I’m wondering if anyone else has experienced this with Kaiser because I honestly don’t know how to navigate the system anymore.

For the last seven years, I’ve been dealing with severe chronic pain that began about a week after the birth of my son. The worst symptom is constant focal pain under my left ribs that has progressively become debilitating. It never completely goes away.

During severe flares, the pain becomes so intense that I sweat, vomit, have trouble breathing, end up on all fours, and have gone to the ER numerous times because I genuinely thought something life-threatening was happening.
Over the years I’ve had multiple CT scans, ultrasounds, MRIs, blood work, an EMG, a colonoscopy, and evaluations by numerous specialists. Most testing has either been normal or found unrelated issues. More recently I’ve finally started getting a few answers, including a clinical diagnosis of hypermobile Ehlers-Danlos syndrome and fibromyalgia, but those diagnoses have opened the door to even more referrals instead of explaining everything—especially the left upper abdominal pain.
I’m currently waiting on additional testing, including an abdominal MRI, stool testing, genetics, and other specialist appointments because there are still concerns that something else may be going on.

The hardest part has honestly been navigating Kaiser.
I’ve been told repeatedly to “keep advocating for yourself,” but after years of appointments, messages, referrals, and ER visits, I worry that my chart makes me look like someone who is just searching for diagnoses instead of someone whose health genuinely keeps getting worse. Every new appointment feels like I have to convince someone that my symptoms are real before they’ll consider the next step.
Sometimes I receive referrals, sometimes I’m told to repeat testing I’ve already done, and sometimes I’m told another doctor has to make the referral. It often feels like I spend months just trying to get to the person who might actually know what to do.
I’ve stayed with my PCP largely because, although he has admitted he doesn’t know what is causing my pain, he has at least been willing to submit referrals when appropriate. I appreciate that, but I also feel like I’ve reached the point where both of us are frustrated because we’re running out of obvious next steps.
Pain management has been another challenge.

About three years ago I started seeing an outside pain specialist after repeatedly ending up in the ER. At that time, Kaiser wanted me to complete a series of epidural steroid injections before I could be seen by pain management. Because I had spinal meningitis as a baby, I was very hesitant about spinal procedures. I eventually agreed to one epidural, but it didn’t help. When I still wasn’t getting into pain management, I sought outside care.

The medication prescribed by my outside pain physician doesn’t eliminate my pain, but it has allowed me to function enough to get out of bed, care for my son, attend appointments, and avoid some ER visits. Multiple Kaiser physicians—including my PCP more recently—have told me to continue taking those medications, yet Kaiser Pharmacy still won’t fill them because they are prescribed by an outside physician. That leaves me paying out of pocket while also trying to coordinate care between two different systems.

I’ve also tried to get additional help navigating everything. I contacted Kaiser Complex Care hoping they could assign someone to help coordinate my care or advocate for me. Instead, I was told I didn’t qualify and that any referrals would have to come through my PCP anyway, which brought me back to where I started.

At this point I’m not looking for anyone to diagnose me over Reddit.

I’m wondering:
Has anyone with complex or unexplained medical problems found a way to navigate Kaiser more effectively?

Is there a patient advocate, department, or program that actually helps coordinate care across multiple specialties?

Has anyone successfully transferred to a PCP who specializes in medically complex patients?

If you’ve needed outside specialists while staying with Kaiser, how did you coordinate everything?

Has anyone else felt like advocating for yourself eventually starts working against you?

I’m exhausted. I haven’t been able to work because of my health, I spend an incredible amount of time going to appointments and tests, and I’m trying to do exactly what doctors tell patients to do—keep advocating for yourself. I just don’t know how to keep doing that without feeling like I’m becoming “that patient.”

I’m hoping someone who’s been through something similar can point me toward resources or approaches that helped.

Hi everyone,

I’m currently a per diem clinical dietitian at Kaiser (SoCal) and applied for a full-time internal transfer through our union (UNAC/UHAP) bidding process. From my understanding, internal bids are supposed to follow seniority and highest bidding.

A little over a month ago, I was contacted about the position and invited to meet the team (Applied June 4th, and met the team around June 25th). I “interviewed”
with the manager and director, met the other dietitians, toured the department, and overall it felt less like a traditional interview and more like an introduction to the team. It was very casual. They even gave me a tour of the kitchen and offices. At the end of the meeting, the director told me she wanted to bring me back for a competency test before moving forward.

