doc you want. Given the limited choice of locations for Kaiser, your better bet would probably be HMSA since there are more docs under that plan. Can't vouch for the quality of care of either Kaiser or HMSA on the Big Island, though.

    Miulang
    "Americans believe in three freedoms. Freedom of speech; freedom of religion; and the freedom to deny the other two to folks they don`t like.” --Mark Twain

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    • #3
      Re: Health Insurance...Kaiser or HMSA

      I've been a Kaiser member going on 30 years. They've grown and then some. As far as I know if you need specialty care or need to have tests that aren't available there your coverage covers plane, pick-up which is usually is a Kaiser Van that regularly goes to the airport. Yes, Kaiser is top-notched. You still have the choice of whom to choose as your physician within their system which are all excellent. Personally, I feel the care and professional aspect of Kaiser Permanente is unbeatable. I know first hand! Go with Kaiser!
      Be AKAMAI ~ KOKUA Hawai`i!
      Philippians 4:13 --- I can do all things through Christ who strengthens me.

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      • #4
        Re: Health Insurance...Kaiser or HMSA

        Did you guys know that Kaiser is a non-profit organization?
        I am Jack's absent signature.

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        • #5
          Re: Health Insurance...Kaiser or HMSA

          Originally posted by 1stwahine
          I've been a Kaiser member going on 30 years. They've grown and then some. As far as I know if you need specialty care or need to have tests that aren't available there your coverage covers plane, pick-up which is usually is a Kaiser Van that regularly goes to the airport. Yes, Kaiser is top-notched. You still have the choice of whom to choose as your physician within their system which are all excellent. Personally, I feel the care and professional aspect of Kaiser Permanente is unbeatable. I know first hand! Go with Kaiser!
          I'm an HMO member up here in Seattle, too, and my HMO allows me to get treated at a Kaiser facility if a Group Health facility isn't available, so if I got sick in Hawai'i, if I could get an appointment, Kaiser would treat me, too. But if there's only one clinic serving 10-15,000 people in one area (and remember the Big Island has only 3 Kaiser clinics), then chances are that you aren't going to have as much flexibility with docs or treatment as you would with a more open plan like HMSA in Hawai'i.

          Miulang

          P.S. Kaiser is a not-for-profit organization, just like my HMO is. We can make money (and have this year, unlike Kaiser), but we don't have shareholders to pay dividends to, and we get certain tax breaks, but any "profit" is kept in the organization for those rainy days when income doesn't meet expectations, which happens about every 3 years or so.
          "Americans believe in three freedoms. Freedom of speech; freedom of religion; and the freedom to deny the other two to folks they don`t like.” --Mark Twain

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          • #6
            Re: Health Insurance...Kaiser or HMSA

            Originally posted by Miulang
            I'm an HMO member up here in Seattle, too, and my HMO allows me to get treated at a Kaiser facility if a Group Health facility isn't available, so if I got sick in Hawai'i, if I could get an appointment, Kaiser would treat me, too. But if there's only one clinic serving 10-15,000 people in one area (and remember the Big Island has only 3 Kaiser clinics), then chances are that you aren't going to have as much flexibility with docs or treatment as you would with a more open plan like HMSA in Hawai'i.
            I don't go to the doctor unless there is something wrong with me (sick, broke something, etc.), so the Kaiser model seems to work well for me. It's got kind of an "urgent care" feel. One lame thing though - it took me like 2 months to get an apointment with a dermatologist.
            I am Jack's absent signature.

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            • #7
              Re: Health Insurance...Kaiser or HMSA

              Originally posted by Garland
              Aloha,

              Which coverage is better living in Kailua-Kona?

              Mahalo?
              Do you have an employer who's giving you the choice? If you're self-employed there are several hurdles you have to jump over to get coverage from either organization, and I can tell you the Kaiser plan for us self-employed is a 50% co-pay for labs, radiology, etc.
              http://www.linkmeister.com/wordpress/

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              • #8
                Re: Health Insurance...Kaiser or HMSA

                Originally posted by Linkmeister
                Do you have an employer who's giving you the choice? If you're self-employed there are several hurdles you have to jump over to get coverage from either organization, and I can tell you the Kaiser plan for us self-employed is a 50% co-pay for labs, radiology, etc.
                Yeah, health insurance really sucks if you're self-employed, doesn't it?

                Miulang
                "Americans believe in three freedoms. Freedom of speech; freedom of religion; and the freedom to deny the other two to folks they don`t like.” --Mark Twain

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                • #9
                  Re: Health Insurance...Kaiser or HMSA

                  There's an Added Coverage Plan (they can choose to go to outside) for Select Groups that is available through purchase from Companies for their employees. Participants pays 20%. Non participants pays 20% to Kaiser and 20% to the outside Medical Facility or Office they choose. per Holly at Kaiser Permanente's Honolulu Customer Office.
                  Be AKAMAI ~ KOKUA Hawai`i!
                  Philippians 4:13 --- I can do all things through Christ who strengthens me.

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                  • #10
                    Re: Health Insurance...Kaiser or HMSA

                    Originally posted by Miulang
                    Yeah, health insurance really sucks if you're self-employed, doesn't it?

