Kaiser Permanente Insurance Reviews

They are an absolute joke and can give a rip about their patients. It so scary after being prescribed medication wrong you need to know about how they are mistreating you and call them on it. All they want to do is prescribe medication regardless if that’s what you need. They never read your charts and always want you to go over everything that is documented In Their charts. Don’t believe their markets because after 25yrs of being with them that when I see their commercials I laugh because it’s so far from the truth it’s comical. They are horrible and you will always fight for the care you pay so much money for!!!!

Unless one falls under specific medical diagnosis (and this narrows the crowd significantly), complete anesthesia is not covered for Colonoscopy screenings. Has anyone ever had a colonoscopy and wanted to be aware of the procedure? They state they will cover a sedative that numbs feeling but you are awake, possibly slightly groggy in the best of circumstances. If there is too much discomfort the procedure cannot be completed. Have not gone through the procedure to attempt a cervical cancer screening - I can't even start to review what could they possibly not cover for that.

Preventative services are done for early detection and need to be done completely to make an accurate diagnosis. During procedures Kaiser has told me it is my responsibility to ask at every action "does Kaiser cover this?" How would the person doing screening possibly know the answer to this - only accounting with the codes can truly answer. There needs to be governance over this type of selective billing. A procedure needs to be covered to the point of making the accurate diagnosis. This screening reduces their costs, why are they penny pinching for this, WHY ARE THEY ALLOWED TO PENNY PINCH FOR THIS?

Please pay more attention to mental health, especially in teens and young adults. Stop sponsoring many events, and start helping our teens/young adults with therapy and long term mental health. If kaiser cannot provide this help, please pay for out of network help. We have an individual plan, and pay an arm and a leg every month. Other insurance companies know how serious mental health is, and are willing to pay for the services. My family and I are seriously contemplating switching to another insurance company.

Originally, They told me I needed one of their providers to refer me for a mammogram and that if I made an appointment, and got that referral, then they would partially cover my mammogram. So upon the advice of the person at customer service, I made that appointment. The person I made an appointment with said they would make the referral but, I never got the referral and they charged me for an appointment to get a referral (there was no exam, just a request for a referral.).

When I finally found a well-hidden way to submit a claim, they said I could just self-refer and pay for my mammogram myself. So, 1) they lied to me and 2), if I am paying for it myself, what is the point of Kaiser? I was so frustrated that I found a job this better insurance because thanks to Kaiser I've gone 2 years without a mammogram when I am at risk and supposed to get one every 6 months. This entire situation has been going in circles for way too long. If you just want health, care, or healthcare, get as far as possible from these people who will deny you that while trying to extract office visit payment for doing absolutely the opposite of what they said they would do.

I mentioned to my dr that I felt like I needed to drop a few pounds after Covid lockdowns. She looked at me and said "You look fine." I asked for a referral for mental healthcare. They provided me with a code, but they didn't pay any amount for coverage. OVERALL, terrible care. I hate to say that because I'm sure the people who work there care about their patients to some extent. But I am beginning to think that Kaiser hires the lower half of the graduating classes of Medical School... it's also no shock that they (locally) bought out another healthcare facility that was renowned for horrific care (Group Health) and was nicknamed Group Death.

1. Want to see you psychiatrist? You'll only be able to see them 2 or 3 times a year because they're booked out 4-6 months between appointments. Each psychiatrist has about a thousand patients.

2. Want to see a specialist? Good luck. I told my primary doctor that I wanted to see a dermatologist about a couple skin conditions. He insisted I didn't need to and that he was good enough to handle it himself. Another time, I went in because my knee was hurting, which I had surgery on a few year prior. My primary said it was just because I'm overweight and just need to exercise more. I said I really would like to make sure it's not something more serious like so he wrote me a referral to get an x-ray. I scheduled it, went in to get it and found out I was going to have to pay $500. I left, then called to see why I was being charged so much. They said it was because he coded it a certain way and if he coded it differently, it would have only cost me $50.

3. I went to see a my primary doctor (different one than before) because I found a lump I was concerned about. He agreed it was very concerning and was going to write me an urgent referral so I could get an ultrasound. When I called to schedule it, the earliest appointment was over 2 weeks away. Call me crazy, but that doesn't seem like a very appropriate timeline.

