Complaints

This profile includes complaints for Kaiser Foundation Health Plan Inc's headquarters and its corporate-owned locations. To view all corporate locations, see Find Local Branches.

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  Kaiser Foundation Health Plan Inc

  One Kaiser Plaza 19th Floor Oakland, CA 94612

• 

  Kaiser Foundation Health Plan Inc

  PO Box 12916 Oakland, CA 94604-2916

• 

  Kaiser Foundation Health Plan Inc

  4131 Geary Blvd San Francisco, CA 94118-3101

• 

  Kaiser Foundation Health Plan Inc

  39400 Paseo Padre Pkwy Fremont, CA 94538-2310

• 

  Kaiser Foundation Health Plan Inc

  900 Veterans Blvd Ste 200 Redwood City, CA 94063-1740

The complaint text that is displayed might not represent all complaints filed with BBB. Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business.

• Initial Complaint

  Date:07/16/2025

  Type:Product Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  On July 8th I submitted a prescription request for a chemo medication, ********, which has a co-pay 2nd insurance through the manufacturer, ********. They call it a universal co-pay through OpusHealth. My card information is in my Kaiser profile. I had problems getting the Kaiser pharmacy to understand how to use this earlier in the year. The card has right on it a number for pharmacy to call to figure out how to bill. Important: Kaiser calls it a coupon, it is not a coupon, it is a second insurer which accepts claims from the pharmacy only (not me, the customer.) I have been in the ********************** pharmacy in person with the card, I have confirmed with the counter and their manager that this information is on file and they know how to appropriately charge me. The medication shows as $150, with the co-pay enabled it should be $50. Later in the day on the 8th my bank account indicated a hold for $150 had been placed by Kaiser. I called their pharmacy line, they saw the transaction, they say the Novartis/OpusHealth co-pay (coupon) information and they ASSURED me they would reverse the charge and appropriately charge me $50. I checked my account daily and the hold did not change, the charge went through at $150. I called to complain. They said they COULD reverse it and would take care of it. Days later, July 15th, they called me to say they could NOT reimburse me or reverse the charge or refund anything. They told me to call Novartis/OpusHealth. Basically - they lied to me outright at the first, second, and third call. They always could have refunded or changed the charge, they told me they would, and then they did not. I've just gotten off the line with Novartis/OpusHealth, they can not refund as they are a second insurance and Kaiser should be billing them and REFUNDING ME. They again provided the number that the Kaiser Pharmacy should call to learn how to bill them. This is something that Kaiser has correctly done several times, but they suddenly can not or have forgotten.

  Business Response

  Date: 07/22/2025

  Thank you for your email.  I've forwarded this concern to the Member Relations Department.  A representative will review and follow up with the patient directly to address this issue.   Thank you for reaching out. 

• Initial Complaint

  Date:07/10/2025

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I'm a member of Kaiser Permanente and Dr ***** was my PCP. This doctor has not been responsible enough to provide care or medical advice as needed and does not respond to messages. Details:1. Being a diabetic and following intermittent fasting plan, I had asked him to send me a prescription for *** in April . He said that he had sent it to me on April 16th but I did not get it until May 2. I sent him a message on on May 7th and he never responded 3. Some other doctor responded to messages on 10th July (with irrelevant information 4. I had requested Dr ***** to order me HbA1C test by end of May during my April consultation - He never did that. 5. There was no alternate doctor provided to respond to the messages while Dr ***** was out of office. There was no out of office response either 6. I sent a message to Dr ***** on 1st July and so far he has not responded either. As per Kaiser guidelines, the doctor is supposed to respond within 48 hrs. 7. I filed a grievance with Kaiser on 10th June and someone with name ******** responded on 9th July with irrelevant information and closed the case without even making sure that a satisfactory resolution was provided. It clearly is a case of how Kaiser doctors are neglecting patient care and unable to provide proper medical advice or care. This is extremely serious. My previous doctor assigned me to someone who prescribed me a diet which increased my blood sugar level and prescribed me medications with many side effects. Also, one doctor said not to take B12 regularly but other doctor said yes, take it regularly.Kaiser seems to be playing with patient's health here and making them suffer.

