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TwinsDad
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Kaiser Permanent Southern California Insurance
#158000 - 08/01/05 01:50 PM
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Hello,
I have Kaiser Permanente Insurance and I was wondering if you guys have some type of experience with them regarding HIV treatement. Do they cover all the medicines or treatment?
Should I get a different insurance? Please let me know. I am looking for all the advise of the world to fight against this virus.
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_tylox99_
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Reged: 07/14/05
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Posts: 38
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Loc: MA
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I have not had to deal with Kaiser, but I have had dealt with many insurances in my day to day practice.
The best thing to do would be to call their Customer Service line and ask them either for a formulary (which lists which medicines they cover and what their copays should be) or ask them about the particular medicines directly. A formulary may be better because then you have it in writing.
Or you could ask wherever you are getting the insurance through, be it your benefits department or whatever, for a formualry list. The list may be better because than you would know for all medications as well.
Good luck to you!
--------------------
Words are, of course, the most potent drug used by mankind.
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ScotCharles
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Legend
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Reged: 05/06/05
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Posts: 924
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Loc: Los Angeles
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Ten years ago, Kaiser was sued by a group of AIDS patients in San Francisco because Kaiser was refusing to pay for Protease Inhibitors. The law suit was successful, but Kaiser remains very conservative and cost concious in its treatment of HIV/AIDS.
The HMO I am in, PacificCare, was sued by the State of California in 2000 because the HMO was not allowing a number of services for HIV/AIDS. Though things are better, I still have to be a nagging, well informed patient to get a number of services. And the diagnostic care at PacificCare is third rate at best. My doctor is constantly criticising me for reading JAMA and Johns Hopkins research reports, I am sometimes more informed than she.
If you can stomach the paper work and have an ear to the ground for the best practitioners in AIDS and other specialities, you really can't beat BC/BS. You self refer, and you have a choice of any number of doctors. Dental is shabby; and, as you have HIV longer you will come to need expensive dental care as infections attack your gums.
Shop, pay special attention to prescription drug benefits, the drugs we take are EXPENSIVE. At retail, my regimen is over $1600 a month, but with my drug plan I pay only a $100 a month. Need to look at hospital benefits, you will likely have one or two hospital stays a year as your infection progresses; you need to keep those costs down, they can overwhelm a budget.
Last, make certain your plan allows for thorough, annual physicals. You need a bow to stern going over every year. Cancer and heart disease are on the rise among HIV/AIDS patients. Try to catch it early, you have a greater chance of survival.
Relax, HIV/AIDS can be fun,
ScotCharles
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Life is a river.
Carpe diem.
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ScotCharles
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Legend
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Oh yes, the formulary, many drugs are not covered by a presecription drug plan because they are not on the list of the plan's approved drugs, the formulary. This website has listings of drug regimens which you can check against the formulary.
ScotCharles
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Life is a river.
Carpe diem.
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TwinsDad
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Thank you for your information.
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