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Old 06-29-2011, 10:53 PM   #1
dairyou
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Medical Benefit Question - Kaiser

I just passed my 90 day probation period at work. My husband and I are both in our mid 40's. We have Health Net now (his insurance), but I am considering now adding Kaiser. The reason is: I believe we have a lifetime cap on our current insurance. I think with Kaiser there would never be a cap. My employer has offered me a $3.00 raise if I don't add Kaiser. The coverage with Kaiser is a 3000.00 deductible so we would never use it. It's a just in case.

We could also switch to Kaiser through my husband, but open enrollment is not until December and I don't think my boss will pay for 6 months and then switch over. I don't know though, since I haven't asked.

If I do take the insurance my employer will pay the medical insurance (500.00 per month) and give me a dollar raise.

Opinions please!!!

Deb
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Old 06-29-2011, 11:02 PM   #2
nathalee81
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I remember discussing lifetime caps on a thread awhile back. One of the posters told me that lifetime caps are no longer in effect due to the new healthcare legislation?

Maybe someone else can confirm if this is, indeed, the case?
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Old 06-30-2011, 12:12 AM   #3
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There is no more lifetime max. because of the new healthcare law. One of the many benefits
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Old 06-30-2011, 06:19 AM   #4
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When was your DH's company last open enrollment? If that is coming up in the next month or two, your plan hasn't switched over yet, but it will. If it was anytime after October of 2010, you don't have a limit any longer.
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Old 06-30-2011, 08:58 AM   #5
dairyou
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I think our open enrollment was in April and not again until December.

Thanks so much for the information! I knew my Disfriends could give me so insight!

Deb
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Old 06-30-2011, 10:46 AM   #6
barkley
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one thing you might want to consider is how close you are to the nearest kaiser with an e/r, and also talk to some people who have kaiser in your area.

we lived near sac and could have opted for kaiser vs. healthnet. we stuck with healthnet (hmo) because the nearest kaiser e/r was not convenient to us, and i knew people who had horrendous waits at both the kaiser e/r's as well as getting in to see a specialist.


also look carefully at the coverage-both the kaiser offered through your employer, and your dh's-they could be substantialy different plans, with very different costs. that you've got an employer who will pay the entire cost with no share on your part is realy great. you might want to check to see what would happen if you both opted for kaiser through your employer's (and covered each other on the policys). with some plans double coverage eliminates any deductable entirely (and i'm not sure if kaiser has the kind of deal like healthnet where there's a maximum out of pocket per year cap-not something you ever hope to have to deal with, but if you end up with one emergency that requires return appointments and such, those co-pays and scrips can sure add up).
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Old 06-30-2011, 03:00 PM   #7
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I have Healthnet, my half brother Kaiser, we both live in the Sacramento area.
There are good and bad with both.

My brother had a serious illness earlier this year. 3 months in the hospital (well 10 days in the hosptial, the rest in a rehab facility, or what in reality was a convelescant home). His bill $ 0, (zero). His portion of the premiums are $800 a month.
My wife had a minor 15 minute procedure, my out of pocket was $3,000.
My portion of the premiums is $500 a month.

For me, I wouldn't take my cat to Kaiser. Being free is nice, but I just don't like their assembly line procedures.
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