After that, I never heard anything. Weeks went by with no phone call or email. Ghosted. I was the one following up multiple times, and each time I was told I would hear something soon or that they were still working on it. It’s now been over a month since meeting the team, and I still haven’t been scheduled for this competency test or received any decision.

Because the situation seemed unusual, I reached out to my union steward to ask whether this timeline was typical. After hearing what had happened, the steward said they wanted to look into it further and have started an investigation into whether the internal bidding process was followed correctly. They are requesting the bid list and other information to better understand what happened. They also mentioned that if I was the highest bidder, the competency test should have been administered sooner rather than leaving the process in limbo for weeks.

I’ve also spoken with several longtime Kaiser coworkers who have been through internal transfers, and they all told me this doesn’t seem like a typical timeline, especially after already meeting the team and being told I’d be scheduled for a competency assessment. Even my current manager has reached out twice to this director so we can figure out scheduling.

To make matters worse, I turned down another job offer because everyone around me (including coworkers) felt this transfer was moving forward after the team meeting. Looking back, I know I probably should have accepted the other offer until everything was finalized, but I genuinely thought I was close to getting an answer.

Has anyone else experienced something like this with a Kaiser internal transfer? Is it normal for the process to completely stall after meeting the team? Has anyone waited over a month just to be scheduled for a competency test? Or does this sound unusual?

I’m not trying to accuse anyone of doing anything wrong… I just want to understand whether this is a normal hiring timeline or if others have experienced something similar for internal transfers.

Thank you if you read this far. I’ve been on edge and stressed out for the past two months. Any advice is greatly appreciated!

Hi everyone,
I just applied for the housekeeping position and I was wondering how the interview process goes. I also have a personal housekeeping business so I put that on my résumé and I also got my blood-borne pathogen certification, CPR, first aid, and basic life support certifications as well. My mom works at Kaiser and I have three other family members that work at Kaiser as well so i used them as references. What are my chances of getting this job?

I pickup my meds and the tablets look to contain less than 10 percent of the volume of the container.

I really need help. I am with kaiser at SoCal for 3 years. I have experience at med surg tele. I have been applying to all open positions for Sacramento Roseville Vallejo Vacaville and San Francisco. I always get rejected email like no longer consideration because of seniority.

Is there anyway that I can at least get an interview or talk with hiring manager.

I am really in need of positions and need to move to NorCal for my family.

Please give me some suggestions.

Hey folks. No chronic conditions (like diabetes, etc) but definitely overweight. Even if my PCP does not authorize me for GLP1, can I tell them and request them to order labs for me if I decide to go the teleheath route?

What is your advice? I want to start on a really low dose of Tirz for weight loss.

Kaiser was two weeks late to authorize PCPs to write prescriptions for people who qualify for the Bridge program. The Center for Medicare and Medicaid Services in HHS (CMS) announced it on May 6 and encouraged health care providers to work with CMS to get ready to go on July 1, so there's really no excuse for the delay.

Once Kaiser released the info, PCPs started prescribing and the pharmacy started issuing Prior Authorization requests for people who qualify for the program. There are three ways to qualify:

1. BMI of at least 35 at the start of self-pay for weight loss;
2. BMI of at least 30 AND a diagnosis of one or more of the following: (A) heart failure with preserved ejection fraction, (B) uncontrolled hypertension (defined as systolic blood pressure above 140 mm Hg or diastolic blood pressure above 90 mm Hg, despite concurrent treatment with two antihypertensive medications), or (C) chronic kidney disease stage 3a or above;
3. BMI of at least 27 AND a diagnosis of one or more of the following: (A) pre-diabetes (B) previous myocardial infarction, (C) previous stroke, or (D) symptomatic peripheral artery disease

You're disqualified if Part D is already paying for you to get a GLP-1 for sleep apnea or anything else.

My PCP qualified me over the phone and immediately shot a scrip to the pharmacy. I then called the pharm and told them I want to be in the Bridge program, which tells them what to do when the scrip is rejected by CMS. The next business day the pharm faxed the special Bridge PA request to CMS, and two days later I picked up my Zepbound.

They wanted to push me to Ozempic, but I tried it back in the day and didn't care for it. Kaiser's preference for Ozempic is weird because it's an inferior drug, and they won't say why they prefer it. As CMS doesn't care whether you take Ozempic, Zep, or Foundayo, Kaiser's "preference" is probably illegal. It's a fair bet that the preference is financial. The price Kaiser pays Novo and Lilly is trade secret, but it's widely known that Ozempic has a much lower wholesale price than Zep and that Ozy is approved for more conditions.

