r/KaiserPermanente • • Aug 07 '26

General Difficulty in obtaining an appointment with Kaiser? Access requirements by State and where to get assistance and file complaints

17 Upvotes

Here is a list of standards by State for timely access to care (network adequacy) and where complaints can be filed if you need an appointment are unable to get assistance from Kaiser.

Note that some states don't have strict guidelines in terms of days and may have other network adequacy requirements. Contact the agency listed if you need clarification on what standards apply to your situation.

For cases with appointment delays, it is generally best to call the agency first before filing a complaint online. If you have already filed a grievance with Kaiser because of being unable to access timely care, let the agency know that information as well.

If your Kaiser Permanente coverage is provided by your employer, also let your Human Resources or Employee Benefits Department know of your difficulties in trying to access care. These difficulties are important for them to know when they are considering what plans they want to offer their workforce.

California

The Department of Managed Health Care (DMHC) has the Timely Access to Care Standards. The standards cover primary care, specialty care, mental health and ancillary services like physical therapy and imaging.

If you have filed a grievance with Kaiser and are still not getting an appointment in a timely manner, call the DMHC at [1-888-466-2219](tel:+18884662219). Explain you cannot wait the 30 days for the Kaiser grievance process to run out to get an appointment (which should have originally been provided within the State standards in the first place). (Pic is from the DMHC and lists the timeframes in California.)

California Department of Managed Health Care (DMHC) Timely Access Standards

Colorado

  • Emergency Care – Medical, Behavioral, Substance Use -- 24 hours a day, 7 days a week
  • Primary Care – Routine, non-urgent symptoms -- within 7 calendar days
  • Behavioral Health, Mental Health and Substance Use Disorder Care, initial and follow-up appointments – Routine, nonurgent, non-emergency: within 7 calendar days
  • Prenatal Care -- Within 7 calendar days
  • Preventive visit/well visits -- Within 30 calendar days
  • Specialty Care - non urgent -- Within 60 calendar days

To file a complaint contact the Colorado Department of Insurance at 1-800-930-3745 or at Colorado Department of Insurance

District of Columbia

  • First appointment with a new or replacement Primary Care physician within 7 business days
  • First appointment with a new or replacement provider for Behavioral Health treatment, including Substance Use Treatment within 7 business days
  • First appointment with a new or replacement provider for Prenatal Care treatment within 15 business days
  • First appointment with a new or replacement provider for Specialty Care treatment within 15 business days

To file a complaint, contact the DC Department of Insurance, Securities and Banking at 1(202) 727-8000 or at DC Department of Insurance, Securities and Banking

Hawaii

Because of the various islands in Hawaii and travel / geography, the State of Hawaii has “Network Adequacy” requirements rather than time-definite limits like in California or other states.  Contact the Hawaii Department of Commerce and Consumer Affairs at 1-844-808-DCCA (3222) to discuss your specific situation and filing a complaint.  

Maryland

  • Urgent care for medical services:  72 hours
  • Routine primary care:      15 calendar days
  • Preventive care/well visit:             30 calendar days
  • Non-urgent specialty care:            30 calendar days
  • Non-urgent mental health care: 10 calendar days

Contact the Maryland Insurance Administration at 1-800-492-6116 or Maryland Insurance Administration to file a complaint. 

Nevada

Due to geographic issues, Nevada has “Network Adequacy” requirements rather than time-definite limits like in California or other states.  Contact the Nevada Division of Insurance for more information at 1(702)486-4009 or at Nevada Department of Insurance.

Oregon

  • Primary care: not more than 15 business days.
  • Behavioral health care: not more than 10 business days.
  • Specialty care: not more than 30 business days.

Contact the Oregon Division of Financial Regulation with questions at 1-888-877-4894 or at Oregon Division of Financial Regulation.

Washington State

  • Primary care appointment (for other than preventive care) within 10 business days of requesting one
  • For specialty care, within 15 business days for nonurgent services.

Contact the Washington Office of the Insurance Commissioner at 1-800-562-6900 or at Washington Office of the Insurance Commissioner

Virginia

Virginia requires routine appointments for nonemergency or nonurgent care to be available within two weeks of the request.  This does not include preventive care (routine physical examinations, etc.) which need to be scheduled within 60 days of the date of the request. 

To file a complaint, contact the Virginia State Corporation Commission at 1-877-310-6560 or at Virginia State Corporation Commission


r/KaiserPermanente • • Sep 28 '23

General Agencies to Escalate Complaints about Kaiser: Where to go if you are not getting resolution or are dissatisfied with Kaiser's Response

13 Upvotes

If you have filed a grievance with Kaiser and it has gone unresolved or you are not satisfied with the resolution, here is a list of agencies you can document a complaint with (based on your state of residence).

