Insurer record · Medicare Advantage & Medicaid · nine regional reports, PDF and XML

Kaiser Permanente

19.5%

of standard requests denied, flagship So. California Medicare contract (H0524), 2025

Dataset: Prior-authorization postings · payers' own sites · CY2025

Complete reports found See the public-record check →

From the payer’s own CY2025 posting

What Kaiser Permanente disclosed

Measure	What the insurer reported	Note
Standard requests, contract H0524 (So. California MA)	143,690
Denied in full or part	19.48%	27,992 denials
Denials appealed	310	about 1.1% of denials
Appeals won by patients	25.48%
Mean decision time (standard)	22 hours
Contract H8794 denial rate	10.95%	37.2% of 94 appeals overturned
CA Medicaid (So. California) denial rate	6.39%

Source · Kaiser Permanente CMS prior-authorization reports (Southern California PDF)

Published: report dated Mar. 27, 2026
Source note: Captured Jul. 8, 2026.
How to check it: The original public source is linked below. We label the market, year, and known limits beside the number.

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Appeal drafting · free to use

Denied by Kaiser Permanente? Build a fact-specific draft.

Start with the facts in your notice. The builder adds public context only when it matches Medicare Advantage prior authorization, and labels that context so it is not confused with evidence about your individual request.

Write my appeal letter

The block below is for Medicare Advantage prior-authorization appeals only.

I ask that my Medicare Advantage prior-authorization appeal be reviewed carefully. I include the following public figures as background only; they do not describe my individual request and do not, by themselves, show that this denial was incorrect: - KFF's analysis of insurer-reported CMS data found that 80.7% of appealed Medicare Advantage prior-authorization denials were overturned in 2024. CMS does not audit these insurer submissions (https://www.kff.org/medicare/medicare-advantage-insurers-made-nearly-53-million-prior-authorization-determinations-in-2024/). - Kaiser’s 2025 posting for Southern California Medicare contract H0524 reports that 25.48% of appealed prior-authorization denials were decided in the member’s favor. (https://healthy.kaiserpermanente.org/legal-regulatory/reports/cms-prior-authorization). Please reconsider my individual request on its facts, provide the specific criteria used, and identify the credentials of any clinician who reviewed it.

On the record

Fewest requests, hardest reversals.

Across Medicare Advantage in 2024, Kaiser required the fewest prior authorizations per enrollee (0.6), saw the smallest share of denials appealed (1.6%), and overturned the smallest share of appeals (51.0%) of any major insurer.

Source · KFF analysis of CMS Medicare Advantage data (2024)

Published: Jan. 28, 2026
Source note: Insurer-reported to CMS; unaudited.
How to check it: The original public source is linked below. We label the market, year, and known limits beside the number.

Open original source ↗

See how these figures are collected, what they can and cannot tell you, and how to request a correction on the methodology page. Compare payers on the rankings page.