SANTA ROSA , CA ., CALIFORNIA -- Please! If you have KIASER, HMO, for a few dollars more you can have an 'PPO' . If, you have serious issues, you need to venture on to a 'PPO'! Its literally a few dollars more. We "WERE" members threw his work, and they were taking $40.00 month out of his check.
PPO.....$5.00 more.... a month ! Prescriptions 1/2 the cost!!!!!!!!! He went in and, was diagnosed to have hepatitis B, then they fraud gently said he has hepatitis A-C-D-E, and was charging his insurance $100,s of thousands of dollars! They had us in there every 3-5 days, we were dropping $20's and $40's like playing the slot machines! repeating the same test. I kid you not............you know us women........... IF, I DON'T GET AN STRAIGHT ANSER, LIKE THE STRAIGHT QUESTION I ASKED, THEN YOU KNOW, THERE HIM HOLLEN YOU AROUND!!!!!!!!
And, guess what O.M.G! Proof, it was just that! This the Santa Rosa, Ca . Located at #401 Bicentennial . the main one. Dr. Susan, his liver doctor, the gastroenterologist dept. O. M.G! Please beware. I had his primary doctor call me he was like " Hay this is doctor James, I was like hay!, he's not here..... he's at work! He was like," well you are the one ,...I want to speak with............... you're always together! You know ,.... he's very, very, sick !!!!!!!!!! He has less than 10 percent liver function, and he can die today or next year."( And, a little more said of the same.) He's very sick from the hepatitis A-B-C-D-E . And , I was already being doubtful.( now keep in mind we know of the b, and he will out live all of us, not an issue ). Okay I get to the point. I knew something was terribly wrong when .... a botched hernia operation... went in with 1, and came out with 6. It was obvious for a the need of a second opinion, they refused .... so we dropped them.... and got a PPO and,.... was cheaper, (we see who we want, when we want for the same money ! You see .....if its a closed network, that allows them to lie, make up, and create bogas non- existing reports , ) We had 4 test done Sutter, Memorial, Santa Rosa Community Clinic, and, UCSF, and O.M.G! it came back 'NEGATIVE!!!!!! NEGATIVE !!!!!!!!!!!! NEGATIVE!!!!!!!!!!!
Never, even came in contact (We all come in contact, 1/2 creates antibody to rid of those diseases, and the other 1/2, has issues. ) And the B.... he's so low, it's undetectable. That is ;1 of 5, serious ongoing medicals procedures, being "ongoing" makes it to be one of the most expensive treatment's to treat, because its" ongoing ," beside aide's !!!!!!!!! And ,they charge the insurance up the " WAH- ZOO " !!!!!!!!!! They refused us second opinion, by law you can get a second opinion . They are one net work... all one network. He ,now have" ANTHEM- BLU- CROSS" not the one, just anyone off the street can get ..... we know that can be pricey !! BUT threw your work, of course its going to be cheaper,. you can get it .... but you to drop KIASER . They will have the option, for you to have ANTHEM-BLU-CROSS, among other's, we liked ANTHEM. We so far LOVE ANTHEM. Kiaser is a poor mans insurance. *Now, you'll see I left out some letters, of the doctors names .. but , I guarantee, you will find the names if ,you pull them up. So , I guess I would not get in trouble!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! OOOOOOOOOOOOOOO!
But! Dr. Richard, the hernia dept. ( He would refuse to see us even if, we made an appointment, he would cancel ,or do a no show.!!!!! concerning the 6 hernias, that sticks out 10 inches I swear! There was a Dr.M , he popped up from absolutely no where and purposely jammed a 3 inch needle into the hernia and ,..smiled like.. when you say....did it hurt !!!! The nurse said ;" we need to file a complaint on him for his conduct !!!!! " When , we tried doing just that , we were told", that he did not work there any longer! Dr. James, primary doctor (he said, I'm sorry I can't get involved in this hernia drama, but urged us to keep asking the right questions !!!!!!!!!! All these hernia issues ....politics .....we said " yeah we know its a job... I know we couldn't help but ,... feel for him! Dr. Susan- the gastroenterologist dept. Now! you make your decisions, and while your doing that ....don't count on the research on these doctors, because ,...they will come up as magnificent brain surgeons, and they cook for the needy...and pay for it all !!!!! Its ALL a bunch of crap!
As long as they Kiaser keeps there dues to the city/state paid , they can write what ever, REMEMBER ITS A FREE SPEECH, and its a network, within a network, so ........ your not going to find out squat . Here's the real messed up thing ,...from the liver doctor Susan she was like yeah! his , "doe doe" is a little high and his" gaga " is a little low ( and if that's all true then the only thing is in question to have done is a biopsy!