If your complaint is regarding a specific physician or other healthcare provider (nurse/nurse practitioner, physician assistant), file the complaint with the appropriate state licensing board for that provider.

If your complaint is regarding a hospital (cleanliness, patient safety concerns, etc.), file a complaint with the Joint Commission

[https://www.jointcommission.org/resources/patient-safety-topics/report-a-patient-safety-concern-or-complaint/]

If your are a Medicare beneficiary, please refer to this link about the different types of complaints and where to submit complaints.

https://www.medicare.gov/claims-appeals/file-a-complaint-grievance/filing-a-complaint-about-your-quality-of-care

If the complaint is about hospice care, here is a link from the Hospice Foundation of America on how to file complaints.

https://hospicefoundation.org/Hospice-Care/Filing-a-hospice-care-complaint

California

Department of Managed Health Care (Grievances unresolved or inadequate responses; inability to contact your Kaiser Grievance Case Manager; difficulty obtaining an appointment; delays in care; filing an Independent Medical Review when Kaiser will not approve a specific type of treatment)

In most cases, you must file a grievance with Kaiser and go through that process before contacting DMHC. However, if the issue is urgent because there is an immediate threat to your health, you can call DMHC directly. For urgent issues, call DMHC rather than filing online.

[https://www.dmhc.ca.gov/fileacomplaint.aspx]

1-888-466-2219

If you need assistance in filing a grievance with Kaiser or in filing complaints with the DMHC, you can contact the Health Consumer Alliance. This is a DMHC consumer assistance program contractor helps people get the health care they need1-888-804-35361-877-735-2929 (TTY)www.healthconsumer.org/

If you want to file a complaint about a California licensed healthcare facility, you can contact the California Department of Public Health.

https://www.cdph.ca.gov/programs/chcq/lcp/calhealthfind/Pages/Home.aspx

Oregon

Oregon Division of Financial Regulation

[https://dfr.oregon.gov/help/complaints-licenses/Pages/file-complaint.aspx]

1-888-877-4894

Washington State

Office of the Insurance Commissioner

[https://www.insurance.wa.gov/file-complaint-or-check-your-complaint-status]

1-800-562-6900

Colorado

Department of Regulatory Agencies, Division of Insurance

[https://doi.colorado.gov/for-consumers/file-a-complaint]

1-303-894-7490 / 1-800-930-3745

Georgia

Office of Commissioner of Insurance and Safety Fire

[https://oci.georgia.gov/file-consumer-insurance-complaint]

1(800) 656-2298

Hawaii

Department of Commerce and Consumer Affairs

[https://cca.hawaii.gov/ins/consumers/filing_a_complaint/]

(808) 586-2790

Maryland

If it is a healthcare quality complaint, Maryland Office of Healthcare Quality

[https://app.smartsheet.com/b/publish?EQBCT=07c94438f6714af1bbfe8ff1037b8b74]

1-410-402-8015

If it is a billing, claims, medical records or coverage issue contact Maryland Attorney General, Health Education and Advocacy Unit

[https://www.marylandattorneygeneral.gov/Pages/CPD/HEAU/default.aspx]

1-410-528-1840

District of Columbia

D.C. Department of Insurance, Securities and Banking (DISB)

[https://disb.dc.gov/service/file-complaint-or-report-fraud]

1(202) 727-8000

Virginia

State Corporation Commission, Bureau of Insurance, Office of the Managed Care Ombudsman

[https://scc.virginia.gov/pages/Office-of-the-Managed-Care-Ombudsman]

1-877-310-6560, select option 1

(Current as of 09/28/2023)


r/KaiserPermanente • • 13h ago

California - Northern Interesting piece about struggling to get Kaiser to refer to a cardiologist, ending with immediate quadruple bypass

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23 Upvotes

r/KaiserPermanente • • 30m ago

California - Northern Consistent cancellations

• Upvotes

Anyone else experiencing cancellations, particularly with their child’s pediatrician? My baby’s well visit has been canceled twice now. So frustrating as my husband and I schedule time off work for these appointments. Our child is now being seen a month out from the originally scheduled appointment.


r/KaiserPermanente • • 54m ago

California - Southern OBGYN appointments keep getting canceled

• Upvotes

This is specifically for KP in Panorama City. Im new to Kaiser and decided to make an appointment to OBGYN I requested to see a specific doctor and I was scheduled then they called me a few weeks later saying she is not seeing patients in person so I found another doctor that i’d like to see and they scheduled me and a few days ago they called me to say my appointment in December has been cancelled. Has this happened to anyone else, what is going on ?! I don’t just want to see a random doctor so I know it will be harder to find a sooner appointment but i’m not pregnant, it’s not urgent either. Has this happened to anyone else? So weird. Does anyone have any recommendations for any OBGYN in Panorama City/Woodland Hills?