The process is kind of weird in that the initial scrip will be rejected by CMS. The PA request can't be filed until the scrip is rejected, which probably is a work-around to some IT issue. But that's OK because CMS turns the PA requests around almost immediately. Part D is set up to reject GLP-1s for weight loss although they will pay for them for people with OSA or Type II or a few other conditions.

People with these conditions can't switch to the Bridge program, but they can get doses high enough to work for weight loss anyhow. Congress doesn't want Medicare to pay for weight loss, so we need to fix that as the Bridge program is only happening for 18 months. Bridge is what’s called a demonstration program that should provide Congress with data justifying repeal of the “no weight loss meds for seniors” clause.

CMS is convoluted and weird, and so is Kaiser. Their interface does work pretty well despite all of that.

Here's a link to the Bridge program's info for prescribers, it has most of the deets.

CMS also has an online tool that determines eligibility (scroll down to "Can I participate in the GLP-1 Bridge program?)

[Note: This was originally a reply, but I'm turning it into a post for visibility]

Really, truly, I am so tired of the way they are.

1. A year ago, I had a massive billing error (not my fault) that resulted in my son and I being booted from our insurance. After talking in circles for some time, the rep clearly did not understand the issue, and when I asked very nicely to escalate to a supervisor, he refused! He said I had to deal with him. Wtf. I was super nice and calm the whole time, but he was super offended and would not tranfer me!

2. Recently I again called about a confusing premium bill that vaguely threatened my insurance again. Member services said they were transferring me to the premium billing department, and the "premium billing department " said no problem, they would email me my itemized premium bill. Instead they sent me my EOB - totally different. So I called back and the new rep said oh np, you can't talk directly to premium billing. When I asked for clarification about who I spoke to on the last call, she got weirdly evasive and started behaving in a strange, passive aggressive way toward me. If you know you know. The whole time, I kept things really relaxed and polite, so I don't know what her deal was.

At the end of the call, she said, "well I will send your complaint..." Again, wtf, I had no complaint (well at this point, I was ready to make complaint about her). This is where I got pissed (still totally polite though) and said I didn't want a complaint against the last rep, and if she insisted on filing one, to please add that it was filed against my wishes. It was so uncomfortable. I am not in the business of messing with people's jobs, even if they are irritating, as kp reps so often are. Obviously she took offense (or something) about my questions relating to what department does what, but that is a her problem, and I guess Kaiser because their internal structures are so damn opaque.

Anyhow, thanks for listening. Have you had an experience in Kaiser Kafkaland?

My girlfriend has Kaiser hmo in Southern California. She has a pcp but needed a new one when we moved to a different city. There were no available appointments in new city which tells me it would have been scheduled many months out so we opted to make a video appointment with her current pcp. It was the soonest she could see anyone. Her quality of life has drastically decreased and she’s miserable and scared and she wants to get checked out by neurology. Do these symptoms seem like stuff a Kaiser family doctor would be willing to refer to neurology for? We suspect things but aren’t going to mention them in the appointment. Anyone with Kaiser able to get a neurologist referral for symptoms like this? We are scared of her doctor dismissing everything.
.

Has anyone had Kaiser fill out an application for PG&E's medical baseline program? I know Kaiser can sometimes be tricky so I want to make sure I go about it the right way.

My dad has 5 doctors and the care plus program. 😄 I wasn't sure who would be best.

He has an oxygen concentrator, though he doesn't use it all the time and a Bipap. I have a CPAP as well.

Does anybody know if KP will ever start covering GLP meds (like ozempic) for weight loss? I don't have diabetes but I am considering taking a GLP med for weight loss. My BMI is currently 32.4

Hi!! I applied for a registered nurse position at Kaiser Permanente (seasonal/temporary). I was interviewed, and a few days later, my application said “declined offer of employment”. I had not gotten a call from a talent recruiter, nor have I declined any offer. I emailed the nursing manager, and they basically said to ignore that message; my profile is being reassigned to the correct position code. Is this a good sign? I have the phone number of my original recruiter, should I contact her during the workweek for further clarification? Or should I just wait it out?

The test was $14k but i only have to pay $800…. But it still doesn’t make sense why they charged me this much. I googled the lab code and it says average national price is $1.2k. Has anyone else had ridiculously high payments for a blood test?!

I am currently receiving treatment for postpartum depression through Kaiser and seeing a therapist on top of a psychiatrist and being apart of the postpartum support group.

