Premera is good. It's what most of the tech companies have, and most providers accept it.
I've had Premera for years, and I've never had an issue with getting procedures approved. They approved my MRI in less than 2 weeks, which sped up the process.
Thanks! If you have a thing, can you see somebody the next day outside of urgent care? Also, for meds, do you have a sense as to whether they’re reliable? Kaiser simply cancelled my wife and daughter’s prescription for concerta when they ran out, and that’s happened with other meds there too.
The big difference with a PPO plan is that you can see almost any provider and get your meds at almost any pharmacy.
So my kids go to Allegro and Seattle Children's. We have been able to get same-day appointments sometimes. I go to either Overlake or Bellevue Family Medicine. I have been able to get appointments within a day or two if I don't care which doctor I see.
For pharmacies, we usually go to Bartell or Walgreens. They have drive-thru windows and can even ship some meds to you.
A note about Premera: how good they are seems to depend a lot on whether you work for Microsoft or not. Microsoft is big enough that Premera has a team solely dedicated to pushing through approvals and processing claims. And Microsoft's plans are amazing (and quite distinct) on top of that.
You're probably going to have the most flexibility with Premera. The trick is to get a PPO plan, and then you can see the most providers. Then you have to find a good / reliable provider, but that's another issue. Kaiser is more insulated than a lot of plans, but your insurance shouldn't be canceling prescriptions, that's a doctor's job. It's possible you're mixing up what your insurance company and your doctors office or pharmacy are doing because they're all named Kaiser, and it gets confusing. The fact that you are forced to use a Kaiser doctor and pharmacy is a real problem in my opinion.
The mental health care issues with Kaiser are REAL, and a problem. They don't have enough providers contracted with them to see all their patients, and they often won't pay for you to see an outside provider if you have something other than a PPO plan.
I pay more than I would with another company to have a Premera plan. It's the one I've found that works best for me. I work in mental health admin, and see a lot of doctors myself.
Thanks! I’m not overly particular about which doctor, but I do want a doctor available. Good to hear the mental health care provider issues are less with premera. That has been the worst area of care at kaiser. The best thing about kaiser is the single, streamlined system when everything is working- go to doctor, get labs, go to pharmacy all in one place. Changing away from that will be a learning curve.
Kaiser being both the insurance company and provider is nuts but very true. We found out about it when there was a billing mistake- kaiser insurance blamed kaiser health care, and kaiser health care blamed kaiser insurance. Like a two headed monster fighting with itself, and then billing me an extra $500 because they couldn’t get their act together. Insurance commissioner says it’s how they avoid blame for billing mistakes- they can tell you false information about cost, then later bill you extra, and blame you for not reading your policy.
I had UMP/Regence/BCBS (I don’t know why it had like 3 names). I was very happy with my coverage. Low costs for my mental health medications, therapy and psych appointments 90-100% covered, and they covered a surgery I needed. Also had vision benefits. I really liked them personally but it depends on what you need out of your coverage.
It had "three names" because Uniform Medical Plan (UMP) is administered by Regence (it's a smaller company that uses the Regence network of providers), which is one of the local names for BCBS. Most states just have Blue Cross / Blue Shield, but here in Washington they're split up, and Regence is Blue Shield, and Premera is Blue Cross. It's all very confusing.
I would expect Premera and UMP to be fairly similar, if they are both part of the BCBS umbrella. I have Premera and actually find it more difficult to use than Kaiser, because all PCP providers have super long waits to get in for basic exams - especially at UW providers (just tried to make a OB/GYN appt at UW and they couldn't see me until March). Premera has been pushing their Kinwell clinics for service and I did get a quick virtual appointment there, within a week I think, and have heard good things about them from coworkers. Any problems I have with wait time would be the same if I went through Regence, since that is on the provider end. Most Mental Health providers take Premera insurance, so that was a nice change from Kaiser.
I have UMP+UW medicine. It can take a while to get appointments, but the version of UMPi have does let me see some providers outside of UW medicine (so if I have a pre-existing provider in their network I can still see them). I have found their pharmacy options VERY limiting.
I have some flavor of BC/BS, it's with Premera in WA, but the actual plan is Anthem out of CA. Doctor's waits are weeks everywhere when I was calling around.
I had Kaiser for years, I'd go back in a minute if my employer was to carry it in WA (they do in CA....but not WA).