  Business Response

  Date: 07/23/2025

  Thank you for your email.  I've forwarded this information to the Member Relations department.  A representative will review and follow up with the patient directly to address this concern.   Thank you for reaching out. 

• Initial Complaint

  Date:06/26/2025

  Type:Product Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I requested specific lab tests, but my doctor failed to include key ones: Cortisol, B12, Ferritin (iron), a full thyroid panel (TSH, Free **, Free T4, Reverse **, TPO antibodies), and *********. This is the second time this has happened. Now Ill have to pay additional ****** to return for the tests that shouldve been ordered initially. This was clearly a mistake on Kaisers part. Im requesting a prompt appointment and reimbursement for the added costs due to this error.

  Business Response

  Date: 07/03/2025

  Thank you for your email.  I've forwarded this information to the Member Relations department.  A representative will review and follow up with the patient directly and address this concern through the Health Plan grievance process.   Thank you for reaching out. 

• Initial Complaint

  Date:06/24/2025

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I have been trying to get my **** certification done. The process is very ************ May i had to get one for my very sick mother, and they were very rude and process took almost 2 weeks. When I filed a grievance, nothing happened with that.The whole process was so stressful, i had an panic attack because of all the things i was dealing with my mothers health. Now i am dealing with my own health issues and trying to get someone on the phone almost takes over an hr.They are always so rude on the phone as well.I just want there to be a easier process so I can get what i need done.

  Business Response

  Date: 06/24/2025

  Thank you for bringing this to our attention. A case manager will be assigned to review the situation and assist with next steps. 
  

  Customer Answer

  Date: 06/25/2025

   
  Complaint: 23511815
  
  I am rejecting this response because:
  I was able to call myself and get my fmla certification, but i still wanna keep a complaint about the horrible experience with the medical records department here.
  Sincerely,
  
  ****** ***

  Business Response

  Date: 06/27/2025

  Thank you for your email.  I've shared this concern with the *************************** for further review.  A representative will follow up with the patient directly to address this concern.   Thank you for reaching out. 

  Customer Answer

  Date: 07/03/2025

   
  Complaint: 23511815
  
  I am rejecting this response because:
  
  Sincerely,
  
  ****** ***

• Initial Complaint

  Date:06/19/2025

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  In 2024, we paid $751.20/month to include me in my husband's employer-sponsored health plan with Kaiser Permanente. We paid this every month without interruption. Nonetheless, Kaiser recently decided that I was covered by United Healthcare from Jan 1 2024-Aug 1 2024 and has withdrawn all payments to healthcare providers that I saw during that time. They now deny every claim from Jan 1-Aug 1 2024. I have never had health insurance with United Healthcare. I have never paid a dime to United Healthcare for health insurance. On May 12th, I called Kaiser and told them this. I called again today and nothing has changed. They continue to refuse coverage for Jan 1-Aug 1, despite us having paid my premium in full. They have sent me no proof or documents whatsoever in support of this fake claim that I was covered by a different healthcare company during that time instead. Meanwhile, the providers I saw during the first half of 2024 are now billing me for the money Kaiser automatically withdrew from them. I don't even know how to start to fix this. Please help.

  Business Response

  Date: 06/23/2025

  Thank you for your email.  I've forwarded this information to our Member Relations department.   A representative will review and follow up with the member directly to address this concern.   Thank you for reaching out. 

  Customer Answer

  Date: 06/24/2025

   
  Complaint: 23492334
  
  I am rejecting this response because: I spoke with Kaiser Member Relations on May 12th, and again on June 19th. They have indicated zero willingness to resolve this in any way. They told me to take the matter up with United Healthcare. I have never been a member of United Healthcare so would not even know where to begin. Why would United Healthcare do anything to help me here, when the agency I have been paying and been a member of will not? Hence contacting you. 

  Thanks for helping get this resolved. 

  
  Sincerely,
  
  ****** *******

  Business Response

  Date: 07/01/2025

  Re: Complaint ID # ********
  
  Dear Resolutions Specialist:
  
  Due to privacy reasons, we are unable to address any individuals complaint in detail through correspondence with the BBB.Therefore, this response is acknowledgement that we are in receipt of this concern. This complaint is already under review with Member Relations (Grievance Operations) to investigate and provide resolution. Upon completion of the investigation, we will contact the individual directly by letter with the outcome within 30 days.
  