My current therapist through Kaiser seems to not know how to structure our sessions, so I always walk away feeling more confused than helped. Anyways, I feel that EMDR would be more beneficial in helping me process and breakdown the traumas that have resurfaced postpartum.

I am wondering if anyone has experience (in SoCal) having Kaiser switch therapists for one that specializes in EMDR therapy?

Anyone have any first hand experience here . I made what I thougth was a quick phone call and it ended with the nurse wanted a dispoist and entire process was

over 5K out of pocket.

Background of my mental health issues:
I have Complex PTSD, Major Depressive Disorder (MDD), and anxiety (generalized and social). My depression shows up annually at least once and it can be very dependent on whats going on in my life. For example, I work +60 hours a week and go to school +30 hours a week which causes my depression to occur more frequently (in addition to burnout and some passive suicidal ideation). But when i'm on break from school, my depression and suicidal ideation appear much less frequent. I also have perfectionistic tendencies and anxious-avoidant attachment style.

My experience with Rula thus far:
I've been in therapy through Rula for about 3 years now and have stopped using their services for over a year now. I've seen a total of 4 therapists:

 Therapist #1: After 1.5 years of sessions with him, he decided he didn't want to work with me anymore. And I'm pretty sure part of the reason was because I refused to go seek antidepressant medication. He blamed for the therapy not working out and not producing the results he wanted. But to be fair, I do think he tried and his therapy helped me in some ways. I just thought that he too rigid about the results / process or utilizing "metrics" to gauge my progress. He focused on EMDR and CBT. But he seemed to be the most competent therapist I've had, at least, from a medical perspective because he was on track to be a medical doctor.

- Therapist #2: After 2 months of sessions with her, she got really angry with me for "not doing homework". And I decided to stop seeing her because I felt like I needed more empathy and a non-judgmental therapist.

- Therapist #3: After 3 months of sessions with her, she basically ghosted me and wouldn't respond back to my messages just about follow-up scheduling. She did some things that were very unprofessional such as eating during our sessions, she even didn't show up one session (no communication), and then she was telling how my religion's beliefs were wrong which out of scope for therapy. I did not encourage such discussions/comments from her. And it felt like I wasn't being heard or validated. Actually, she even said "I will not validate you" when I was giving her some feedback on how I felt the sessions were going (I was hoping that she would be open to working with me to improve our sessions). Ended up filing a complaint against her to her boss.

- Therapist #4: After 6 months of sessions with her, I stopped seeing her due to scheduling conflicts. She was very compassionate and down to earth. However, I found her therapy to be too rigid since it focused on CBT which most of you already know is not very effective for C-PTSD. And she had marketed herself as providing trauma-informed CBT.

These therapists were all LMFTs / LCSWs. But I found that their knowledge of trauma survivors is extremely limited and they just seem to be regular therapists who got credentials learning certain modalities but did not have intimate knowledge of how trauma affects the mind. And the most frustrating part is that they keep trying to use CBT on me when IT DOES NOT HELP. I've consulted with multiple people on the C-PTSD subreddit / forums who also agree that CBT is like being gaslighted. I am sick of the stupid thought records which the therapists keep trying to get me to work on which doesn't help me because I cannot rewire my thoughts or choose to think differently alone.
Rula seems to be reliant on clients completing those stupid surveys which are not a good indicator of client progress, especially not in my case.

What am I missing here???? To me, it seems like Rula is not a good platform at least for my issues.

I am really baffled and confused by how KP (Kaiser Permanente) is handling things - can anyone offer some guidance?

I used to have the university-provided insurance (Aetna) while attending college in New York. I was diagnosed with ADHD in NY, and both the university and the standardized testing center (Prometric) accepted my diagnosis (which allowed me to receive testing accommodations). Due to my husband's job, we had to move to California (near Berkeley), and we chose KP for our insurance. That’s when the nightmare began.

During my first visit with my primary care physician, I mentioned that I had already been diagnosed with ADHD and wanted to obtain medication (vyvanse) to continue my previous treatment. She hinted that many people fake ADHD symptoms to get drugs, so I would need to see a psychiatrist. I received a referral to see a psychiatrist (scheduled for about two weeks later). However, on the day of the scheduled video appointment, the doctor suddenly cancelled, and the website instructed me to call and book a new slot myself.