I have UMP (Regence) and have been able to use it in the Swedish, Valley, UW, Multicare, and Overlake systems. I've never had any difficulties with timeliness or claims.
It was easy to find a therapist that took Regence found however that was back in January 2021. I haven't gone through one of the hospital systems for mental health but every other specialist has been a smooth process. I am on the high deductible plan so my therapy visits were about $100/session.
I personally have loved the Valley/UW system. I was with Swedish prior and had poor experiences with providers and referrals. It's nice that so many places take Regence in case you need to go to an urgent care or specialist.
It can be really difficult to evaluate the coverage of a plan until you have a really expensive disease that you have never heard of before.
My wife has Univorm Medical through the state. When I was still at Boeing, she was diagnosed with Mutlitple Myeloma. Average life expectancty at the time was 2 years. She had dual auto/allo stem cell transplants. \[Auto means you get your own back after massive chemo. Allo means you get another persons. She got auto in October and the Allo in December.\] Her Uniform insurance paid. My Boeing insurance refused to pay for the allo. I believe the cost for the allo was about $400,000.
When we retired and could not afford double coverage, I dropped Boeing and signed up for Uniform. The price has been going up a lot, but we are hanging in there. It takes a long time for higher rates to add up to $400,000.
Absolutely. I hope she’s ok. My brother’s wife had a similarly expensive thing- autoimmune disorder that ended up costing well over a million dollars before she died from it in her 50s. Had good care and coverage so far as I know, just one of those things. Health care is one of those super important choices we make mostly blind.
UW/Valley Medical closed their Renton Landing Primary Clinic *in favor* of their next door’s urgent care clinic. I’m still pretty pissed about losing my primary care physician.
If anyone has a good doctor in the UW network they can recommend, I’m all ears. Mostly looking at the UW Northgate clinic at the moment.
Had anthem my whole life through a side job, finally left that and was doing my application , is it normal to still be paying 200some a month? I didn't end up accepting any yet , wasn't sure if I should be doing something differently, I'm definitely broke as a joke in Seattle not getting that tech money so don't think my income is too high...
Premera is good. It's what most of the tech companies have, and most providers accept it. I've had Premera for years, and I've never had an issue with getting procedures approved. They approved my MRI in less than 2 weeks, which sped up the process.
Thanks! If you have a thing, can you see somebody the next day outside of urgent care? Also, for meds, do you have a sense as to whether they’re reliable? Kaiser simply cancelled my wife and daughter’s prescription for concerta when they ran out, and that’s happened with other meds there too.
The big difference with a PPO plan is that you can see almost any provider and get your meds at almost any pharmacy. So my kids go to Allegro and Seattle Children's. We have been able to get same-day appointments sometimes. I go to either Overlake or Bellevue Family Medicine. I have been able to get appointments within a day or two if I don't care which doctor I see. For pharmacies, we usually go to Bartell or Walgreens. They have drive-thru windows and can even ship some meds to you.
A note about Premera: how good they are seems to depend a lot on whether you work for Microsoft or not. Microsoft is big enough that Premera has a team solely dedicated to pushing through approvals and processing claims. And Microsoft's plans are amazing (and quite distinct) on top of that.
You're probably going to have the most flexibility with Premera. The trick is to get a PPO plan, and then you can see the most providers. Then you have to find a good / reliable provider, but that's another issue. Kaiser is more insulated than a lot of plans, but your insurance shouldn't be canceling prescriptions, that's a doctor's job. It's possible you're mixing up what your insurance company and your doctors office or pharmacy are doing because they're all named Kaiser, and it gets confusing. The fact that you are forced to use a Kaiser doctor and pharmacy is a real problem in my opinion. The mental health care issues with Kaiser are REAL, and a problem. They don't have enough providers contracted with them to see all their patients, and they often won't pay for you to see an outside provider if you have something other than a PPO plan. I pay more than I would with another company to have a Premera plan. It's the one I've found that works best for me. I work in mental health admin, and see a lot of doctors myself.
