Question:
Should I switch to Kaiser for WLS????

I live in Tulare CA and have Blue Cross HMO (California Care) and was referred to Fresno Surgery Center. At the WLS seminar, I was told Blue Cross patients have a six month wait for surgeon consult, and that's before seeking approval from the insurer. The problem is that there are so many people requesting the surgery and limited OR time at the hospital is booked for six months. They are talking about using St. Agnes but the hospital is in negotiations with Blue Cross (at the time of the seminar). Well, November is open enrollment for my insurance. I am considering a switch to Kaiser HMO and want to know if it's worth it. It would require me to move closer to Fresno (a twenty mile move, which I don't mind) because of Kaiser's service area and Kaiser is going to save me $884 a year in premiums, and more in copays, etc. I just don't want to be told that I have to start the process over if I do switch. It took me two months to get into the seminar and six months for the consult. That is set for about March of 2003. I'd appreciate responses from anyone that has dealt with either Blue Cross or Kaiser or anyone in the Central Valley that has any advice. Thanks.    — MrsGadget (posted on November 2, 2002)

November 2, 2002
I live in Colorado and have Kaiser. In Colorado, we have to wait a year or longer for surgery. Everone must join Kaiser's Weight Management Program. You are not even considered for surgery before that year long program is complete. Then to get approved to see a surgeon and get a date can take another 3-6 months. The process can take 18 months before surgery. I do not know if Kaiser California has the same rules, but I would check it our before changing. I am changing insurance companies and taking a chance for approval with United Health Care. So do extra checking before you change. I hope things turn out for you. We all know this process takes time, but to wait over a year is unreasonable.
   — Terry Lynn W.

November 2, 2002
Do both insurance companies have the same requirements for wls? Will your benefit plan with Kaiser cover wls? I do believe you can go online and find what Kaiser requires before considering to approve you. It may be worse than BCBS. I guess it will also depend on if you want the surgery sooner than later. I've read online that Kaiser can often make it a very lengthly process. I read where some waited a year to be approved because they didn't have everything Kaiser wanted such as doctor supervised diet history length. My 2 cents. best of luck.
   — Natalie M.

February 24, 2003
As a Kaiser Fresno patient (having surgery tomorrow in fact, 2/25/03!) I can tell you that it is NOT going to save you time to switch to Kaiser!! When I started a year and a half ago, I had to take a year's worth of classes and then it took six months to get scheduled. Compared to other insurance, it is a nightmare. Now, as I understand it they have recently changed it to only six months of classes, but I would still say you would be looking at a good 6-12 months before having surgery. If you do switch, Dr. Streat is a good PCP to see in regards to being "pro" surgery. Even though you can't have him for your own PCP you can still see him and get referred for the classes. I chose Dr. Banerjee as my surgeon, and ask me tomorrow if I made a good choice. :) Good luck!
   — Mrs B.