HELP!! Quit Job to Be Home and Give up PPO Health Insurance for Kaiser??????

Updated on March 07, 2008
K.K. asks from El Segundo, CA
22 answers

I really need advice. I have an incredibly intense job - which I have worked extremely hard to achieve. I have a 9 month old amazing baby, who I stayed home with for the first 4 months but went back to work in early October. My work has been wonderful in some ways, letting me work from home on Fridays and take some flex time when needed. However, the job is a 50-60 hour week job minimum...very demanding. So when I put my little one down to bed, I end up staying up until midnight to continue to working.

I am just burning out and really feeling like I need more time with my baby -- at least more time that is free (not worrying about all the things I have to do for the job.) Plus, I have had to decline certain responsiblities like going to Asia twice for work (each trip at least 7 days!!) I just need a less stressful enviroment and more time for my babe.

The big issue for me (and maybe this sounds like a no brainer but it is a big deal for me) is giving up my great PPO health insurance. I have been going to the same GP since I was 9 -- who is amazing (my husband and baby go there too now.) My husband works for Kaiser Permanente and we would have to go on KP insurance if I quit and give up all our docs.

My big concerns are switching to KP. What kind of care will we get, what happens if one of us gets a major illness and can't go to see any doc we want in this country? I am not sure I am ready to give up our amazing docs and freedom of having the choice to see the best specialists out there if something goes wrong.

I am not trying to come off as a brat - I think KP is good in many ways and my husband believes in the company or he wouldn't be working there. I have just heard horror stories from not to disgruntled patients but from other medical physicians and nurses from outside of Kaiser.

Any insights, help and opinions would be graetly appreciated.

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A.W.

answers from Los Angeles on

Hi K.;

I could imagine how you feel. It is a stressful job and if you could give up working and look after your baby, it is important for you and the baby to be bonding together at this stage. If you're using Kaiser and your husband is working with Kaiser, Please continue to have an insurance because your baby and your family needed a care. My husband is retired last 2003 and after a year, we went to a Cobra Plan which the company should pay half of our premiun then after a year, we are paying our own family plan by ourself. I paid for myself which is $283.00/month, my 16 yrs old daughter is $131.00/month and my 14 yrs old son is 291.00/month. Just requested them to sent you a booklets and you will study different plan that they could offer. I paid $50.00 for a visit as my Co-payments. If we go to hospital, the first amount of co-payment is $500.00 and the rest is Kaiser. Try to stayed with Kaiser because it is important to have your insurance handy and just in case your son and the rest of the family get sick. I know that our insurance company in america is a rocket but we don't have any choice and we needed to protect ourself. If your husband can afford to support the whole family, why not stay home mom and raise your baby. It is worth the time and money to invest with our children well being. After he started going to school, then you can work part time and come home when your baby comes home from school. It is important for us as a mother to stay home so that we could look after our children but also to protect them, guide them and nurture them. since we have so many problems in our society, we would like to contribute to our society a better child like yours and mine. Good luck.

A.

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S.M.

answers from Los Angeles on

It sounds to me like your first choice is to spend precious time with your baby. Great choice, because you don't get any time back that you've already missed. Don't torture yourself with what you're giving up, but focus on what you'll be gaining. I consider my family to be very fortunate to have Kaiser as managers of our health. We gave up PPO long before our little one came along and my husband and I feel we have the best of the medical community. Not long ago, we went through a medical emergency with our daughter and our Kaiser Pediatrician was calling us at home to check on her, before we even got back home from the emergency room. She followed up with us for two weeks to make sure we were comfortable with our daughter's medical concern. We realized then, that none of our PPO doctors had ever taken such extra care of us.
I quit my job in Novemeber of 2007, for the exact same reasons the demands of work and not enough time with my daughter ----BEST DECISION OF MY LIFE!!!!
Good luck with your decision.

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L.N.

answers from Los Angeles on

K. - Kaiser actually has pretty good customer service ratings, but it will definitely take some getting used to. I personally know some Kaiser docs who are excellent. You should also keep in mind that with your PPO plan the doctors you are currently seeing are in your network now but may not remain so. In addition, most PPO plans have very limited out of network benefits, so while you feel like you can go to anyone, in reality you would probably have some very significant out of pocket expenses if you wanted to use a non-network provider.