4. Kaiser's online portal and general software system is awful. When I have a video appointment, they don't have a way to join from the online portal. I have to wait for them to send me a link to join. That doesn't sound too bad, right? Well, they have either sent me the link only via text message or not at all. So I have to copy the link over to my computer to do the appointment. Still not the worst? Well, when they have sent me the link, I get it 5-10 minutes AFTER my scheduled appointment time.

5. The pharmacy - what a disaster. When nothing goes wrong, it's fine. Unfortunately, I've had multiple terrible experiences with the pharmacy. One time, they said I couldn't fill one of my prescriptions because it was too soon, even though their system texted me saying it was time to fill. I told them I always pick up my prescriptions together so they should either both be available to fill or neither should be. They looked through their records and said I hadn't filled one of them for over 6 months, which I knew wasn't correct since I take these meds every day and get a 90 day supply every time. Plus, these meds require my doctor to write a new prescription every time I have them filled, which they shouldn't do if I was requesting a refill too soon. I ended up picking up the meds that were ready and having to come back a few days later to get the other.

6. My employer-sponsored coverage started at the beginning of the year. I hadn't received my Kaiser membership cards yet so I called Kaiser. I spent over an hour talking to 2 people from Kaiser, which ultimately ended with them saying, "you'll need to work with your company's HR because we don't see you in the system."

The next day, I asked my company's HR if there was an issue. They said it looked like everything was correct on their end and even sent me a screenshot of my info in Kaiser's system. I was now able to login to Kaiser's portal, but could only access Northern California, where I used to live multiple years ago. I had been a member of Kaiser Southern California for a couple years since then so I was very confused by what was going on.

I called Kaiser back, spoke with a total of 4 people over a couple hours. The call ended with them telling me, "we changed something on your account so you should be able to access it now." I confirmed I was still not able to access Southern California and they said, "give it 24 hours and it should be fixed." The next day, it seemed to have been fixed so I went ahead and requested refills on my prescriptions. Later that day, I get a text saying one of my prescriptions is out of stock. Fine, I'll just go pick up the other prescriptions that are marked as ready.

I go in to pick them up. The price is way higher than usual so I ask why. The pharmacist looked and said, "weird, for some reason it didn't go through the insurance. Do you want me to do that?" Obviously, I said yes. He then takes a while to try to run it through insurance with his manager, comes back and says my insurance only covers a 30 day supply so I'll have to pay out of pocket. I said, "I've been getting 90 day supply for years and it's always gone through." He looks and sees that's true so he talks to his manager for a while, comes back to tell me there must have been a change in the policy in the new year. I said, "fine, I need the prescription so I'll just pay out of pocket."

10 mins goes by so I ask what's going on. He replies, "Oh, we need to re-process it without the insurance." More time goes by. I see his manager talking to someone else about it. He comes back to tell me that they actually can't give me the 90 day supply at all and will need to completely start over to only give me 30. Needless to say, I will not be staying with Kaiser any longer. I wouldn't recommend them to my worst enemy.

At this point I settled for any doctor that could see me, and got in to meet a very nice resident that spent time with me and even looked at my joints. The referral I was given for my joints got me to a person that could identify swelling and painful areas just by comparing sides. One wrist has fewer wrinkles, since it’s inflamed. Same with my elbows. So, I could have gone six months waiting for an appointment with my PCP, in hopes it would not be canceled again. Things that could have been treated as soon as discussed were discounted and treatment was seriously delayed. I’m the expert on my body and know when it’s not working right. The doctor is the expert on the human body. But, with Kaiser, it seems that people get only urgent treatment anymore. We are told to wait six months for an appointment, but pay our monthly premiums on time. It’s not right.

I talked to the pulmonary doctor and she agreed with me. She said she did not think it was a blood clot I had back then and took me off the blood thinner because of the kind of work I do. Because an injury could cause me to bleed out faster. She figure it was the lesser of two evils because the downside of that is that in putting me on a blood thinner and taking me off them I am now more likely to a blood clot than if I had not been put on them. I was not aware of this until I started checking the info on my doctor visits starting with June 2021 when I was hospitalized for a POSSIBLE blood clot.