But ,no issue, then no biopsy. Yeah!!!!!!!!!!!! We know now .Please good luck. I pray for you. ex Kaiser member.
I couldn't believe it- I'm a 52 year old RN who has worked for Kaiser Medical Center as a per diem RN for 11 years. I am in perfect health. I windsurf, surf, roller blade, hike, bike... I never get sick. I have always worked as a per diem RN ( for 30 yrs.) so that I can control my own schedule and travel etc. I have always had high deductible Blue Cross. I have never used it. I was always a little embarrassed when my pts. in the hospital would ask me something about my personal experiences with Kaiser health care and I would have to say I don't have Kaiser- I have Blue Cross major medical. I would try to avoid telling them that I have almost never had a Dr. appt. in my life. My only preventive health care is occasional paps at Planned Parenthood (all negative).
So I decided to finally fork up some more dough and pay for a Kaiser plan that would include regular check ups so I would finally start getting regular check ups.
I filled out the application online with no doubt in my mind I would be accepted. I wanted to be sure they couldn't ever use the excuse that I didn't reveal something on the application so I put everything I have ever been seen for down- a sprained knee, pre-cancer from too much sun on my face removed by the derm (show my an adult that doesn't have that and I'll show you a person that never gets sun- it is completely benign), and to the question "Do you have regular periods?" I answered "no" because I have been in menopause for a yr. ( a perfectly normal situation for a 52 yr. old- DUH!)... but they offered no chance in the application to elaborate that I'm in menopause.
I couldn't believe it when I was denied health insurance because :
1- Unspecified muskuloskelatal condition
2-Unspecified gynecological condition- irregular periods
3- Unspecified skin condition
Keep in mind I provided the name, addresses and phone numbers of the dermatologist and the orthopod that treated my face and diagnosed my knee (no treatment needed- just resting it).
Meanwhile I'm back on the medical surgical unit at Kaiser Hospital lifting and turning pts., running around the unit --- but they won't give me health insurance!!!! (I very seldom call in sick and when I do it is really a mental health day.)
I'm so furious! At least I will never again be embarrassed when pts. ask my about my Kaiser health care and I have to say I don't have Kaiser.
I will also never be embarrassed if I ever have to go to an ER or Dr. with my essentially worthless Blue Cross insurance. I did my part to attempt to pay for better insurance. I will have no qualms if the need arises to get the health care I need and then just declare bankruptcy and refuse to pay it. The system is so screwed up it begs for that.
Thanks for giving us a voice!
REDLANDS, CALIFORNIA -- I had a bad seizure on Dec 7, and was taken to Redlands Community Hospital ER. They brought me out of it, stabilized and discharged me the same night. I called in to my primary care doctor at the Kaiser Redlands clinic; and he saw me in a very timely manner. But then he ordered a follow up visit to a neurologist, and the earliest appointment I could get was not until Jan-16. The reason I need to see him is that the seizure zapped my short term memory; that and during waking hours my experiences become dreams instead of memories. The ER doctor thought that I had suffered hypoxia during the seizure. I can't believe that Kaiser, knowing what I went through and the after effects, thinks it is fine for me not to see a neurologist for six weeks after a seizure that nearly killed me. I have to call in every day hoping there will be a cancellation, but it's no use. I suspect that Kaiser Fontana is understaffed. My husband and I pay almost $1,800/month for our two premiums. That is why I say that Kaiser charges like Kaiser, but at least in this case it feels like I'm on Medicaid! Perhaps that is naive. Perhaps it takes six months to see a neurologist on Medicaid. I just think that considering the brain damage from a seizure that almost killed me, I'd be a higher priority to Kaiser.
