My insurance gives me the option to drop Kaiser, which I have had for the past 6 years and go to UCSF. Given a choice, what would you do? Doing some research I can see that the UCSF Urology dept is rated #3 in the US (score of 91.2/100) while Kaiser is not even rated (score of 35/100) per health.usnews.com. Is there a major difference between the treatment I would get at UCSF or are current treatments for PCa well established that I would not see a difference? Not that I am a fan of Kaiser, my physician there ignored doing ANY blood tests at all on me for 3.5 years, which is how we missed detecting my PC before it metastasized.
I was reading an article, where a doc from UCSF suggested that multiple treatments are being used at the same time these days as they seem to give a better survival rate - webmd.com/prostate-cancer/f...
Given infinite time, I would not even think and just move to UCSF but I live in Oakland and have school drop/pick plus other responsibilities for a 10-year old (I am a single dad). I would have to replace my 10-minute drive to Kaiser with a 1-hour drive to UCSF, each way. So time is a major consideration, however, if it buys me some more time with my son down the line, it is worth it, have to try to be around until he turns 18, alternate guardian etc complicates his life.
My background: Advanced PC (stage IV) with mets to the lymph nodes. GC: 9. Currently on Lupron, Zytiga, and Prednisone. A radiation oncologist at Kaiser said no to radiation as my cancer has spread too far. The latest CT scan shows my prostate is back to normal size and all lymph nodes have reduced quite a bit.
Your feedback is much appreciated.
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barrybayarea
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Hi barry, I’m not completely tracking on your question? Is it your employer that allows you to choose coverages that include Kaiser or UCSF? If so I’m wondering how you can switch now since most open enrollments are over for the 2020 calendar year? And is UCSF in the network of a particular PPO plan? Anyway, when sick, most people typically like to have more options for doctors and hospitals than a closed network HMO. I defer to the other guys who responded about UCSF since I don’t know it very well. I’m speaking from the point of view of closed network HMO vs. open network PPO with out of network options.
Yes Daniel my insurance carrier has UCSF in network, they said I just have to drop Kaiser and say UCSF is my choice for health. In fact they have a new program with Stanford too, just for cancer.
I am not switching my insurance, just my hospital. The insruance I have assigned me to Kaiser for treatment as I had Kaiser within 90-days of join them. They also have UCSF in their network. So they will just switch my provider.
So you will be switching from an HMO to a PPO, correct? If out-of-pocket costs are the same, going with UCSF would be the easy choice. They are one of the best medical centers in the country.
My guess is out-of-pocket costs will be more for UCSF. If the costs are more and money is no object, I'd go with UCSF.
If your funds are more limited, you might evaluate the care you need and see what it's going to cost and answer the question: do I really need USCF for that care? A Lupron shot is a Lupron shot. If you are taking Zytiga, I'd want to know what the prescription cost would be in both places.
I was happy with Kaiser for my diagnosis, initial treatment and chemotherapy I did there. For the treatments I had there, they were just a good as anywhere else. But if I had needed to get on a clinical trial, I would have been better off having more flexibility with somewhere like UCSF.
Thank you Gregg, I am going to make some calls tomorrow and see how easy the switch is. I will report back. Seems you might be looking at options too, I will let you know what I find.
About my insurance and how I would switch. I am 55 so no medicare, I applied to coveredca and they sent me to my local county for medi-cal, who gave me a choice to select from 2 options, I chose - Alameda Alliance for Health. Who in turn sends me to Kaiser. They cannot send everyone but only those who have had Kaiser before in the last 6-months, which I did through my previous employer. I do not have a plan with Kaiser directly. So now to switch to UCSF for my prostate treatment, I would drop Kaiser and select a local PCP. That PCP has the freedom to refer me to UCSF for any specilty services e.g. cancer treatment. UCSF is considered in-network but just for cancer kind of treatment. I would see my PCP locally for any other needs. In fact using this setup, I can get a referral to Stanford too. I am not switching from a HMO to a PPO, I stay in the HMO and using this route to get better cancer care. So my deductibles, out of pocket etc do not change. Hope that helps someone else trying to do the same thing.
I am truly blessed to be able to have UCSF as part of my medical choice. I have an oncologist there that is one of the top prostate specialist/researchers in the United States. He actually calls me at home. He works with my Oncologist here in the Eastbay. Their my team. I'm not saying they all do that (call your home) but I'm fortunate to have that for me. You have that choice to go there I would do it. The toll costs of the bridge the parking garages all are expensive. I was there most of last Thursday. I hate all the traffic. UCSF is a gift and I can handle anything knowing they are in my corner.
I can attest to that. 2 years ago, my son's mom was diagnosed with brain cancer. She was given 12-months or less with treatment to control it, there was not cure, she had glioblastoma. The pallative, then hospice care was excellent. Their support structure was awesome. They helped me and son evrryway that they could, even dealing with family drama, wills, etc. She passed away Feb 2019, 11-months after her diagnosis, a few months before I got diagnosed.
Run, don’t walk to UCSF where they will spend the money on you to give you the very best care, you are worth it. Your son would say so too. My hubby misdiagnosed at Kaiser 14 years ago. He got a 2nd opinion, not cancer but Pin2. We left Kaiser. He gained 13 years before G3+4, recent successful radiation and ADT at age 76.