Anyways now onto the rest. I had multiple visits after the being hospitalized as follow up appointments. I went in on Sept 21, 2021 to the urgent care with swelling in my legs. They treated me but it never really went completely away. Then on Dec 8 2021 I went to the urgent care who sent me to the er because I was suffering from shortness of breath. All they did was prescribe me more meds & sent me home. They never did a chest x-ray. It kept getting worse to the point that on April 12, 2022 I again went to the urgent care complaining of shortness of breath. They prescribed me more meds and sent me home. Again they never did a chest x-ray. And again it got worse not better and I went back to the urgent care on April 26th with the same complaints. They prescribed me more meds and sent me home. Again they never did a chest x-ray.

We waited thinking that maybe it was kidney related and since I had an appointment with my kidney doctor on May 16th. Nothing came of that and it kept getting worse. It got so bad that I could not walk half a block without gasping for air. I had to be pushed in a wheelchair by my girlfriend from the parking lot when I had to go in for my MRI because I could not walk that far without having an attack. After that we waited hoping that my phone appointment with Dr ** would be able to get some results because the urgent care visits were a waste of time since all they would do is prescribe more meds and send me home without doing a chest x-ray.

I missed the phone appointment because I could not answer the phone in time. I waited 30 minutes for him to call again and he did not call again so I called to try to let his office know what happened and the person I talked to could not get hold of anyone in his office so I left a message telling what happened. I got another appointment with Dr ** for June 10th, 2021. Meanwhile my girlfriend and me as well as her son had called his office trying to get help at least twice so he aware there was a problem. On June 10th, 2022 I got a call early in the morning cancelling my phone appointment with Dr ** and they rescheduled it for the end of July.

On June 11, 2022 I went back to the urgent care with the same complaints as well as complaining my shoulder hurt when I fell down from having a problem breathing. I basically passed out when that happened. They finally did a chest xray but did not contact me with the results. On June 15th 2022 I came home from work and felt really bad, so bad it scared my girlfriend who told me, "You are going to the urgent care again" so I went back to the urgent care and the doctor there took one look at the xray from my last visit and sent me to the er where they hospitalized me. One lung was almost completely full of fluid. Obviously it had been building up for the last year and until the one doctor saw the xrays they did nothing to treat me for it, just gave me more pills & sent me home each time.

Managed to snag a same day appt with some unknown doctor who prescribed stronger meds to address my back pain. Still did not help. Was finally referred to Physical Medicine where a doctor there prescribed medication strong enough to alleviate the inflammation. Managed to see my PCP (only because there was a patient cancellation, otherwise wouldn't have been able to see him) who said there was no diagnosis (when in reality there was and I didn't even know as nobody bothered to explain to me I had lumbar radiculopathy aka sciatica). Lack of and poor communication.

I am really fed up with doctors asking me questions when I'm a patient and they should be aiding and guiding me. Neighbors and friends said I need a cane to assist me walking and to secure a Handicap Parking Placard. I had to go inquire over and over and over to get the placard to assist me as I continued to limp along due to two herniated disks. I'm looking to switch to PPO insurance. Kaiser is FOR PROFIT regardless what the ads that say otherwise. Until Kaiser hires sufficient doctors to address the volume of patients, it will continue to dole out less than acceptable standards in dealing with patients with acute onset immediate crisis care needs.

Kaiser's approach seems to be downgrade, delay and deny. Initial contacts may go through a web or phone consultation that is about as useful as self research using online sites like WebMD. Getting even simple prescriptions like a rash cream would be denied. My explanations that I have already tried self-researched and over-the-counter remedies is ignored. You must go through the Kaiser process at every step, even when you are happy to pay directly. The next step is typically the office visit with a general practitioner or PA. There is no luck going to straight to a specialist even when you are experienced and knowledgeable with a condition. You will wait to get these appointments unless Kaiser deems urgency.

The providers are fine, but the care is still general and if you will pay the deductible, suffer the condition and be delayed. This will often be another wasted appointment. You will not be able to bypass the system. Your experience, research and knowledge is meaningless as is the inconvenience, expense, time and suffering. I never made it to the specialist within the process. My attempts were denied or delayed. My child was unable to sleep properly for months or to use drugs recommended for days, not continual use. When I asked to go to specialists outside of Kaiser and pay completely out-of-pocket, it was denied. They put barriers to even working with outside providers.