WOODLAND HILLS, CALIFORNIA -- I broke my ankle, went to urgent care. ($40 copay). They referred me to orthopedics. ($40 copay). They told me I needed to go to the "casting dept", but they only put casts on from 8 am to 10 am and it's on a first come first serve basis so get thereby 7 am. the next day. That's 2 days with a broken ankle, with no brace and no cast. 7 am the next day I arrive and sit with many other people with broken bones waiting for their casts. I saw an "attendant" ($40 copay) who was very rude. For my follow up visits if I wanted to see an orthopedist it would take 2 months to get an appointment, so I could only see an assistant also for a $40 copay. Now that I am assigned to an assistant, I can not see an orthopedist, only the assistant. After 6 weeks, the "assistant" told me I should be healed and to "just walk on it". That was 7 months ago and many complications and lack of answers. I have run the gambit of seeing Podiatrists, Physical Therapists (which you cannot get a standing appointment for each week). Today I called to ask the Orthopedists assistant can renew my temporary handicapped placard, because Physical Therapist can't do it, and orthopedics said they won't renew it because I should "be healed by now". My records indicate that I am in Physical therapy, and still walking with a cane. The person on the phone said maybe he would renew it if I came to see him again ($40 copay). It could be so easy, but Kaiser doesn't make anything easy. Most times when I've gone to Kaiser for anything it's been an assistant, not a doctor or there is about a 2 month wait. Why is the copay the same to see an assistant as it is a doctor? If I could get off Kaiser I would in a heartbeat.
SANTA CLARA, CALIFORNIA -- My Mother has Kaiser...always has. She pays for her benefits quarterly, and always on time. She underwent bi-lateral knee replacement at the old Santa Clara Facility. Her Orthopedic Surgeon was great. While in the hospital (Kaiser Santa Clara) she was subject to the usually poor "in hospital" care that we all have heard about. She was transferred on a holiday to the SNF (Skilled Nursing Facility) without her medications or CPM devices. On her second day at the SNF, a "Patient Care Nurse" (that's DISCHARGE NURSE") told her that her rehab was not progressing. The nurse then later ignored the Durable Power for Health care and violated her privacy (Sections 160 and 164, SS A,E according to the OCR). In a conversation with the son (DPH), the nurse blurted out that the patient didn't even deserve to have Kaiser benefits, because she only had them because of a retirement package! The nurse then made 2 harassing phone calls to family C.P.C. 653M (a crime, misdemeanor) which the family recorded and played back to the Santa Clara County Sheriff. Upon filing a complaint with Kaiser's "Patient Relations" a series of letters discounted the ordeal and claimed it never happened. In some letters, the issue was never even addressed, it was as if they were having a monologue. Kaiser NEVER even asked for any clarification, to listen to the tape...NOTHING!! It was reported to the OCR, Office of Civil Rights, and a year later....nothing has happened.
Recently, My mother went into Kaiser because her foot was red and swollen...they took an MRI, and prescribed 2 courses of antibiotics...without taking a culture. 25 days later still painful and swollen, I insisted on a referral to Podiatry, they took a X-ray....BROKEN FOOT! The moral of the story: Don't bother complaining...Kaiser will brush it under the rug....then discriminate against you....in a very business-like manner giving the appearance that they are doing everything they can. This "Patient Relations" is a nothing but a drop bucket for complaints....that go no-where. KAISER FOUNDATION is a business. While other hospitals are going under and struggling with budgets...they built a $700 MILLION PLUS new hospital in Santa Clara Ca. You figure it out. I can't get my mother to leave Kaiser, though she knows it's not all she thought it was. She knows Kaiser isn't the best, she CAN afford better....I guess she's used to Kaiser's abuse and sometimes does not seek treatment, because she says;"Kaiser is trying to kill off old people". NOW THAT"S NUTS....In my opinion Kaiser isn't trying to kill off old people....Kaiser is running a hospital as a business....as cheaply as possible....and if people die...so what!.
The day they opened the new hospital, they had all the Kaiser big wigs there for a walk through....these are some of the most repugnant individuals I have ever seen....all patting themselves on the back about what a great hospital they have....I wonder how many people they have MIS-Treated to build that thing! It was the 2nd largest construction project in California!!! The stories people tell about Kaiser...I'd have to say they are ALL true. Kaiser is in it for the money....nothing else! Even Kaiser employees say it's LOUSY care!!!Too Much!
SACRAMENTO, CALIFORNIA -- After being on Kaiser from the age of six months to now at 58 and never having a problem, all that has changed. In the last few years the rates have gone up and up and service has gotten worse. It's all about the money. I have a chronic, painful condition- arthritis in my neck (diagnosed by a Kaiser Dr.) and TMJ. I have had an RX for a pain med and muscle relaxer for years, which was used only as needed and sparingly. I was sent a notice recently that they had assigned me a new Dr. after years of seeing the old one who never gave me a problem with refills. I recently sent in a refill request for my meds and the request was denied saying I had to come in for "lab tests" and an evaluation to determine "if I actually had the condition and or if it still existed" What??? NO! I'm not stupid and know Arthritis and TMJ do not resolve. They are permanent conditions and "lab tests etc. are NOT necessary for these conditions. They only want me to come in and pay the MUCH higher than before co-pays to run tests that are not necessary and are worthless as far as my conditions. They kept me going through tons of red tape and hearings I didn't request only to keep denying me my meds. NO more Kaiser for us. We are leaving and going to a new health plan. Kaiser is no longer the good company it once was. Now it's corporate greed.