One good thing about Kaiser is that they tend to be very preventive care focused, so you'll be able to stay on top of all the requirements for that new baby.

If you are really concerned, you can check with your company about COBRA options...you may be able to buy into the group plan for a period of time(at full premium, not the subsidized one you pay now), which would allow you to continue with your current providers.

Best of luck...

L.

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V.G.

answers from Los Angeles on

I know changing health insurance sucks. But I have had nothing but good experiences with KP, I had 2 difficult pregancies and had a whole team who saw me every 2 weeks. Yes, you do not get to see the doctor you choose, that is the bad part. But be gratfeull you still have a chance to have any helath insurance at all. I had to change form KP to a Gp and i prefered the convenience of Kp so much more !!

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E.L.

answers from Los Angeles on

K.,

Sorry to hear of your situation. Can you move to a different position within your company that demands less hours? Can you go part time in a position in your company? If I were in your shoes, I would explore all my options with my employer first. Do they have an open door policy where you can have the conversation about you being an asset to their company but also needing to be at home.
If they can't give you an answer that your family is comfortable with, then I'd quit, take Kaiser and enjoy my child. Can you go on an extended leave of absense? I know that at some point benefits would run out, but you'd have the option of going back to that job.
I've heard 'horror' stories about Kaiser and I have friends that have them and love them.
Listen to your heart...it'll tell you what's right for you. Good luck!
E.

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J.R.

answers from Los Angeles on

I have had nothing but excellent care from Kaiser. I also delivered both of my children with Kaiser. Good luck with your decision!

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H.F.

answers from Los Angeles on

The opportunity to stay at home with your baby is an amazing one. You might not notice the great influence this will have on him and your relationship with him now, but it will flower and as he gets older. Don'y miss this opportunity just to stay with your current doctor!

I had to switch from a great PPO to blue cross when I quit my job to stay home with my kids. I only regretted it once, when I went through a miscarriage and had to go to a new Obgyn. That was awful. But I really like my primary care physician and my children's pediatrician. Most of my family has their health care through kaiser and they have no problems with it, though you do have to double check things and be a good advocate for yourself to get the best out of it.

Forget the PPO. Stay home.

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C.B.

answers from Los Angeles on

We went through the exact same situation last fall. I'm glad to report that we do have Kaiser and our baby has received excellent care there. We have had no trouble getting appointments with the regular pediatrician who has been wonderful, although sometimes when we need to go to urgent care, we have seen a couple of alternate physicians. Still, they have both been excellent as well.
The big plus w/ Kaiser is the ability to access urgent care, Saturday appointments and labs, and the nurse advice line, which has saved us tons of unecessary doctor visits.
Hope this helps.

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S.J.

answers from Los Angeles on

Hello,

My husband has two options at work when it comes to medical insurance, PPO or Kaiser. My personal choice of course is PPO like yourself. I would not go with Kaiser unless you have no other option for insurance. I believe they treat you like cattle, and you can never seem to get seen by the same doctor ever. You see who ever is working that particular day.

Good luck on your decision.

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R.P.

answers from Los Angeles on

I was just as hesitant as you when I switched over to Kaiser 8 years ago. However, I have to tell you, I have received the best care of ever with Kaiser. My son was born in the Harbor City Kaiser last year, where they have a new labor and delivery ward, and the care we received was awesome. Overall, almost every single person I have come into contact with at Kaiser has been very caring and gone out of their way to provide us with excellent care. My husband, my son and I are all Kaiser members now, and we have no complaints. I even love my son's pediatrician! I definitely think that the Kaiser we heard of when I was growing up had a bad rap, and thus Kaiser has worked hard to eliminate it. Another benefit of their organization is that they have gone paperless for the most part, so that all immunization records are in the computer, and your entire medical history is available for any doctor/specialist you visit to pull up. This is all linked to their website as well, so you can log into your personal profile and view your lab test results, make appointments, email your doctor, etc. I once had Kaiser email me my test results 10 minutes after I visited the lab!

The only caveat to my experience with Kaiser is this: it's all dependent on the area you live in. I personally have visted the Kaiser locations in South Bay, Whittier, Anaheim, and Bellflower, and never had any problems; however, when I had to visit the location in Los Angeles, I had a less favorable experience. I think this is just due to the fact that it was in a population dense area.