I literally had to go to an outside provider, walk in to their office, explain and beg them to ignore my insurance, to provide service and charge me directly. Calling was not sufficient. When my child was eventually seen by a specialist outside Kaiser, they initially recommended a long regiment of antibiotics, since we had tried a standard regiment the year before. Kaiser denied all but over-the-counter and home remedies we were trying for years. They didn't care. Stay in the system. Outside information is not considered.

The outside specialist also recommended a further diagnostic should this not work. We did not want to wait or go through the roadblocks that Kaiser would undoubtedly put up and had the specialist perform the diagnostic immediately. As we expected, there was reason for the chronic problem and an easy solution. It took us at least six months, much effort, costs, sleepless nights and unneeded suffering of our child trying to Kaiser. A horrible value is an understatement. Thankfully we never needed urgent medical emergency coverage and I suppose that provides some value. Beyond that, I would accept Kaiser's coverage if it was offered free of charge. Do yourself a favor, pay more in premiums elsewhere.

I make another appointment with another KP doctor at another facility only a week out thanks to a cancelation- I get a phone call the morning of telling me the doctor won't do the paperwork I need because she isn't my GP. I MAKE ANOTHER APPOINTMENT (Each phone call to make an appointment takes minimum 40 minutes on Hold BTW). I manage to get a phone appointment another week later with yet another GP. This one says she's happy to get all the paperwork done - And does it over the phone sight unseen. (Bless her).

I finally get a phone call to schedule the Stress test I am told I need to do before the cardiologist can see me. First available is three weeks out. The morning of the test I get a phone call telling me they have to cancel, BECAUSE THE DOCTOR HAS CALLED IN SICK. I manage to reschedule in the phone call - FOR MORE THAN THREE WEEKS OUT. That's where it stands now. To save people the math, I am now more than four months since calling to change medication that the KP Nurse insisted could be a heart attack and sent me to ER - where the doctor said see a cardiologist without delay. Assuming the next appointment isn't cancelled (mind, I am 0 for 4 in actually seeing a doctor who will do anything), it will be five months before I even get the Stress test to then see a cardiologist sometime after that. KP - Health Insurance in Premium Only.

I brought in all her latest assessments that prove she is unable to make her own medical decisions (This she knows because she did write the letter. She is not against it) but she did not sign the legal form. This form is 100% necessary and there is no “not filling it in.” Because of this my child’s medical care beyond 18 is up in the air. If you have a special needs child run far far away. No one waiting Kaiser has any idea on how to care for autistic children and now even adult!

The person that received that email just assigned a new case number and filed another grievance against that grievance. So I called and escalated to a manager, they sent an email to the case manager and the case manager's manager and told me they will call or reach out to me. It’s been over a week, no one has bothered to reach out.

In another incident, I just tried to get an appointment for my child but they are booked up at all facilities today, no appointments when I call at 7am. He needs to be seen today so I pay to go private outside of Kaiser. My son needed a prescription filled. I took the prescription to Kaiser and they refused to fill it because one of their Dr's didn't write it! But they take my monthly premium for prescription services! So now I have to pay 100% of the cost of the medicine- it makes no sense. They also canceled 2 appointments back to back the morning of the appointment with different Dr's and my son ended up in the emergency room. They really have gone down as a service provider.

Fast forward to March: I had trouble with their mobile application not letting me send e-mails to my doctor. I called technical support the first time, and they weren’t able to figure it out, so they escalated this issue to a “Tier 2” concern. I waited a week, and they still hadn’t fixed the issue, so I called back a second time. The woman on the other end told me I needed to call my doctor directly if I needed help, and she wouldn’t let me speak to anyone else, telling me they don’t take calls for Tier 2 concerns. So in other words, they are unable and unwilling to do their job, so I have to put up with the inconvenience! I called back again, and they raised my concern to a “Tier 2” again. Weeks passed, still no action.

I finally got my employer involved, who investigated the matter. They told me that Kaiser mentioned that since I switched to a PPO from an HMO, I wasn’t allowed access to e-mail my doctor since their database store information only for HMO patients. This makes zero sense because I had a PPO since August and I was able to use their e-mail in the app back in January! To top this all off, each time I seek care from them, I am told that I don’t have an active policy when this is clearly not the case. I highly recommend against doing business with this insurance company. They apparently care more about making a profit from their customers than they do providing the quality care they deserve!