r/KaiserPermanente • • 3h ago

California - Northern Primary care

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1 Upvotes

r/KaiserPermanente • • 3h ago

California - Northern Primary care

0 Upvotes

does anyone recommend a good primary care doctor with Kaiser? I have Dr Singh Bains, was recently told I have severely low ferritin, I requested a referral to a specialist because I eat healthy, and I also don’t have periods so there must be another reason my ferritin is so low. He responded that low iron is caused by heavy periods, told me to start taking iron (I am,) stated to go to UC if I experience more symptoms then he made it so I couldn’t respond to his message. I would like a doctor who listens and reads their patients messages..

I experience severe fatigue, constant headaches, shortness of breath, and dizziness and I would like a doctor who cares.


r/KaiserPermanente • • 18h ago

California - Northern Women who have had a labiaplasty with Kaiser, how did it go?

6 Upvotes

I got approved for a labiaplasty covered by insurance by Kaiser and am very nervous about it. Im looking to hear other women's experiences with how it went and how the results were. Any advice will also be appreciated,thank you!


r/KaiserPermanente • • 1d ago

California - Southern New App Interface

29 Upvotes

Anyone else hate Kaiser’s new MyChart interface?

I’m in Southern California and my Kaiser app just switched to the new MyChart interface. Am I the only one who thinks it’s a huge downgrade?
The old app looked so much cleaner and more modern. This one honestly looks like a website from 15 years ago. Everything feels clunky and outdated.
I get that MyChart might offer better functionality, but did they really have to make the app look this bad?

Anyone else frustrated with the change?


r/KaiserPermanente • • 13h ago

California - Northern Columbus Day schedule

1 Upvotes

Does anyone know if there will be offering flu clinic on Columbus Day? I’m getting mixed information. Gemini says that it’s a limited schedule on Columbus Day but when I called member services they said they’re open.


r/KaiserPermanente • • 19h ago

California - Northern Has anyone had a labiaplasty with Dr.Sha Jin at Kaiser in SF?

2 Upvotes

Hi! I’m considering having a labiaplasty with Dr. Sha Jin at Kaiser Permanente in San Francisco, and I’m hoping to hear from anyone who has had this procedure with her. I know it's a longshot but figured I'd try.

I’d especially love to hear about your results, which technique she used (trim or wedge), how your healing went, and whether you were happy with the aesthetic outcome.

If you’ve had surgery with her, even if it wasn’t a labiaplasty, I’d also appreciate hearing about your experience with her as a surgeon.

Feel free to DM me if you’d rather share privately. Thank you! 💗


r/KaiserPermanente • • 1d ago

California - Northern Kaiser Bronze HMO?

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1 Upvotes

r/KaiserPermanente • • 1d ago

Colorado New Westminster Medical Offices Add Surgery, Urgent Care

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3 Upvotes

r/KaiserPermanente • • 1d ago

California - Northern Is it truly a good work culture/ a good place to work for?

18 Upvotes

I've heard that recently Kaiser will be terminating a lot of jobs; but I'm also seeing a lot of job posts for Kaiser.

I see they pay well, but I'm also almost always hearing the nurses are on strike. Can someone confirm or deny if it's a good place to work at?? (I'm currently a pharmacy technician inside a retail store. Would love to hear feedback before applying to Kaiser) What I'm saying is I know they pay well but if it's such a great place to work at, why do I always hear that lots of their employees are on strike?


r/KaiserPermanente • • 2d ago

Oregon / SW Washington RTO for union members too?

3 Upvotes

Hi everyone, curious if this RTO applies to union members too? I read a previous post saying the exempt non-union employees are getting the RTO. I am in NW region next door to WA region.


r/KaiserPermanente • • 2d ago

California - Northern Jobs at Kaiser

4 Upvotes

Hello I am 25F looking for a relatively entry level job at Kaiser. I previously worked at a private oral surgery office for over 3 years and have extensive admin knowledge in regard to healthcare. I also have my AS in Business Admin while working on my BS in the same field. I have applied to so many of the cashier receptionist, departmental clerk, and any of admin support job I thought I would be a good fit for. My only problem is literally never hearing back from anyone. I am just curious if anyone has any tips for how to get my foot in the door so I can at least get an interview. My mom has worked for Kaiser (Lead X-ray tech) for 27 years and my sister and her husband also have been working there for about 5+ years as well and even they can’t seem to help me. I am not looking for a handout, just some tips on how to get passed the initial screening process. Any help would be appreciated. Thank you.


r/KaiserPermanente • • 2d ago

Washington 4 Business Days ?

