WESTERN HEALTH ADVANTAGE VERSUS KAISER
.png)
In certain areas, Kaiser and Western Health Advantage are the two dominant carriers…for HMO at least.
The entire Sacramento area falls in this category.
How do we compare Kaiser and Western Health and more importantly…
Who’s better?
Great questions and increasingly important as rates keep going higher for health insurance.
You can always jump right to the rates below for Kaiser and WHA but there’s a real difference between the two carriers.
Let’s get started!
What Do Kaiser And Western Health Advantage Have In Common?
They’re both HMO’s!
You can read detailed info in how HMO’s work versus PPO’s (its major market alternative) but here are the key take-aways and then we’ll look at how Kaiser and WHA differ.
First, what is an HMO?
Here’s the a quick refresher.
The HMO or Health Maintenance Organization specifies a way of accessing care and from whom you can access that care.
They came about in the 80’s to contain health care cost (that’s monthly premium to you) and they were popular due to their lower costs.
There are a few important points to focus on:
- You choose a primary care physician and/or medical group through which your care is managed
- The providers are within a certain distance from your residence
- Care is more managed than with PPO or EPO type plans.
Okay…let’s look at how these work in the real world with Western Health and Kaiser!
The WHA Way Of Doing HMO’s!
Western Health actually contracts out with independent doctors, hospitals, and medical groups.
These providers are responsible for providing your healthcare.
You generally have to remain in this group of providers and there are specialists available for referrals.
The Providers that an HMO contracts with are KEY!
This is really the big deal today (even for PPOs) since the networks are smaller.
This is also why Western Health Advantage is so….advantageous!
WHA has contracted with some great providers!
Here’s a small sampling but if you live in the vicinity of these providers, you’re in good hands.
Traditionally, the available list of doctors has been the issue with HMO’s.
WHA aggressively went after better medical groups such as those tied to UC Davis to neutralize this concern.
Again, the chosen medical group needs to be within a given radius of where you live but WHA has made provider contracting their primary concern (and strength).
That’s one down. (actually two with the vicinity question).
So that’s WHA’s version of the HMO. What about Kaiser?
Kaiser’s HMO Model
Kaiser’s model of the HMO stands alone in California and even the U.S.
Kaiser went a completely different way.
Instead of contracting with independent doctors, hospitals, and medical groups, Kaiser owns the facilities and employs the doctors.
With Kaiser, you need to stay within its network of providers…essentially Kaiser facilities. You can use Kaiser in other areas if they have facilities and doctors there.
It’s generally not easy to see providers outside of Kaiser’s network.
Since the insurance carrier owns the facilities and employs the doctors, there’s a built-in cost containment that takes place.
This is the ultimate goal of an HMO with either Kaiser or Western Health Advantage.
So…those are the two models. How do they compare?
The other consideration with HMO’s like Kaiser and Western Health
Two words up above may have slipped by. We need to address them in more detail.
Cost Containment
Innocuous sounding enough but we need to understand it.
One major difference between HMO’s and PPO’s is that the carrier will “manage” health care more.
This sounds worse than it probably is but that depends on the health care shopper.
Basically, there will be more scrutiny of health care decisions.
With PPO’s, your contracted doctor decides on course of action and the carrier (generally) pays accordingly.
With HMO’s, you may have to get pre-authorizations for certain courses of treatment.
A course of treatment could even be denied before something else is tried first.
Keep in mind that PPO’s are also seeing more pre-authorizations needed now as carriers scramble to contain costs.
More “managed” care.
There are many times when what is financially prudent and what is medically prudent align and this is actually the best course of action.
We’ve gone the other direction where surgeries are consistently rattled off as first option (think prostate) when that may not be the best advice.
We won’t point fingers at doctors but…
People usually have a good sense of their feelings on this matter.
The response we hear generally is “I love Kaiser” for example…or “I hate HMO’s”.
HMO may be the direction that everything’s going anyway. PPO’s are becoming EPO’s which is somewhere in between PPO and HMO.
We’re scrambling to keep costs down or the system blows up.
With Western Health and Kaiser, you’re likely to see comparable levels of “management” so that doesn’t figure into our comparison as much.
So…how do we compare them?
Comparing Kaiser And Western Health Advantage
First, let’s address the big question.
Pricing!
On average, Kaiser and Western Health Advantage are the two best priced plans in a given area.
We typically see Western Health be the cheaper option at a given benefit level but they’re both significantly lower than other carriers.
You can quickly run your quote below to see how they stack up.
If price is comparable, what’s the second biggest concern?
Choice Of Providers With Kaiser And WHA
It really comes down to which providers or facilities you want access to.
If you want to see a specific doctor or use UC Davis, WHA is going to be your best option.