Anyway, hope this helps. If you're comfortable with all other aspects of your decision to leave your job, I don't think KP should be of any concern to you. They really have come a long way. Feel free to contact me if you need any other info!

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S.A.

answers from Los Angeles on

My two cents: I had a demanding job that I quit when I had kids. I have NEVER regretted it or looked back. You never get this time back and it is so nice for my husband and I that we can relax and enjoy our time together and enjoy our kids instead of everything feeling like a race.
As far as Kaiser, we had it some years ago and I had no complaints. Granted we're all relatively healthy. Assuming you are too, I'd say it is well worth the price/gamble. You can always go back to work when your kid(s) are in school - it's only a few years in the great scheme of things.

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S.U.

answers from Los Angeles on

Hi Kristin. I'm in sort of the same position. I will be leaving my job soon and our family has insurance through my company. We need to continue with a PPO, so we're just going to get an individual plan. It's not as expensive as I thought, but of course much more than what my deductions are at work. But that's an option if you'd like to continue with the PPO. As for Kaiser, I think it just depends on each person's experience. I used to have Kaiser for over 10 years and loved it. Never had any problems or issues. I have heard the same horror stories from other people, but I've also heard very good stories as well. So it just depends on people's experience. Hope that helps.

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M.W.

answers from Los Angeles on

i have kaiser, and i haven't experienced any problems. no matter who you talk with and what coverage that person may have there will always be positives and negatives. no plan is excellent or flawless. even your ppo health insurance has its drawbacks as well as its draws.

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M.B.

answers from Los Angeles on

Quit. As long as hubby agrees, you should be with the wee one while you can.

1) My dearest friend just did the same thing and was really worried about KP. She has been pleasantly surprised and in fact has raved about the doctors and service she's gotten from KP.

2) The fact is that you will be spending a lot more time with the baby than at the doctors. I am assuming your darling needs you more than you need your doctor right now.

3) Since your hubby works there. I would imagine you may get some inside scoops as to the best GP's, specialists, etc.

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D.G.

answers from Los Angeles on

Dear Kristin,

I have had Kaiser for the last 42 years. Had both my children there and now I took an HMO with my job. My children are still with Kaiser and I for one can't say enough good things about it. There are bad doctors everywhere as well as bad service. For the most part I have had great service. I had one peds dr for my kids and didn't like him so I switched to another dr, no big deal. For me, I can't say enough good things. It is a system you must work, but it isn't difficult. Don't sweat it. Enjoy being at home with your baby. The time goes so fast

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M.L.

answers from Los Angeles on

I have had Kaiser for 12 years and choose them over a PPO. You have the right to ask for any doctor that you want in the Kaiser network. if you don't like your ob/gyn you can switch to another one. There is bound to be someone you like at Kaiser (you can go to the one in Torrance, South Bay, Gardena, Inglewood, West Los Angeles, Los Angeles, Orange County... etc.).
I had both my children at Kaiser and they were both delivered by the same ob/gyn. It's absolutely not true that they send you to another hospital if there is no room. Plus, Kaiser South Bay just opened a labor and delivery facility that is quite amazing! Their breast feeding clinic is free - no copays at all - and when my son was having problems nursing when he was first born we went in twice a week for 6 weeks until I was confident everything was ok. When my son was 10 months old and I had questions about nursing and weaning, I called them and they provided me with all the information I needed. They had free prenatal safety and infant nursing classes.
Last year when my oldest son was 3 he had brain surgery. It turns out that there are only a handful of pediatric neurosurgeons in Southern California and Kaiser has one of them. When he was in pediatric ICU the nurses made sure that I was comfortable as well. (BTW, I did not even have to make a co-pay for his brain surgery as well as the 5 days he was in the hospital.)
When my son was referred to speech therapy he had a speech therapist whose part time job was teaching speech teachers at CSUN. My son's pediatrician is the assistant chief of pediatrics. When he had to have a pediatric endocrynologist come evaluate him, the doctor actually came to another floor in the building where my son was, to do the exam since my son has major issues with hospitals/doctors. That particular doctor even gave me his personal work number. Imagine my surprise when I called to leave him a message and he actually answered the phone. The physical therapist that sees my son is extremely patient and personally schedules his appointments for me to fit my schedule. Every referral I have asked for I have received and had the appointment within 2 weeks.
The flu shot is free and in fact, they have drive-up clinics, where you don't even have to get out of your car and they will give you a flu shot.
I think that Kaiser gets a bum rap. I'm not saying it's perfect but I don't see any of its physicians or facilities as below standards.