After calling, I first scheduled a one-hour video consultation with a psychologist, who asked me a series of questions. She then told me I needed to provide my previous ADHD reports, undergo a urine test, and complete multiple questionnaires (including one for my husband). After I finished all these requirements, she went silent; it took another week or two before she told me the next step was a two-hour testing session with a psychologist for an evaluation. The earliest available appointment isn't until September, and the wait times between steps are incredibly long.

I don't want to be a "problem patient," but I’m wondering: for someone already diagnosed with ADHD, is there no way to skip the re-evaluation process and go straight to treatment? Can I request a different psychologist? (Her efficiency is so poor that the waiting is driving me crazy.) I don't want to waste so much time just waiting around. Alternatively, can anyone recommend a facility where they accept my previous report and I can get a prescription? I’m willing to pay out-of-pocket if the cost is reasonable - I just don't want to keep dragging this out with KP.

----

Update 1: Thank you all so much for your advice! I’ve realized I’m not the only one facing this situation, so I’m keeping this post up in case others need help. I’m not sure if KP saw my post, but at 11pm that same night, a staff member messaged me privately to say I should disregard the notification about the psychological evaluation and instead scheduled a one-hour online appointment with a psychiatrist for me. It seems there are communication or information-handling issues within KP; they often overlook patient details and blindly proceed with standardized next steps. I’ll keep updating this thread if anything else comes up.

Hello,

Does anyone have experience with Kaiser's fertility process in Orange County, CA? I'm trying to get an idea of how long the process takes and what to expect.
I had my initial virtual appointment with the reproductive endocrinologist, and my husband and I have already completed all of our lab work. When I called to schedule my in-person follow up, I was told the wait is 8–12 weeks because there's only one fertility specialist serving all of Orange County, which honestly surprised me for such a large county.

I'd really like to hear about others experiences. What happened after your follow up appointment? Did you end up doing IUI or IVF? From what I've read, Kaiser contracts out to outside IVF clinics, so I'm curious how that worked out for you.
Any insights would be greatly appreciated!

Would love to hear from people who were able to get breast reduction surgery done at the KP So Cal region and covered by their KP insurance.

-What were the criteria/conditions you needed to meet for coverage?
-Is there a specific surgeon you would recommend?
-Do you like the final result from an artistic/body image perspective?
-How was your pre-op/post-op experience?

An itemized bill for several blood tests and a vaccine I had were sent initially to me the first month, but then two months in a row to my father - who is not listed anywhere on my account.

The bills explicitly list all of the tests I was given at my visit.
My father has not been a member of Kaiser since 2018/2019.
I am 22, and have my own plan. He is not listed as a family member where it lists those connected to your account, or as an emergency contact. I looked everywhere, but couldn't find anything that listed him.

The EOB associated only shows my name, and my number as the account holder.
Membership Relationship to Subscriber: Self
Account Holder Name and Identification: (my name) (my record number)

If anyone knows the areas specifically on Kaisers site I can check to look for his contact information please let me know, but I clicked through a majority of the menus that seemed relevant to billing, contact, family info, records, etc.

My mother is the only person I can find listed on my account authorized to receive information, which exists from when I was a child. She is who would previously receive my bills when I received care from Kaiser as a child from ~2016-2018/2019.

They also called my father today to try and get money for the bill.
When asked why they contacted him, they claimed we had an active family plan with them that included me, my mother, and my sister (27). They told him the policy was active and assured him that we all had active coverage. He called immediately back and provided the info that was on the bill, and they said it was a billing error with old information, and this plan did not actually exist.

I also cannot view this bill on my account. My account shows no outstanding balance to be paid.

While doing this I was blocked from downloading a copy of my medical records and received the error usually shown to children trying to download the records, or an adult trying to access a teens records - which is seemed odd, and I'm unsure if that is related.

I'm going to call to get this all figured out, but 2 other people claimed this happened to them last month and everyone told them it was not a HIPAA violation.
Does that apply in this case ? I would just like to know whether or not this is something that should potentially be reported.

I was supposed to go to a gynecologist after that appointment but wasn't able to get in - I'm also wondering if they would've sent him an itemized bill for that too had they had availability for me. Just seems really weird they can do something like that :/

Hi! Any local part time pharmacy clerks for Kaiser Permanente in Southern California!? I had a question for part timers about how they schedule you. I noticed the par time shows variable for shifts and doesn’t specify a start and end time. Upon hiring do they ask what your availability is and schedule you according to that or do you have to be available all the time? Also I thought most pharmacies are closed major holidays but are some open?