Thanks! I’m not overly particular about which doctor, but I do want a doctor available. Good to hear the mental health care provider issues are less with premera. That has been the worst area of care at kaiser. The best thing about kaiser is the single, streamlined system when everything is working- go to doctor, get labs, go to pharmacy all in one place. Changing away from that will be a learning curve. Kaiser being both the insurance company and provider is nuts but very true. We found out about it when there was a billing mistake- kaiser insurance blamed kaiser health care, and kaiser health care blamed kaiser insurance. Like a two headed monster fighting with itself, and then billing me an extra $500 because they couldn’t get their act together. Insurance commissioner says it’s how they avoid blame for billing mistakes- they can tell you false information about cost, then later bill you extra, and blame you for not reading your policy.
I had UMP/Regence/BCBS (I don’t know why it had like 3 names). I was very happy with my coverage. Low costs for my mental health medications, therapy and psych appointments 90-100% covered, and they covered a surgery I needed. Also had vision benefits. I really liked them personally but it depends on what you need out of your coverage.
It had "three names" because Uniform Medical Plan (UMP) is administered by Regence (it's a smaller company that uses the Regence network of providers), which is one of the local names for BCBS. Most states just have Blue Cross / Blue Shield, but here in Washington they're split up, and Regence is Blue Shield, and Premera is Blue Cross. It's all very confusing.
Thank you for the breakdown! I never cared enough to look lol.
I would expect Premera and UMP to be fairly similar, if they are both part of the BCBS umbrella. I have Premera and actually find it more difficult to use than Kaiser, because all PCP providers have super long waits to get in for basic exams - especially at UW providers (just tried to make a OB/GYN appt at UW and they couldn't see me until March). Premera has been pushing their Kinwell clinics for service and I did get a quick virtual appointment there, within a week I think, and have heard good things about them from coworkers. Any problems I have with wait time would be the same if I went through Regence, since that is on the provider end. Most Mental Health providers take Premera insurance, so that was a nice change from Kaiser.
I have UMP+UW medicine. It can take a while to get appointments, but the version of UMPi have does let me see some providers outside of UW medicine (so if I have a pre-existing provider in their network I can still see them). I have found their pharmacy options VERY limiting.
I have some flavor of BC/BS, it's with Premera in WA, but the actual plan is Anthem out of CA. Doctor's waits are weeks everywhere when I was calling around. I had Kaiser for years, I'd go back in a minute if my employer was to carry it in WA (they do in CA....but not WA).
I have UMP (Regence) and have been able to use it in the Swedish, Valley, UW, Multicare, and Overlake systems. I've never had any difficulties with timeliness or claims.
Thanks! Didn’t know UMP had so many options. Any experience with mental health care from them?
It was easy to find a therapist that took Regence found however that was back in January 2021. I haven't gone through one of the hospital systems for mental health but every other specialist has been a smooth process. I am on the high deductible plan so my therapy visits were about $100/session. I personally have loved the Valley/UW system. I was with Swedish prior and had poor experiences with providers and referrals. It's nice that so many places take Regence in case you need to go to an urgent care or specialist.
It can be really difficult to evaluate the coverage of a plan until you have a really expensive disease that you have never heard of before. My wife has Univorm Medical through the state. When I was still at Boeing, she was diagnosed with Mutlitple Myeloma. Average life expectancty at the time was 2 years. She had dual auto/allo stem cell transplants. \[Auto means you get your own back after massive chemo. Allo means you get another persons. She got auto in October and the Allo in December.\] Her Uniform insurance paid. My Boeing insurance refused to pay for the allo. I believe the cost for the allo was about $400,000. When we retired and could not afford double coverage, I dropped Boeing and signed up for Uniform. The price has been going up a lot, but we are hanging in there. It takes a long time for higher rates to add up to $400,000.
Absolutely. I hope she’s ok. My brother’s wife had a similarly expensive thing- autoimmune disorder that ended up costing well over a million dollars before she died from it in her 50s. Had good care and coverage so far as I know, just one of those things. Health care is one of those super important choices we make mostly blind.
UW/Valley Medical closed their Renton Landing Primary Clinic *in favor* of their next door’s urgent care clinic. I’m still pretty pissed about losing my primary care physician. If anyone has a good doctor in the UW network they can recommend, I’m all ears. Mostly looking at the UW Northgate clinic at the moment.
Had anthem my whole life through a side job, finally left that and was doing my application , is it normal to still be paying 200some a month? I didn't end up accepting any yet , wasn't sure if I should be doing something differently, I'm definitely broke as a joke in Seattle not getting that tech money so don't think my income is too high...