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C.C.

answers from Los Angeles on

Hi K.,

When I went on my hospital tour when I pregnant, the tour lady told me that Kaiser insured moms to be had to call in advance to make sure there was a bed for them. If there wasn't a bed, they had to be sent to another hospital to deliver. I don't know how much truth there is to that since I didn't have kasier at the time.

I had Kaiser a few years back and wasn't too impressed with them. It takes several days to make an appointment with them. And once I was there, I had to wait at least 30 minutes for the doctor to come see me.

That's just my take.
Good luck!
___________________________________________________________
Keep a log of your baby's growth. http://gagazine.com/join/

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D.A.

answers from Los Angeles on

Just an Idea, Why not have a ppo to back you up. If you can afford to buy a PPO . You are not paying into your husband group plan. So if you put you and the child or just the child. Who ever you are most concern about at this time , call me I am INSURANCE AGENT and I offer PPO/hmo I can send you a quote. I am appointed with all the carriers. Just let me know which one you 've been with and I can work with that if you want.
Deborah Alpert ###-###-#### after 10am. call
____@____.com
Put subject "Mamasource" so I won't delete it..

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E.L.

answers from Los Angeles on

I really like Kaiser

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C.L.

answers from Los Angeles on

Aloha K.,

I have just changed back to my PPO from Kaiser.
I could not find the same quality and specialty care I or my two sons, needed through Kaiser. Others in our family were ok with preventive care and even with that, I truly felt like we
were on a cattle call most of the time.

I did not appriciate one doctor making the decissions as to
weather we needed to see the dermataogist or OBGYN or SCIphysican before going to the specialist I knew we needed to see. It was not so good for us, but for my mother and dad who are in their 80's and 90's their doctors are set with one main doc. and they are pretty much covered by that one unless the doc could not make the diognois. that is in Hawaii..
when we came to California....Oh my Gosh did we have problems getting a doctor to work with my parents and follow what they needed. I didnt even mess around with me and my boys..I knew I would not have the specialist I needed so I went to the PPO's doctors that my old PPO doctors recomended.

I appriciated the indivisual care I recived from our own doctors whom I have been with years before and when Kaiser could not assist my needs right away I went back to my ppo doctors any way and paid their fee on top of my Kaiser membership.

I decided that my peace,health and my childrens health was a priority and I needed to 1st.make the change. I Must Change.

Today I am back to being a business owner and investor with my own hours growing my passive income and building my daily income to afford my PPO and so much more.

I am peaceful and know that I made the right decesion.
If you need to talk call me at ###-###-#### (cell)
###-###-#### (hm)

Aloha Ke Akua,

C.

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A.L.

answers from Los Angeles on

Would you be able to buy PPO health insurance on your own? I think you have made a great decision already to spend more time with your baby by giving up your work. That is a wise choice and will make you and your baby much happier. I think the issue of insurance comes secondary compared to the sanity that you get without work stress.

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D.L.

answers from Los Angeles on

personally i have never used Kaiser and I am sorry to say never will. I have heard the worst stories about people going there. my sister is a speech pathologist and she says that it is fine if you are healty but god forbid someone who is actually sick. the care stinks! A little boy in my sons kindergarten last year started mumbling and slurring his speech in class. they reushed him to kaiser and they sid nothing was wrong with him. My sister who works with brain injury jumped in and told the family to demand a pediatric neurologist now. They finally got one after an intense struggle and he was having like 40-50 seizures a day. something Kaiser missed. Kind of serious. My husband was a realtor for years so we always had to have private insurance. We found that healthnet ppo was a great option for us. Affordable, great benefits and regular care. If you are ready to give up your job then do it and find another job with good benefits. sounds like you are very qualified to negotiate a good deal for yourself with a new company and have less hours.

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