                    Miulang
                    In a word, yes. It would be useful if there were groups actively seeking members to enlarge the health insurance pool the same way Credit Unions look for new members (your third cousin twice removed qualifies for c/u membership! Make a deposit now!)
                    http://www.linkmeister.com/wordpress/

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                    • #11
                      Re: Health Insurance...Kaiser or HMSA

                      Originally posted by Linkmeister
                      In a word, yes. It would be useful if there were groups actively seeking members to enlarge the health insurance pool the same way Credit Unions look for new members (your third cousin twice removed qualifies for c/u membership! Make a deposit now!)
                      There may be some "affinity groups" that exist within Kaiser and HMSA already for self-employed business people who have professional organizations, like real estate brokers, for instance. I don't know how you'd find out about those though, unless you belong to a professional organization and then I guess you can ask if they have a group policy already. Most insurance companies will insure a group as small as 10 individuals, so if you have 10 friends who work in the same industry, my guess is you could probably buy a group policy that way. It won't be that much cheaper than an individual policy (the big money savings comes in groups larger than about 50 "employees", but any money saved is money saved, right?)

                      Miulang
                      "Americans believe in three freedoms. Freedom of speech; freedom of religion; and the freedom to deny the other two to folks they don`t like.” --Mark Twain

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                      • #12
                        Re: Health Insurance...Kaiser or HMSA

                        Mahalos for the replys. Here's a post from another board that I frequent.

                        HMSA is better. I know for a fact, it cost your employer more money for you to sign up under HMSA than Kaiser.

                        Kaiser supposed to be better in terms of costs. Recently Kaiser posted increases in their health plan costs, which goes straight to consumers, which means you pay more. Now Kaiser and HMSA consumer out-of-pocket expenses are the same, which gives Kaiser a big disadvantage.

                        Under HMSA, you have two choices, HMO or PPO. PPO is more expensive for your employer. HMO requires you to have one primary care physician, which will end up costing you more. If you have a sports injury, you will have to see your regular doctor for a referral. If you are under PPO, you can just go see the sports doctor right away, with no referral.

                        I know under PPO, for prescription meds, you pay $5/mo for generic, or $20/mo for name brand. I believe Kaiser was $10/generic and $25/mo for name brand.

                        Kaiser has one advantage, in which you don't have to travel anywhere outside of the Kaiser facility if you have any problem. Sports injury, same building, having a baby, same building. HMSA, you gotta go to a specialist for different types of ailments.

                        In that sense, Kaiser sucks that there are limited number of locations to serve you. And Long's Drugstore only takes HMSA for prescription meds. There is only one Longs in the entire state that takes Kaiser, it's Long's Ewa Beach. There are no other drugstore that takes Kaiser in that area of the island, so Ewa Beach Longs agreed to take Kaiser.
                        So as you can see, I'm still unsure. A little more research is needed for sure!

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                        • #13
                          Re: Health Insurance...Kaiser or HMSA

                          So as you can see, I'm still unsure. A little more research is needed for sure!
                          I agree with you. The most important considerations (besides the cost) should be convenience (how far away is that doctor's office), the ratio of patients/provider (in an HMO situation, it's typical for one doc to have a panel of 2-3,000 patients), availability of things like same-day appointments (essential if you have kids), after hours consulting (usually a nurse hotline), affiliation with a hospital. I think in the case of the Big Island, Kaiser probably contracts with Hilo General and the other local hospitals for beds because it would be cost prohibitive for Kaiser to build its own hospital, so the hospital affiliation isn't crucial there.

                          If you decide to go with HMSA and have a choice, pick the PPO option. That will give you most of the benefits that an HMO will give you but allow for more choices outside of your general HMO system. Your copays will be slightly higher, but if you need to see a doc outside the system, at least you get a discount over paying the normal rates for seeing a doc outside the system.

                          Take a look at your drug bennies, too. HMOs generally have lower copays for drugs (in my healthcare system, we don't have the option of paying more if we want a brand name v. a generic drug, so everybody pays the same for their drugs, depending on their contract, and because they buy in bulk, the costs are less). I think Kaiser has a mail order pharmacy (like my HMO does) which means you can get your drugs online and mailed to you rather than have to deal with ANY line.

                          HMOs are good for young people with growing families (the one stop for everything feature is one that parents like) and for older people with medical problems (their costs tend to be less, especially for the drug benefit, although it costs more for the systems to have older patients). I have a prescription for a drug that would cost me over $400 for a 3 month supply that I pay $30 for.

                          If you're young, healthy and have no kids, then HMSA will be cheaper for you because you're not going to be seeing the doctor very often (except probably for emergencies).

                          It really depends on what your priorities are. And I'm glad you're taking your time deciding. Most people spend more time trying to figure out what their next car will be than what kind of health care they want...until it's too late.

                          Malama pono,
                          Miulang
                          "Americans believe in three freedoms. Freedom of speech; freedom of religion; and the freedom to deny the other two to folks they don`t like.” --Mark Twain

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                          • #14
                            Re: Health Insurance...Kaiser or HMSA

                            Just found out that your State Legislature last year passed a law which allowed "trade associations" the ability to negotiate group contracts with HMSA and Kaiser. So if you're currently an individual member of either health plan because you own your own business and belong to an organization like the Chamber of Commerce, more than likely you can join a group plan for either Kaiser or HMSA.

                            Miulang
                            "Americans believe in three freedoms. Freedom of speech; freedom of religion; and the freedom to deny the other two to folks they don`t like.” --Mark Twain

                            Comment


                            • #15
                              Re: Health Insurance...Kaiser or HMSA

                              Originally posted by Miulang
                              Just found out that your State Legislature last year passed a law which allowed "trade associations" the ability to negotiate group contracts with HMSA and Kaiser. So if you're currently an individual member of either health plan because you own your own business and belong to an organization like the Chamber of Commerce, more than likely you can join a group plan for either Kaiser or HMSA.

                              Miulang
                              Now that's interesting. I have to find some time to look for trade associations. DPMA (Data Processing Mgmt Ass'n) is defunct, I think; that's one I used to belong to.
                              http://www.linkmeister.com/wordpress/

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