Out of Network Referrals

Kaiser Advantage is good about approving out of network referrals. They suggested I go out of network as the wait would be too long within Kaiser. I researched who I wanted to see and Kaiser approved it.

I see the Doctor I requested on the first visit but not on the second and following. I am told that the Doctor I made the appointment for is not available.

I suppose Kaiser pays a discounted rate. This is the second time I went outside Kaiser and got a less than satisfactory result. I have not had a problem with Kaiser Docs.

Wondering, is this a problem for non Advantage Medicare Patients… makes me all the more to stay with Kaiser Advantage.

Do Medicare patients get the newbies at the practice?

Traditional Medicare here - actually, I kind of like getting the newbies at the practice - that way I can train them to be “my” doc and with less likelihood that they are gonna leave me high and dry by leaving the practice - retirement or dying before me.

1 Like

Kinda an out of network referral story:

My neighbors wife had Kaiser and also has a medical issue. There was a drug (off-label - not approved for that issue but worked) and that drug was very expensive. Her Kaiser physician looked at the cost and suggested that they would write a paper prescription and encouraged her to get it from a Canadian provider at a much reduced cost.


Original medicare and tricare. There really isn’t “out of network.”


Sure there is -
Medicare.gov Lower Costs With Assignment
They are either “non-participating” OR “opt-out” docs.
Many psychiatrist come to mind among other specialties.