Read your post. The answer is right there. Not even a close call. As a single father you have to do everything you can to stick around including going to the best facility. That best facility without question is UCSF
Dr Andrea Harzstark trained and worked at UCSF and has been at Kaiser Oakland for several years. She is an expert prostate cancer medical oncologist. I was a patient of hers when she worked at UCSF. UCSF has great comprehensive PCa program as many have said. If me in your shoes and situation then I would probably transfer to UCSF as you probably don’t need to go there but once or twice a quarter. I would carefully pick out expert at UCSF, probably Dr. Small. If you can look past getting burnt at Kaiser then I would go with Dr Harzstsrk. You’ll like her. Good luck.
Unfortunately, Andrea is not taking new patients last I heard. I did get her on my team when I was at Kaiser and I could get her involved when I wanted her opinion. I was glad she was there because the doctor I had at Kaiser did not specialize in prostate cancer as is typically the case.
I get my care at the VA, but I do now also have Kaiser again through Medicare. Looking at my emails the other day and saw the emails I sent her when I was at Kaiser 2 years ago.
Dr Andrea Harzstark is the HOD in Oakland Urlogy where I am getting my treatment. A friend of mine actually knows her. I have not met her but I can. There are only 2 docs there, as of now. I tried to get her but I was told she is too busy as she also has a bunch of admin responsibilities being HOD. The doc I have been assigned also came from UCSF, I feel that he does know his stuff but is limited by Kaiser on what he can do for diagnosis and treatment. I definately felt cost considerations on his mind at every step. In a meeting with me, he let it slip that if I was at UCSF they might have still given me radiation but not at Kaiser, that is when I started thinking for the first time that maybe I should be at UCSF if they are more aggresive in treating PCa.
I switched to UCSF when I saw them for a second opinion. I’m SO glad I did. I feel I get much better attention and care. It’s a 2 hour drive for me but that doesn’t even matter to me as much as getting the best care I can. I don’t know what medical you have but I have Anthem Blue Cross and UCSF is in their network. After almost 2 years of treatment I have yet to pay anything out of pocket. I’m not saying your experience will be the same, just relating my experience. I definitely would suggest you switch.
Be sure UCSF doctors are accepting new PCa clients before you switch. Some of the highly rated doctors mentioned here have also been turning away new patients. That was the reason I chose Kaiser (Oregon) before I knew my diagnosis, couldn't find a primary care who was taking new patients in this area. And, all the Kaiser docs here have been well versed on cutting edge treatments, with caring, supportive attitudes. No complaints from me about Kaiser but you did have an unacceptable experience so I understand looking elsewhere.
UCSF. 100%. We live in Grass Valley and have an oncologist in Auburn where we get most treatments (at Sutter), but the treatments are directed by Dr Aggarwal at UCSF. You may be able to do the same.
I was diagnosed with metastatic PC about two years ago. I underwent chemo (docataxel-6 infusions) combined with Lupron because using the two in combination was shown clinically to increase survival time. I had the time release Lupron injection every 3 months. The time to progression of disease was stated as 20-24 months. I had progression at 22 months. My (PSA rose from 0.6 to 3 over the last 3-4 months of the period and discomfort to my hip and tailbone retired. They time they added 1000 mg of Abiraterone (Zytiga) with 10 mg of prednisone to the regimen. It lowers PSA through a different mechanism. It dropped my PSA down to <0.03 and bone pain, etc. within the first month. Average time to progression with Abiraterone is around 12 months - then on to something else. The Abiraterone was not covered by medicare since it is administered outside the clinic. First months supply was over $2000. Using the government drug site for part D I found an insurer (Cigna) and pharmacy that cut the cost to around $300 and total for a year to around $2000. Otherwise the out-of-pocket was going to be $9000 - after the donut hole and catastrophic coverage kicked in.
I go to Kaiser in the Sacramento area. I went about 18 months between PSA tests. Then had scans, surgery, radiation and because I have great insurance through my wife's job, I have not paid a dime for anything. I am currently undetectable on Lupron and Zytiga. Once I progress will be when I will probably head to UCSF. Plan on getting a 2nd opinion before I go off ADT in another 8 months if I am still undetectable. Been very happy with Kaiser so far though.
I have Kaiser and they are top notch. They would also send you to UCSF if they believe there is something there that would be better. I'm 10 years in on my journey and feel blessed to have Kaiser as my medical plan.
I have Kaiser in Central Valley. I not going to judge them one way or the other. But if I was an hour from UCSF and medical cost was the same or of no huge consequence, I would fight the traffic and parking and inconvenience and go where the leading edge is. As I count the above votes, I get: Kaiser ok, UCSF great.
As usual I have no experience or opinion regarding Kaiser or UCSF... but it appears that UCSF wins the vote. Now as for the 5 year old, you'll be spoiling his children....You can take that to the bank....
Best of luck to you, Barry. My story is a bit different but as a resident of Walnut Creek, I decided to leave the care of my local urologist and seek a 2nd opinion at UCSF where I received my 3rd prostate biopsy in 2017. To me, UCSF was like the Disneyland of cancer care. Facility was spotless. Staff was well-trained and warm. I was greeted with good eye-contact and offers to help the moment I walked in. I just wish their parking capacity were larger! I am under the care of Dr. Shinohara. He has provided me with adequate care and counsel though I probably communicate more frequently with his staff. On the other hand, I have a friend who underwent a radical prostatectomy with Dr. Carroll, suffered some lingering incontinence and pain issues and struggled maintaining communication with him. Dr. Carroll is the head of the department and probably very busy. Good bedside manner or not. Good communication or not. Favorable outcome or not. My feeling is that UCSF probably provides me with the best possible strategy for detection, treatment and survival. Good luck, Barry. -Don
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