Kaiser Permanente $50M Out-of-Network Claims Settlement
Were you a California Kaiser Permanente member who had to pay out of pocket for out-of-network mental health or substance use disorder services on or after Jan 1 2021? You could receive full or partial reimbursement from Kaiser Permanente’s $50 million settlement. File a secure claim online or download the form below to get started today.
Download Claim Form (PDF)Are You Eligible?
You may qualify if all of the following apply:
- You are or were a Kaiser Permanente member in California.
- You attempted but could not obtain timely in-network mental health or substance use care.
- You paid an out-of-network provider directly for that care on or after Jan 1 2021.
Not eligible:
- Members enrolled in Medicare Advantage plans.
- Copays or cost-sharing amounts when Kaiser Permanente itself referred you out of network.
How Much Can You Receive?
There is no set dollar amount per person. Approved claimants will receive:
- Reimbursement for some or all of the out-of-pocket payments they made, and/or
- Payment of outstanding bills for eligible services.
How to File a Claim
- Submit your claim online OR print and mail the PDF claim form to:
Kaiser Permanente Notice Administrator
1650 Arch St., Suite 2210
Philadelphia, PA 19103 - Include documentation:
- Invoices or itemized bills showing service dates and types
- Proof of payment (receipts, canceled checks, bank statements)
- Your Kaiser membership record number, provider names and phone numbers
- If you are filing for a minor, incapacitated adult or deceased member, attach proof of legal authority.
Deadline: You must file within 180 days of receiving notice or learning about the settlement. Don’t wait—submit now to protect your rights.
Important Dates & Payment Timeline
- Claim deadline: 180 days after you learned of the opportunity
- Payout date: Checks will be mailed as soon as claims are reviewed and approved. Kaiser Permanente may contact providers about unpaid bills.
Why the Kaiser Permanente Settlement Matters
The California Department of Managed Health Care alleged Kaiser Foundation Health Plan Inc. failed to ensure timely, in-network behavioral health care, violating state access and parity laws. While Kaiser denied wrongdoing, it agreed to:
- Pay up to $50 million—$40 million immediately and another $10 million if compliance goals are missed.
- Implement a corrective action plan to improve network adequacy, oversight and timely access to behavioral health services.
Frequently Asked Questions
What documentation do I need for the Kaiser Permanente $50M Out-of-Network Claims Settlement?
Submit itemized bills and proof of payment for each qualifying service. If you seek reimbursement of an unpaid bill, affirm the amount owed; Kaiser may verify with your provider.
Can I file if I never received a mailed notice about the Kaiser Permanente settlement?
Yes. Any eligible member can file even without a mailed or emailed notice, as long as the claim meets the criteria.
How will I be paid?
Approved claims are paid by check sent via U.S. mail to the address you provide on your claim form.
Where can I find more information?
Visit the official settlement website at outofnetworkhealthclaims.com or call the administrator at 1-877-684-4129.