FUDiabetes

Kaiser Permanente: Great insurance for T1 Diabetes

Maybe getting a little off topic, but I can highly recommend Kaiser Permanente, if that’s available to anyone. When our son was always thirsty and peed a lot earlier this year, I emailed them for a urine test on the Sunday before Memorial Day, did the test on Memorial Day itself, results that night, email from Dr the next day, call from hospital before lunch, and we checked into the hospital that afternoon. All set up, no paperwork, perfectly synchronized even during the pandemic. We left three days later with all the education and supplies needed. G6 came in the mail soon thereafter and any reordering of insulin and supplies is online and super easy. Different levels of coverage of course, so one would have to check out what works for them. Just thought I’d mention my great experience.

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@Andre, that is great! It took us months to graduate to a CGM when my son was diagnosed.

How good and forthcoming are they on training? Have they discussed pump?

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I feel that we and our son got all the education we needed to make our own informed decisions and to have a solid foundation as T1D parents/patients to feel comfortable to initially manage. I’m an engineer and my wife is a biologist, so we had more questions about how and why things are the way they are and sometimes they didn’t have the patience, time, or depth of knowledge to satisfy our hunger for information, but I don’t blame them, because the general clientele is probably not as geeky as we are, geeky being a good thing :slight_smile: I felt great leaving there. There were also follow up meetings with doctors, dietitians, nurses, etc, all virtual during the pandemic.

They wanted us to do things manually at first, before graduating to a pump. I agree with that approach. Kind of like learning math the hard way before being allowed a calculator. Although they educated us on pumps, our son didn’t want one yet. He and we, with their help and internet info like this forum here, made the informed decision that a pump is not for him for now for various reasons.

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I am glad you are getting the care you need at Kaiser. Having experienced both the Kaiser PNW way and a standard pediatric endo, I feel that the Kaiser care is way way inferior to the standard pediatric endo. For instance, when my son was diagnosed we had a diabetes educator spend 16 hours personally with my wife and I to ensure we were ready for discharge. Then every day at home for the first week a diabetes educator called and asked if we needed help, then we had access to 6 classes taught by the diabetes educators, including hands-on sessions with CGM’s and pumps as well as a baseline of information on sick days and other important information. In addition we routinely had less than 30 minute call back on questions and requests. At Kaiser in the PNW we aren’t allowed to see an endo, just a diabetes trained general practitioner, who learns from my son rather than teaching us anything. They don’t know any of the current literature or trends and routinely try to get my son to accept a good enough outcome in his A1c rather than continue striving to improve. This was definitely not the case with our commercial insurance endo. It is not all doom and gloom however, where Kaiser PNW shines is in the management of prescriptions and keeping the costs of equipment and prescriptions low. We spend 0 time keeping up with prescriptions anymore, we are allowed to order directly from the manufacturers (huge bonus not having to deal with middle men) when supplies are needed, and our copays are the lowest we have ever had. With commercial insurance we were paying about $200-$250 per month for prescriptions and supplies for both pump and CGM. With Kaiser we pay that much per quarter. It is a noticeable savings, but the quality of medical care isn’t even close. With that being said, now that we are in maintenance mode the trade off is fine.

edit - I should also point out that each region of Kaiser has different rules, so I hope your experience is better than ours since you are in the CA region.

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I’m glad you’ve had great care with them… I think your story is not similar to what we typically hear about Kaiser. But every one has their own experience. Glad they’re taking care of you!

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My son felt the same way for the first three months after his diagnosis. We took him to a week-end diabetes camp the summer after he was diagnosed., where all the camp staff consisted of young T1D adults in their early twenties, who were very able to connect to teenagers: it made his internalization of diabetes so much better!

FYI, when we drove him back home from that camp, he told us that he wanted a pump (every counselor at camp had one).

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Oh yes, we were looking into a camp, because we hoped it would be nice for the connection to kids in the same situation. However, with Covid nothing was available. Next year I hope. I could imagine once he’s out of his honeymoon, he’ll want a pump. He’s doing a rate of 1/30 right now. We hardly ever give more than 3 units right now.

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Sad that experiences vary so much. Wouldn’t it be nice if all healthcare work well and is mostly affordable! I heard general bad things about Kaiser before, but I tried it some 8 years ago and never looked back. We had all the services you described as well. In fact I just emailed the Endo Dr about my son’s unusual highs and she emailed right back on her day off. I don’t mean to shamelessly advertise for Kaiser, I have no affiliation with them, just want to share how happy I am with them.

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Glad it is working out for your family

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@Andre I am happy for your and your family that you have received great care as you embark on this lifetime voyage and happy that you found us in this little corner of the web.

I have had Kaiser off and on over the last 40 years. In my experience if you don’t have a chronic condition your experience is very very different from someone that does. Also, because of the great quantity of members at Kaiser, getting into and scheduling follow up appointments in a specialty clinic can be a challenge.

Those who unfortunately (or possibly fortunately in this case) have a chronic condition generally get faster access/service throughout the system which I believe is so Kaiser can minimize risk and thereby lower costs overall. As an individual with a chronic condition I have gotten appointments with a call to my primary or advice nurse in less than 1 hour. Once I have been seen in a specialty clinic appointments are easier, but wen you call and relate the issue to management of your chronic condition appointments that were previously weeks out are suddenly available that day.

Overall I have few if any complaints regarding quality of care at Kaiser, but that is also based on my being a chronic patient in a multi-risk class system that favors risk aversion and my being a higher risk than some and fortunately less than others. As an added benefit, Kaiser is very very proactive regarding medication safety. The member base is one giant data pool that Kaiser uses to weed out of their medication formulary potentially harmful medications sometimes years before formal FDA recalls occur.

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Also, at least in the PNW division they recommend some tests/vaccines on a very different schedule than others. For instance our friends at 50 got a mail in feces sample to decide if they need a colonoscopy, rather than just getting one. And they don’t recommend the shingles vaccine until age 60, where everyone else recommends 50 or above.

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