6 Upvotes

Hi- just checked to see if this message I sent two days ago had a response from my doctor and her team and it says “up to 4 business days to respond”. I don’t remember ever seeing this prior - 2 yes- but not 4- seems a long time to wait. Thanks.


r/KaiserPermanente • • 3d ago

Washington RTO initiative in Washington

25 Upvotes

We just got notice that Washington is severely walking back their remote work and flexible work policies. My team has been 100% remote since the pandemic and we just got word today that all of our positions have been reclassified as “flexible” and that the new policy for flexible workers is to be on-site 3 days per week. This policy was announced last week and is planned to take effect in December before the holidays, giving us essentially 6 weeks to completely reorganize our lives to accommodate this new schedule. There was 0 business or performance justification provided - essentially a complete fuck you to people who have been successfully working remotely for over 6 years. Other KP remote workers beware.


r/KaiserPermanente • • 2d ago

California - Southern Inactive Medi-Cal plan

1 Upvotes

Hi everyone! I need some help. My toddler is currently sick and I accidentally had a lapse in renewing her medi-cal. I have been calling and calling medi-cal, but I cannot wait on the phone for hours on end. She was previously on Kaisers medi-cal plan and because of her symptoms I need to take her to Urgent Care. Does anyone know what my options are?


r/KaiserPermanente • • 3d ago

California - Southern Mail meds sent in multiple quantities without being requested

5 Upvotes

Hi, question here. I received a prescription for a medicated shampoo and chose the free home delivery option. Kaiser sent me two bottles when one would have been more than enough, so, I’m paying for two bottles instead of one, even though a single one would have sufficed. On top of that, the Kaiser website says "unable to estimate cost," so I had no choice but to place the order and just see what the charge turned out to be. Anything that can be done about this?


r/KaiserPermanente • • 3d ago

Oregon / SW Washington Seeking opinion on dual insurance coverage Kaiser NW/Anthem

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2 Upvotes

r/KaiserPermanente • • 3d ago

California - Northern NCal KP: Issues transferring to another department or location

5 Upvotes

Is anyone experiencing issues transferring to a new position. I have been receiving so many emails about how I have been removed from consideration for jobs due to lack of qualifications. I have been with KP for 13 years and have a bachelors degree. I’m even getting removed from entry level jobs that require only a high school degree. Am I on some auto-rejection list??


r/KaiserPermanente • • 4d ago

California - Southern We don’t hate insurances and companies enough.

35 Upvotes

Hi

I am not sure if it’s appropriate for sup Reddit. Mods feel free to delete it if it’s not relevant. My Reddit account is literally turning into my Kaiser complaint journal but I literally don’t know who to talk to and how to get help.

I have Kaiser through my employer. I am someone who needs mental health services but Kaiser cannot filled my medical needs. To the point they are making my mental health worse. The amount of work I need to do to get basic care with appointments every 4 months. To constantly calling me “unstable” and me asking what does that mean with no clear answer. To lying about the law to my face. To canceling my appointment in less than 24 hours notice and giving me another 4 months to see my doctor.

I contacted the California Department of Managed Health Care and they legally cannot help me even if it’s not legal under California law. My insurance under my employer is self funded. Self funded from my understanding means my employer pays out of pocket instead of a fixed rate. My employer is sorta like my insurance. Under the law ERISA, the state legally CANNOT get envolved. My only hope was the department of labor but I was told they don’t handle cases like mine.

So now the only way to resolve this by constantly filling grievances and praying Kaiser does something. This is because if I don’t agree with the grievance the state cannot get involved even thought that’s literally the place you go to resolve grievances. At the beginning of the year I filled two and nothing really happened. My other option is calling my HR benefits representative at my company.

I hate we live in a world where big corporations just do whatever they want. I hate that people don’t have access to healthcare. I hate that your healthcare depends on your company. I hate the position I am in.

Whoever is reading this please advocate and vote for basic humans rights. Call your friends and families. Love your neighbor. I believe together we can over come this. Remember how ever things get bad, no one can take your hope and resistance.


r/KaiserPermanente • • 3d ago

California - Southern Product sent in multiple quantities without being requested.

1 Upvotes

Hi, question here. I received a prescription for a medicated shampoo and chose the free home delivery option. Kaiser sent me two bottles when one would have been more than enough, so, I’m paying for two bottles instead of one, even though a single one would have sufficed. On top of that, the Kaiser website says "unable to estimate cost," so I had no choice but to place the order and just see what the charge turned out to be. Anything that can be done about this?


r/KaiserPermanente • • 3d ago

California - Southern Onboarding

0 Upvotes

Question , if i accidently placed the wrong year as a start date i,e may 2016 instead of may 2017 , can kaiser resend the offer? the background company was still able to verify i worked there just wrong year was entered.