  Our mission is to offer care and service of the highest quality, and we appreciate your dedication to helping individuals who may have received services at a Kaiser Permanente facility or through our health plans.Thank you for your partnership.
  
  If the individual needs assistance in the meantime, they can reach *************** by phone at ************** or by email at ********************* Monday through Friday, from 8 a.m. to 5 p.m.
  
  Sincerely,
  
  Member Relations Coordinator
  WA ************ Grievance Operations
  
  Coverage provided by Kaiser Foundation Health Plan of Washington or Kaiser Foundation Health Plan of ************************

• Initial Complaint

  Date:06/13/2025

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I had a fracture on my right hand over the weekend of June 6. Initially, I went to a local urgent care center for treatment, as the hospital in ***** was closed. I was advised to get an X-ray by an urgent care specialist, but when I called Kaiser Permanente, they said they would not approve it because a Kaiser urgent care specialist had to order it.I then scheduled a phone appointment with a Kaiser urgent care ******* *** ordered the X-ray. After the report came in, no one followed up with me. I had to be the one following up with the doctor to get appointments and next steps.I was advised again to go to another urgent care center, which I declined. Instead, I requested to see an orthopedic doctor. The doctor I was assigned turned out to be a general orthopedist. He did not recommend surgery, even though I was in severe pain. I sought a second opinion outside of Kaiser, and all other specialists recommended surgery for my fracture.I am in significant pain, and the entire process of getting in touch with a doctor has been very difficult. I am extremely dissatisfied with the care I received. The earliest appointment available is June 23, which is too far away considering the severity of my injury.I would like to file a complaint. Patients should receive better treatment, and Kaiser should provide proper service without delays and confusion.Thanks ****** ***** Aedla Kaiser ID : ********

  Business Response

  Date: 06/16/2025

  Thank you for sharing this concern. A representative in our *************************** will review the issues/request and will notify the member of the outcome within 30 days from the date of receipt.
  
  Thank you
  

• Initial Complaint

  Date:06/12/2025

  Type:Sales and Advertising Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  Kaiser professionals have failed to diagnose my most invasive health issues. Instead I'm required to take part in useless video appointments, travel dozens of miles for several intake appointments that don't lead to anything helpful. I spent a year going to x-ray appointments, trying to see specialists who would cancel at the last minute, and suffering from excruciating foot pain. I diagnosed myself after seeing a picture of my foot problem on a wart remover box at Food 4 Less. I had to switch to ******* in order to have a wart removed. They diagnosed it and removed it within two weeks, without a single x-ray. I switched back to Kaiser because that's where I was born. When I requested my immunizations for a job, Kaiser had no records. All my immunizations have been taken at Kaiser. I had a mental health therapist who barely spoke. I was never diagnosed. No help what so ever! I'm currently having excruciating hip pain. Once again I'm being sent to several appointments and nobody can diagnose the problem. I've been given meds that make it impossible to function. They help with the pain but the side effects make it difficult to stay awake. I've had too many useless video appointments regarding this matter, yet I'm still required to conduct another video appointment before I can see my doctor again. When I reach out through ******, I don't get responses from my doctor. Instead, I get a generic unrelated response from an LVN. I feel that Kaiser is targeting me in order to abuse my insurance. They must have made hundreds of thousands of dollars off me by now. I need actual health care!

  Business Response

  Date: 06/18/2025

  Thank you for your email.  I've forwarded this concern to the Member Relations department.   A representative will review and follow up with the patient directly to address this concern.  Thank you for reaching out.