If you want to use your local Kaiser facility, well…then it’s Kaiser.
It’s that simple because you will not be able to access the other on a given plan.
That decision generally dictates which way to go since the premium is usually comparable.
We recommend checking the providers available to you through the quote above for WHA to see what they offer.
Basically, if you want to join or remain part of the above medical groups listed with WHA, you will want Western Health.
If you want to use your local Kaiser facility, it’s Kaiser.
Of course, if you want the lowest priced option and have some flexibility on provider, run your quote to see who is priced best for you.
For Small Employers, there’s a way to have your cake and eat it to! Read below.
Kaiser’s One Stop Shop Versus Western Health’s Medical Group Model
One interesting difference between the two carriers has to do with how information is maintained.
Some people really like Kaiser because “everything’s under one roof”.
It’s one big facility and they go there for all their needs.
That is an advantage of Kaiser and one that other medical groups are scrambling to mimic.
It’s convenient for say your OBGyn to see the recent labs from your Cardiologist.
It’s also very helpful in actually delivering health care!
Western Health Advantage can’t match this total integration but it does come close!
Since WHA contracts with Medical Groups, your records and care will be administered within that group.
They have the ability to share records and discuss patient needs and care across the group.
There is generally a primary care doctor who coordinates care across the different specialties to make sure you everyone is on the same page.
That’s an inherent benefit of HMO’s and you’ll have it with Kaiser or WHA although Kaiser’s is pretty seamless.
Small Employers Can Offer WHA And Kaiser To Employees
That’s right. A small employer (1-100 employees) can offer both Western Health and Kaiser to employees.
We can even base the employer’s contribution on a given plan (say the Kaiser Silver 2000) and have that amount apply evenly to either Western Health or Kaiser plans.
Very cool and very popular!
With a certain number of employees, you’ll have some that have existing doctors they want to stay with (WHA) while others have been with Kaiser for decades.
There’s no additional cost for this approach and you can quote your company here:
We can do this two ways. One is via a “Kaiser wrap”. Essentially, Kaiser will wrap around the WHA group policy.
We can also run a CalChoice quote which may be the best approach. Why?
There are situations where CalChoice’s Kaiser plans can be cheaper than Kaiser direct!
If you have Kaiser alone, let us run the quote to see if we can get it cheaper.
We’ll create a worksheet for each employee with both carrier options available!
Our services are 100% free to you as licensed California agents and Certified Covered California agents.
We have helped 10’s of 1000’s of Californians across the State make this same comparison.
We’re getting pretty good at it!
Quote both Kaiser and WHA health plans to view rates and plans side by side for both carriers…Free.
New to WHA? Get more info on Western Health Advantage here.
Again, there is absolutely no cost to you for our services. Call 800-320-6269 Today!
Your Calhealth Advantage
Our online tools, free quotes and licensed agents are here to help you find a plan.

ON THE BLOG
Featured Articles
California Individual Vision Insurance
California Health Reform Subsidy
California Health Insurance Resource List
California Health Insurance Rate Increases
California Health Insurance Office Copay
California Health Insurance Maternity and Individual
California Health Insurance Individual Versus Cobra
California Health Insurance Individual Underwriting
California Health Insurance Group Value Dental Vision
California Health Insurance Group Kaiser
California Health Insurance Definitions
California Health Insurance Coverage Rescission
California Health Insurance Continuing Education
California Health Care Rights
California Blue Shield Vital Shield
Best California Health Insurance Plan
Affordable California Health Insurance
Understand Senior California Health Insurance
Covered California for Small Business
Individual California Health Insurance If Declined
Individual California Health Insurance Application Questionnaire
Health Net California Application Center
GURU Which Plan Should I Go With
GURU Subsidy If Offered Group Coverage
Do HSA Funds Roll Over
Compare and Contrast Alieracare Health Sharing Plan Benefits
California Vision Insurance Group
California Individual Dental Insurance
California HSA Plans and Health Reform
California Health Insurance Simplified
California Health Insurance Hospital Plans
California Health Insurance College Plan
California Health Insurance Cancel Individual Group Insurance
California Health Exchange Platinum Plan
California Health Exchange and Non Exchange Plans
Bronze California Health Plan
Covered California Open Enrollment How To
Covered California Open Enrollment
Covered California Early Pre Enroll
