UC Berkeley Health Insurance Options

Parent Q&A

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  • Hi BPN Community,  its enrollment time and looking at how the premiums have gone up, I was wondering if anyone has ever signed up for the $0 premium,  CORE Plan.  It covers annual health check-up, similar to HSA but higher deductible.  I hope I get to see some insight on this from this wonderful and experienced group!  thanks, Dana

    Don't do it!  I made the mistake of going with CORE, and I now owe over $2000 after just two months.  The insurance basically doesn't cover anything until you hit the $3000 premium, and you just don't know when/if you'll get sick.  I got terribly sick for a month, and had to go to urgent care twice -- they did X-rays, tested for Mono, and gave me IV fluids, and that added up to over 2K.  If I didn't have insurance at all, believe it or not, it would have been less expensive because then they could have discounted my bills for me.  I wish I could go back in time but at least I can advise others not to make the same mistake.

    Thank you for posting this: we are in a similar situation during the UC open enrollment period, very disappointed with our current four years with  Kaiser (birthing was great) but primary care for both adults and toddler has been lackluster. The bureaucracy and wait times for even the simplest of requests has been astonishingly slow and frustrating and wondering if we’ll get better service through CORE without spending a ton of money out of pocket. The tables they provide with monthly costs and estimates are virtually useless since they can and do often deny preventative testing or reclassify things as non preventative/elective. 

    It ended up not covering a medication needed by a family member, even though their proposed alternatives (completely different classes of meds) were not suitable per my family member’s doctor. It was just not possible to get any coverage for the needed medication with CORE despite extensive effort on our part and the physician. 

  • Hello.  I figure there would be some UC parents here.  This is the year we are finally ditching UC Blue and Gold.  It is a tough and scary choice as we previously knew exactly what our costs would be and it was a reasonable amount.  But so many doctors have left and Brown and Toland is requiring us to travel all over the Bay Area for care as they are too cheap to pay for care close to home.  We see a number of specialists and are heavy users so we need something easy.  So we are deciding between UC Care and UC Health Savings Plan (Kaiser is out of the question.  Been there done that).  We are leaning toward UC Care because despite its cost and lack of an accompanying HSA to take the edge off, the costs appear somewhat more predictable than UC Health Savings Plan.  I'm wondering if anyone else has made this jump and had any positive or negative surprises with either plan.  Thanks!

    We also had blue and gold and hated it, couldn’t believe how hard it was to find a doctor nearby.

    Not sure what your salary level is because that plays into the premium cost benefit analysis. We chose the HSA, because for us, even if we met our super high deductible every year it would still be cheaper than the sky high premiums that uc care requires. However it is extremely unpleasant to pay huge out of pocket bills for the first months of the year. I’d say we are medium utilizers and really like to have our choice of doctors, and have been mostly satisfied with the plan so far. If you’re a very heavy utilizer, then uc care might be better. None of the options are stellar unfortunately. Best of luck in your decision!

    Curious to know why you aren't considering Kaiser--we switched from Blue and Gold before our kids were born and have never looked back. The single biggest benefit has been how predictable (and minimal) the costs are, and the integration and proximity of care is huge. (We are in Oakland so of course that helps a lot, but the new Berkeley Kaiser has expanded options for friends there as well.) It might be worth taking another look, especially if your Kaiser experience was many years ago. (The caveat, of course, is that if you need specialty care that Kaiser does not offer, it can be a pain to work out of their network--but we have found that, with the notable exception of mental health, their Oakland-based specialist bench is pretty deep and easy to get referrals for compared to our previous non-Kaiser plans.)

    I have UC Care and prefer it because the costs are more predictable.  I have a chronic health condition that requires labs/imaging several times a year.  It seems like Health Savings Plans are suited for people who usually only need for preventative care.  

    Hello, 

    Have you considered switching medical groups with UC Blue and Gold? I'm in Hill Physicians and have been able to continue to see my same doctor (through One Medical) and have most of my referrals to facilities in Berkeley or Oakland. (A couple have been to UCSF in Mission Bay, which is really not that far away.) I had been on my husband's PPO, so I was worried my options for specialists would be much more limited, but so far have been pleasantly surprised. It helps that I really love and trust my PCP. 

    As an aside, I was on the UC Health Saving Plan (or equivalent) years ago when my daughter was born. It was a nightmare having to keep all the costs straight -- I got so many bills from so many different providers. Plus it was so much money out of pocket for the delivery! Was much easier when my son was born (on an HMO) -- $250 and done! I think the HSA plans are best for people who rarely go to the doctor.

    Good luck! 

  • Hoping some other UC Employee or family member has done some research and given careful thought regarding the upcoming open enrollment.  It hasn't opened yet but I thought I'd get a jump on the research as I don't want to procrastinate and just go ahead with what I have next year.  What I have is the Healthnet Blue & Gold plan, Brown and Toland (formerly Alta Bates) Medical Group.  This plan is getting worse and worse.  Limited choice of primary care doctors for adults and terrible physical therapy options.  I'd ideally like to stay with Healthnet Blue and Gold as it is the right price.  So perhaps one of the other medical groups is somehow better?  Not Kaiser.  Been there done that.  Anyone really happy with their plan?  I'd like to know which ones and why.  Thanks.

    I have UC Care and have had this option for several years.  It is not cheap, esp for family coverage, but I have been very happy with the options available to us.  (I still have my Brown and Toland based internist and Ob-Gyn, and see both UC and Sutter based specialists.  I have a chronic condition which requires visits to a number of specialists every year, and my daughter has a condition that requires annual labs and imaging.)  

