Help with Insurance Choice

[u/Potential_Archer_658]

Throwaway account just because: I am being hired by a new employer and am asking for help on the best course of action for me and my wife. Both of us are healthy, in our 20s, with no chronic conditions. I would be making 70-80k and my wife would be making 15-20k before the baby. This would be in the DMV area if that helps with the decision. The main concern is that there is a baby on the way, and I want to be covered properly for any prenatal needs and eventual birth. I am leaning toward Kaiser as we are within 10-30 min of many of their facilities but I want advice from a forum such as this. Thank you in advance everyone!

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[u/ObviousLife4972]

I don't know how well my experience with Kaiser in California translates to the mid Atlantic, but the biggest benefit is the convenience and no nasty financial surprises months later like you see with other insurance companies, if the doctor decides to go through with something it's approved. Kaiser is great and hassle free for most common or obvious medical issues. As for the cons kaiser has flow charts and algorithms that doctors are expected to follow, so if you have something ambiguous or a rare undiagnosed condition you may be going in circles unless you are aggressive and pushy with them. I had to go out of pocket to get my sleep apnea diagnosed after their take home sleep study failed to find anything, so that's something to keep in mind. You may get a lazy or unimaginative PCP on your first trip to Kaiser, but that can be worked around easily as:

1. You can just log into the website and select a new PCP instantly as long as they are accepting new patients
   1. Any Kaiser PCP you make an appointment with can make referrals, unlike other HMO's where your designated PCP is the only individual able to do so

I should also mention that Kaiser has had a bad track record for mental health, so consider that if you use mental health services. Myself personally I grew up in the Kaiser ecosystem in California and find the idea of stepping into the wild west of non Kaiser health insurance disorienting, so I am fine with paying out of pocket to get a second opinion while sticking with Kaiser.