Small Business Tax Credits Covered California
GURU What If I Miss Open Enrollment Period
Free Assistance Covered California Enrollment
Covered California Enrollment After Open Enrollment
Comparing Deductible and Out of Pocket
California PCIP Health Insurance
California Medi-cal
California Health Insurance Group How to Choose
Avoid Bad Health Insurance Plan
Anthem Blue Cross California Application Center
How to Quote United Health National Restaurant Association
Hold On to Grandfathered Health Plans
Health Insurance for Engineering Firms
GURU What Income Period Do They Look At
Carriers
California Health Subsidy Calculator
California Health Reform Penalty
California Health Insurance Group Guaranteed Issue
Are Health Care Sharing Ministry Plans Worth It
Travel Medical Insurance
Term Life Insurance in California
Health Reform Rebates California Health Insurance
GURU Do I Use Business or Personal Gross Income
Guide Continuation of Coverage
Federal Poverty Level and California Health Insurance
California Individual Family Delta Dental
California Health Insurance Exchange
California Health Insurance Discount Plans
California Health Insurance Coinsurance
California Health Insurance Agencies
California Family Health Insurance
Obamacare Health Insurance for Gig Economy
Complaints California Health Plan
California Health Insurance Copays
Anthem Blue Cross Covered California Plans Rates Networks
Short Term Health Insurance
Short Term Insurance
Kaiser Covered California Rates Plans
California Health Insurance Individual Split Policy
Blue Shield of California
HSA Versus PPO Health Plans California
GURU What Effective Date Can I Pick
California Individual Family VSP Vision
California HSA HRA Health Insurance
California Health Insurance Dental Networks
California Health Insurance Concept
Pros and Cons of Health Sharing Plans Like Alieracare
Health Sharing Plans for Short Term Health in California
Embedded Deductibles in California Health Plans
United Health Group Rates Save Employers
Sharp Health in Covered California Reviews Plans Rates
Senior Supplement Best Value
California Health Insurance Negotiated Rates
AlieraCare CarePlus Advantage Catastrophic Health Sharing Plan Review Quote Comparison
Kaiser Through Covered California
TrumpCare HSA and Obamacare Covered California
Guide High Risk Pools
Common Questions Pre-existing and Options
California Restaurant Association United Health Plan
California Health Insurance Payment Options
California Group Health Insurance Eligibility
Current Individual HSA Health Insurance Options
Critical Illness Insurance Review Rates Plans
California Special Enrollment Periods SEP
California Health Insurance Life Time Max
California Health Insurance Claims Processing
Understand Group California Health Insurance
Student Health Insurance California
GURU Whats Difference Between In Out Exchange Plans
Are Health Sharing Plan Payments Deductible
Small Business Penalty Paying Individual Plans
Small Business Penalty Paying Individual Plans
California Health Insurance Primary Care Physician
Moving to California Covered California
California Small Business
California Health Insurance Sick Rates Change
Aetna Leaves California Individual Health Market
Covered California Tax Penalty
What is Best Health Sharing Ministry Plan
United Health Insurance National Restaurant Association Employees
Pacificare of California
La Care Health Plan Review Rates Networks
Covered California Compare Bronze Silver Plans
California Medicare Supplement Center
Basic PPO Blue Cross California
Critical Illness Insurance California
California Small Group RAF
Health Net In Covered California Reviews Rates Plans
California Insurance and Alternative Health Care
What Is Health Sharing Ministry And Plan
Covered California Versus Short Term Health Insurance
California Health Emergency Urgent Care
Smart Sense Blue Cross California
Kaiser Short Term Health Insurance
California On Exchange Application Terms Conditions
Guide Group Health Insurance
Free Assistance Covered California Enrollment
By Major Insurance Company
Blue Shield California Plans Rates Reviews
California Health Insurance Group New Company
Covered California Tax Credit
Health Insurance by State
California Health Insurance Out of Network
Anthem Blue Cross Leaving California Market 2018
Losing Health Insurance After Divorce
Cobra
California Health Insurance Max Out Of Pocket
United Health versus Anthem Blue Cross California
Short Term Health Insurance Between Jobs
Cheap California Health Insurance
California Health Insurance Group Size
California Health Insurance Broker Agent
Anthem Blue Cross Covered California
California Health Insurance Group Premium Only Plan POP
California Health Insurance Deductibles
Alternative to Obamacare Health Insurance
Health Sharing Versus Covered California
Current Catastrophic Health Insurance Options
California Health Insurance Rates Based On
Covered California Open Enrollment Changes
California Health Carrier Comparison
Missed Health Insurance Open Enrollment Deadline
What are Medicare Excess Charges
How to Apply for Aliera Care Health Sharing Plans
Medicare Supplement versus Medicare Advantage Comparison