    Hi, there. We are a UC family who has had Healthnet Blue & Gold for quite a while. We previously had Brown & Toland Medical Group because that's who our Doctor and her practice belonged to. But when the practice was sold, she moved to a new group, and we followed her there. We adore Dr. Audrey D'Andrea; she is now with Canopy Health/John Muir Network; they are on San Pablo just south of Ashby. This is super convenient for us; we can walk there, there's a parking garage with validated parking. There's a lab in the building. There's an urgent care facility in the building. Fantastic! Overall much more convenient for us than the old location in Oakland. A few things are less convenient: I now to go to Orinda for my mammogram, instead of to the lovely facility in Oakland. When my husband needed hand surgery, he had to have it in San Francisco. But overall, we are very happy, and we would follow Dr. D'Andrea pretty much anywhere!

    Hi,

    I remember they used to also include Stanford Health Care, which is excellent; I went to them when I was on Healthnet.  Is that still an option?  They have a clinic in Emeryville.

    I know what you mean about the wretched PT options under Blue & Gold.  But we decided that we could pay out-of-pocket for a lot of PT sessions each year, with the PT of our choice, and still not spend what  we'd pay for premiums with a different plan. In fact, considering the copays and costs (in money and time) of traveling to the few covered PT providers, it wasn't much more expensive to pay out of pocket anyway. (And be sure to use the Healthcare FSA!). We are happy with our PCPs, and haven't needed much specialist care (thankfully), so we've stayed with Blue and Gold.

    Depending on your particular situation (including your premiums at your pay bracket, and how much PT or other specialist care you need), this might or might not apply to you, but it's worth doing some math.

    Hello,

    I am still with Healthnet Blue & Gold.  I was also with the Brown & Toland/Alta Bates group.  I am now with the Canopy Health/John Muir Physicians group.  So far, I have been very please with the services and practitioners.  My primary care doctor and the urgent care services are located at the John Muir/ UCSF Health Center on San Pablo in Berkeley.

    I hope this helps.

    Interested to hear what others say, for such a large and prominent state employer I think that UC has pretty lousy benefits. We have the UC Health Savings Plan, because we wanted to go with a PPO plan, and we figured that even after paying the deductible the premium savings were large enough to go with the HSA. We had UC Blue & Gold HMO our first year and absolutely hated it, they were difficult to deal with and seemed to hardly cover any of the doctors that we would want to see. The physician selection is better on the PPO of course but there's the issue of having to pay out of pocket until you meet the deductible and that really sucks - for an ultrasound to rule out an ectopic pregnancy earlier this year, I had to pay $950 to even get in the door, and then got hit up for a few hundred more for the doctor a couple months later. I guess this is what our health system is, and going in on the HSA plan helps you to see it in all its enraging glory. 

    Which is to say, it just doesn't seem like there are any good plans in particular at UC; just need to pick your poison.

  • I live in Oakland, and all of my doctors are in SF b/c I have various health issues that require me to be followed by UCSF. But it's getting tiresome to run into SF when I have something minor like strep, etc. 

    I'm currently on Healthnet Blue and Gold with Hills Physicians, and if I choose a primary care medical group in Oakland or Berkeley, that's where I need to base my other health services. Not going to work for me. 

    What's the best option for UC insurance holders to allow me access to UCSF without needing  prior approval? I'd appreciate any insight, as open enrollment is fast approaching. 

    Thanks!

    I work for a UC and use UC Care.  It's a bit more expensive, but you have the flexibility to choose where you want to go.  UC Care is administered through Anthem Blue Cross and since you go to UCSF a lot, the copays may be lower since they are "in network".

    We have a similar healthcare situation in our family: specialist at UCSF, but want to have access to primary care nearer home in the East Bay.  UC Care works fine for this.  Costs more, but if you have a serious, complicated medical condition as we do, it is worth it.  Best of luck.

    I have Blue and Gold and have been able to get approval to see specialists across the Bay. Apparently the Dr. just needs to justify it. You might explore before switching.

    I'm in exactly this situation. I believe the only other option is to switch to UC Care (the PPO plan), which is much more expensive.

    Have you checked the list of primary physicians to see if any have offices on both sides of the Bay? 

Archived Q&A and Reviews



Just took a job at UCB, what are our options?

May 2007

My family (includes 2 adults and 11- and 13- year-old children) will be starting to get UC Berkeley benefits on July 1. We'll be moving to Berkeley from out of state and seek recommendations on health insurance choices-- cost, flexibility etc. wondering


I have the Blue Cross plus plan -- although more expensive than the Kaiser plan, I like being able to choose my own doctors (you still have to stay within their network, but there is a pretty large pool to choose from). Also, I like the accupuncture/chiropractic and behavioral health benefits -- they are very good and again the network(s) seem to be pretty good. .


When my husband began his job at UC three years ago, we decided to try the Kaiser plan since it seemed to offer the most coverage for the lowest premiums and co- pays. I was skeptical at first, but decided to at least try it. I have seen doctors at several of the facilities (you have the right to choose). We have been so happy with the doctors and care we have recieved at Kaiser that now I wouldn't want any other plan. I am very attached to my doctors and feel we have been given excellent care even when doctors on call were simply assigned to us. I delivered my baby at Kaiser Walnut Creek in March and had a great experience there as well. I feel so lucky that we are Kaiser members. I should say that I have the least experience with Kaiser Oakland. I usually go to Walnut Creek, Park Shadelands (great facility) or SF. You can get good recommendations from Berkeley Parents Network and remember that you can always switch doctors within the system. There are plenty of good ones from what I can tell. anne