Is Kaiser a Good Place to Stay If You or a Family Member Have a Chronic Illness?

Updated on September 23, 2012
M.P. asks from Los Angeles, CA
6 answers

My 10 yr old daughter has been having all kinds of crazy symptoms for the last 6 months and counting. It started with Chicken pox (and then it wasn't chicken pox) Had a case of encephalitis which led to lumbar puncture (spinal Tap) Ct scan of her brain and a few days stay at Kaiser Pediatric Hospital. Diagnosis...... Fever with no Sepsis. Does that mean it wasn't encephalitis? Since then which was in April, She has been complaining of headaches, back pain, muscle pains, Joint pains, and just not feeling well everyday! She also started having mild fevers on a daily basis. Went to the doctors she ordered a lot of blood work to be done. All lab tests came back normal except for the ANA was slightly elevated 1:160 titter. We were sent to a pediatric rhumetologist specialist. She asked a bunch of questions in which i mostly replied a yes answer too. checked my daughters ROM, looked at her knees and said she's suffering from depression or fibromyalgia. Neither one of those explain her everyday fevers. WE have gone to the dr every other day for about a month now and i still have no answer on what is going on with my daughter and why she is constantly in pain. They all seem to look at me like im a crazy mom or a hypochondriac. We have Kaiser and it's open enrollment time. I'm stuck, i don't know if i should keep Kaiser or change to another insuarnce provider? I also know there's some important things to know about existing condition rules? I've never had any problems with kaiser, but we've also never had any kind of a chronic illness. I just don't know what to do ? If anyone has any kind of advice please let me know. Thanks

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K.B.

answers from San Diego on

As long as you had insurance before switching plans then your new plan has to treat any pre existing conditions. I know from personal experience.

As for Kaiser, they are horrible! Many people I know have suffered at their hands. Even more I do not know. They do everything to avoid finding the solution. When they do, they do everything but fix the situation. They have several lawsuits against them.

I had them during my pregnancy and the Dr's are lazy! I had to file a grievance against my Dr and demanded a new Dr. I had also asked for a C-section due to my back injury and the Dr I had thought I just didn't want to have a vaginal birth and dismissed my request. When I changed Dr's and took him the file I had on my back, which is over 12 inches thick, he granted my request. Even said that due to my condition, my request was not unreasonable. Amen! And just to let you know, I do need back surgery. My L4-L5, L5-S1 (lower tailbone area) discs are protruding and flattening my nerve, and I was worried about aggrevating my condition, further. I'm glad the new Dr saw the risk in a vaginal birth. I either got lucky or he had a heads up about the previous grievance I had filed on the Dr before him.

If you can switch, I highly recommend doing so.

My mother has been battling a chronic condition that they just can't seem to treat properly. Their methods are very questionable, and some even embarrassing, and not necessary.

I have a friend that works at a hospital and I told her about the situation that I had filed the grievance about and when she ran that by another Dr, that Dr was in shock and couldn't believe I went through it. And I've even had the nurses ask me to do things that the Dr should have been doing for me. The patients are none the wiser as to what the proper procedures are for various things. I also always walk out bruised when they draw blood. Even had one nurse who twisted the needle in my arm trying to find the vein. And mind you, I always let them know that other nurses have had a hard time locating my veins. They are small, and they roll. I don't blame them...lol. Anyway, that nurse even repoked the same area a few times before having another nurse try. My dad who has excellent veins for drawing blood, has had the same experiences. Walks out bruised and had a very rough nurse.

My father also had a heart attack a few years ago. During one of his hospital stays the Dr was very lazy and was releasing my dad from care. Luckily he had an attentive nurse that felt it wasn't in his best interest to leave their care and stressed this to the Dr. Shortly thereafter, my dad had another heart attack. Thank God they hadn't discharged him! Thank God he had a nurse that took pride in her job and that was attentive and willing to fight for him to stay admitted!

These are just my horror stories with them. I'm sure there are a lot of people who love them, but I don't know any!

They have some nice perks. After hours office visits. Discount OTC medications and such. That's all I can think of. Are those things worth the care that they offer? Not to me.

I also have a friend that has a daughter that went through something similar. It had something to do with her muscles, I believe. I will have to contact her and ask her the name of the condition and send you a message on here with the information. Her daughter was about 16 when it started. She had to quit dance and can't do anything strenuous. I will let you know what I find out.

Best of luck in your decision.

I do hope and pray that your daughter gets well. I will keep you and your family in prayer.

1 mom found this helpful
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J.C.

answers from Los Angeles on

Think about your out of pocket expense when you make your decision. What if it turns out that your daughter does have a condition that would require medication and/or frequent doctor visits? Just food for thought. Kaiser has great resources (especially at their Hollywood locations) that you need to make sure are used for your daughter. I have Kaiser and know how to get the most out of what I feel I need. Send me a private message if you would like to discuss more.

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C.D.

answers from Los Angeles on

I would never have my family on Kaiser if I could help it. I know too many people that have died or suffered because of Kaiser. If you end up staying with them, you have to be very firm about what you want/need and do not give in to them if they don't want to keep looking for an answer/solution.

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L.C.

answers from Los Angeles on

I've never had Kaiser but I prefer using a PPO where I can choose my own doctors and hospitals. Also, the new insurance laws don't let you get turned down for preexisting conditions. You can call the state insurance commissioner's office and they can explain to you your options. Also Call Children's Hospital of Los Angeles and speak to them. You need a second opinion from a place that specializes in children. Good luck!

1 mom found this helpful
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J.L.

answers from Los Angeles on

I had kaiser years ago and never had issues with them but I did not have any health issues. My mom has had kaiser all of her adult life (thats who I had it with) and as she has aged she has had lots of issues with them. Because of that I never recommend Kaiser to anyone. I understand you are stuck with this whole "preexisting condition." I do not know for sure but I think that it applies to people without insurance trying to get insurance. Call your prospective insurance companies and ask to be sure. When you switch carriers your old insurance carrier has to send you a letter of proof of coverage and I think that is where it comes into play. If you are still left with kaiser I do know you need to fight like a beast to get answers. So be ready to take on the drs. to get answers from them. Occasionally you will come across a great dr. at kaiser. It is difficult to get them to break the kaiser philosophy of put kaiser first and watch out for kaiser's bottom line.

1 mom found this helpful

N.T.

answers from Los Angeles on

Lupus! Lupus! I have it... I had ALL of the same symptoms (except chicken pox) at age 18. It can be triggered by virus. And it disguises itself as other things. I don't have any recommendations as to whether to remain with Kaiser or not.

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