• Initial Complaint

  Date:06/10/2025

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  Kaiser Permanente in ********************* pulled out of an agreement for my wifes FNSD disease. We had to go outside of Kaiser cause Kaiser did not have psychologist that handles in this. We went outside to Kaiser and got approved by a doctor ***** and Danville California Kaiser approved it on January 15 of 2025 the contract expired May 15 of 2025. They said they were gonna extend it longer to November 26 of *************************************************************************** ******* or ******************* which they do not practice FNSD if Kaiser cannot help the patient out they outsource. To make the patient better and we pay for that in our Kaiser contract. Youre just a member with Kaiser.Its very sad your number and its all about the money not the patient even if the patient life depends on it, which I dont care. Trying to get authorization for the company Neuro wellness solutions in ******** ********** a great psychologist thats helping with FNSD 3 doctors from Kaiser approved it. I hope you could help the people who Im dealing with the phone number is ************** is the department number speaking with a lady named ******* ***** give you in the right direction please help it is life and death. Thank you. My phone number is ************. My name is ***** ******.

  Business Response

  Date: 06/19/2025

  Thank you for your email.  I've forwarded this concern to the Member Relations department.  A representative will review and follow up with the member directly to address this concern through the Health Plan grievance process.  Thank you for reaching out. 

• Initial Complaint

  Date:05/14/2025

  Type:Billing Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  May 2024 Moved from ****** to ******** and updated my address with Kaiser's website Kaiser's system cancelled my plan The premium I was paying sat in the Pay Portal unused for billing unit A11 -September 2024 Realized my old plan was cancelled and got a new one Thousands of dollars of my money still sitting on Pay Portal Paid the premium of the new plan at $428/mo to billing unit A03 -October 2024 Kaiser sent letter of rejected payment for A03 Rejected payment was because there was too much money on the Pay Portal -November 2024 I made a premium payment to A03 Kaiser agent told me to let the money, my money, on the Pay Portal run out for A03 -December 2024 Premium came out of the balance sitting on the Pay Portal for A03 -January 2025 Old plan auto-renewed and started accruing debt for A11 Premium came out of the balance sitting on the Pay Portal for A03 -February to April 2025 Old plan accrues debt for A11 Premium came out of the balance sitting on the Pay Portal for A03 All Premium Bills stated $0 owed -May 2025 Kaiser updates Pay Portal Debt accrued on A11 is applied to A03 I call Kaiser to explain situation Kaiser Admin states I owe $2583 for unpaid Premiums for the new plan on A03 Kaiser Admin says the "credit" on A03, which is my money, was used in their error Kaiser will cancel my plan of "non-payment" if I don't pay the $2583 -The "credit" was my own money I was paying for a plan they cancelled without notice because I moved zip codes. They're saying they used it "in error" so now I owe this balance. But, they never gave me a credit, it's my money. I was told to stop paying because there was too much money sitting on the account.-I followed their instructions to let the balance run out and now they are trying to make me pay for their incompetence. All of my Billing Statements are similar to the one attached, that I owed $0 because of my money sitting on the Pay Portal to be used. Kaiser admitted it was their error but refuse to adjust.

  Business Response

  Date: 05/14/2025

  Thank you for sharing this concern. A representative in our *************************** will review the issues and will notify the member of the outcome within 30 days from the date of receipt.
  
  Thank you 

  Customer Answer

  Date: 05/14/2025

   
  Complaint: 23328942
  
  I am rejecting this response because: Within the 30 day waiting period my plan will be terminated by Kaiser's own system, leaving me without insurance nor access to my medications. This has been an ongoing problem for over a year, I have made several phone calls and been cooperative with Kaiser. I refuse to allow any further delay in an actual resolution to their self created problems that affect my state of living.
  
  Sincerely,
  
  **** *******

• Initial Complaint

  Date:05/01/2025

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I had a colonoscopy in Kaiser. Before scheduling the operation I asked about the price, I was told that $150. The price was told me twice before scheduling by different employees as $150. At the day of the operation, during check in, I asked again I was told that the price was $150, I said I was gonna pay it fully at the check in and I paid it. I will not go into the specifics of how I was not happy with the service and stuff which caused me days of pain. But weeks later, they asked an additional $440. I believe it's not a fair request and it's not a good way a business should operate.

  Business Response

  Date: 05/07/2025

  Thank you for your email.  I've forwarded this information to the Member Relations team.   A team member will review and follow up with the patient directly to address this concern.   Thank you for reaching out.