Major Medical California Insurance
Immediate Health Insurance In California
Individual Health Insurance Between States
How to Pay Covered California Premium
Already Pregnant California Health Insurance
Health Insurance for High Earners California
Obamacare Health Insurance Versus Health Sharing Comparison
California On Exchange Application
Is Western Health Advantage PPO or HMO
Health Insurance Between Retirement And Medicare
California Retirement Health Insurance Options
California Health Insurance Group 1099
California Health Insurance Blue Card
California Health Insurance Acupuncture
Are Health Sharing Plans Like Alieracare Tax Deductible
Guide California Health Doctor Network
Health Savings Account
GURU What If I Move To California
Blue Cross Blue Shield Short Term Health Insurance
Calcobra Extension
Oscar California Health Insurance Review Rates Plans
Losing Health Insurance at Age 26
California PPO POS Health Insurance
California Health Reform 400 Poverty Level
Covered California Login Issues
California Health Insurance High Deductible Plan
GURU Medi Cal for Children
California Health Pre Existing Condition
Obamacare Income Guidelines in California
How to Designate Covered California Agent
How to Quote AlieraCare for Short Term Coverage
California Health Insurance Full Time Student
Do Health Insurance Plans Cover CBD
Catastrophic Health Insurance California
California Health Insurance Out Of State Employees
Covered California Marketplace Tax Credit
Health Insurance For Larger Family Of 4 5 6 Or More
Common Questions Individual Contract
Can You Have HSA Account With Health Sharing Plans
Blue Cross Senior Smart Choice
GURU What If My Income Changes
California Health Insurance Carrier Comparison
Self Employed Health Insurance California
Health Insurance for 1-2-3 Months
How to Apply for Covered California
Kaiser Versus Western Health Advantage Comparison
California Health Insurance Chiropractic
Covered California Versus Cobra Comparison
California Los Angeles Medi Medi Anthem Mediblue Health Plan
How to Quote Aliera Care Health Sharing Rates
California Health Insurance Dependent Children
GURU Tax Filing Status and Covered California
California Health Insurance HMO Versus PPO
GURU Difference Between EPO And PPO
California Health Insurance Group Part Time
Comparing Covered California Plans
Covered California Self Employment Income
Health Net Versus Anthem Blue Cross Comparison
Common Questions Time to Process Application
GURU What Type Of Income
Kaiser Versus Sharp Health Plan Review Comparison
How To Pick Best Covered California Health Plan
Do HSA Funds Roll Over
Anthem Blue Cross Versus United Health Comparison
Kaiser Versus PPO
Aliera Care Health Sharing Plan Review Rates Plans
Health Care Sharing Ministry Comparison Review
Emergency Health Insurance California
Secular Non Religious Health Sharing Plan
Blue Shield California Versus United Health Comparison
Kaiser Versus Health Net Comparison Reviews
Health Net Versus Blue Shield California
Blue Shield Versus Anthem Blue Cross California
Blue Shield California Individual Rate Increase
Does A Company Have To Offer Health Insurance California
Kaiser Versus United Health Comparison Reviews
Kaiser Versus Anthem California
Blue Shield California Versus Kaiser Comparison Review
Blue Shield California Individual Rate Increase
Holiday
California Health Insurance Law
Blue Cross Smart Sense Individual
Blue Cross May Focal Renewal Group
Blue Cross Group Rates
Blue Cross California Individual Rate Increase
Blue Cross California Individual Rate Increase
Blue Cross Anthem Name Change
SCHIP Status
Immunizations
HSA Guideline Update
Blue Shield HIPAA Approach
Blue Cross Urgent Care Network
Blue Cross Small Group Rate Increase
Blue Cross Rate Increase Individual
Blue Cross Rate Increase Client
Blue Cross New Consumer Driven Plan
Blue Cross Healthy Living
Antibiotic Power
Holiday
California Mental Health Parity Bill
California Mental Health Parity
Blue Shield Rate Increase Individual
Blue Shield of California
Blue Cross Transfer To Colorado Nevada
Blue Cross Lawsuit
Blue Cross Billing Fee
Blue Shield New Individual Plans
Blue Cross Core 5000
Two Decades Of Helping Californians Find Affordable Health Insurance
Kaiser Versus Blue Shield Of California
See All Reviews on the Blog
See All Reviews on the Blog
- Over 500,000 Quotes
- 10’s of 1000’s Enrolled
- Guaranteed Best Rates
- Referenced for finding affordable
- California Health Inurance

20 years of experience in the California health insurance market has taught us one thing… Competent and experienced guidance is INVALUABLE
We are licensed Covered Ca agents with in-depth knowledge of their plans, process, and tax credits.
This website is owned and operated by Goodacre Insurance Services, which is solely responsible for its content. This site is not maintained by or associated with Covered California, and Covered California bears no responsibility for its content. The email address and phone numbers that appear throughout the site belong to Goodacre Insurance Services, and cannot be used to contact Covered California.