ONTARIO, CALIFORNIA -- I fractured my knee cap March 2011. It was shattered and surgery with hardware was used to reduce the fracture. I was referred to physical therapy. However, the woman to whom I was assigned never spoke to me or really provided me any real treatment. She was busy training a physical therapy student.
I was unable to walk properly when released. I discussed this matter with the surgeon and nothing was done.
I sought private treatment paying on my own.
By August 2013, I was unable to walk at all and in extreme pain. I saw their doctor. I was given a sheet of exercises. I persisted. I was given a referral to an orthopedists. X-rays were taken. The X-rays showed the arthritis but the denied the necessary treatment. They focused on my bad knee but I kept telling them it was left hip. I was seen by a physician's assistant who told me this was "my new normal."
I was referred to Physical Therapist, but despite how crippled I was, I could only get an appointment every 3 or 4 weeks. The therapist tried to make an opening for me, but was completely overbooked.
On 12/31/14 I switched to Aetna on a PPO. My left hip is now completely frozen. It turns out the hip was completely arthritic and had been since August 2013.
I am going to have a hip replacement. I is now June 2014. I have been walking with a cane and in severe pain. It has taken this long, after escaping from Kaiser to get treatment.
My advice is to stay are far away from Kaiser as possible. Despite their representations, they balance their books by collecting co-pays and denying necessary care. Beware.
LARGO -- Double nightmare with Kaiser. I am livid to the point of tears. These people are more interested in the number of patients and days of stay than providing care and information. I am still dealing with a mess of a system that only cares about the Kaiser bottom line. I can not speak to one person that can answer my questions or provide advice. Everyone tells me I need to talk to someone else, yet I find that decisions are being made without my knowledge, consult or advisement. I can not plan for these decisions without being advised of then in advance. They have major implications for my time, purse and other resources that I have to have in place. They discharged my mother, who has Alzheimers, from a Kaiser facility and I was not advised that this would occur, never told them that where she would go upon discharge, was never advised of the discharge care needed, of the equipment that the facility to have to rent (which I will have to pay for), was never given an opportunity to plan for an alternative facility for the discharge, the list goes on and on. I was advised that she would be discharged in 2 days. I was called after 4 o'clock on New Year's eve. Which gives me only 1 working day to prepare for the discharge, financially and otherwise. I would have appreciated some prior discussion before they decision regarding her care were made and put in motion. I am not invisible, deaf or dumb, and I am her surrogate of record.
ROCKVILLE, MARYLAND -- Kaiser started billing me after I had a foot surgery even though I had paid for everything up front, and went against their own member services, and surgeon on the 90 day universal health laws in the state of VA/ They also refused to fill my primary DR's prescriptions at their own pharmacy! Stay away ! Each Primary has hundreds to thousands of patients and has no time for you ( 5 min or less per visit, I was told the 1 st day by my Dr) If you have serious issues, you will get 3 world care at best! These Dr's are there due to failing at their own practices, or being sued for malpractice! Think about what your doing ?
SOUTH SAN FRANCISCO -- A Kaiser Dr. finally prescribed an MRI for my lower back when I began showing nerve damage, never mind I've been suffering from back pain since the age of 26. It takes nerve damage people so if you need an MRI then say you have nerve damage, as evidenced by the numbness in my legs.
Anyhow, I also had upper back/lower neck pain and requested that area have an MRI as well in the same visit rather than my having to take more time off work to have it done on another day, and hopefully before nerve damage happened.
I was denied by the Dr. and the MRI was not granted until I asked for the denial in writing. So ask for denials of care in writing! I asked the reason for her denial and she said " because it's expensive". Even if that's the reason and I know and she knows it, I couldn't believe she said those words, but she did. As a side note, the MRI techs said it is not that much more expensive to combine the tests.
Now I am truly afraid to trust Kaiser for any back surgery, so I live in pain every day. I have been denied other insurance due to my existing back condition. When COBRA runs out, I'm screwed.
My advice to anyone/everyone dealing with Kaiser. You MUST do your own research, and DEMAND care. It is stressful and I left Kaiser crying but you have to do it. I understand You cannot sue Kaiser in most cases because your policy calls for arbitration. If I had any other choice I would get other insurance.