u/Much-Swordfish6563

▲ 1 r/Medi_Cal+1 crossposts

I'm wondering if anyone knows if I can pay out-of-pocket for an out-of-network doctor in the following situation:

I am a member of Kaiser Permanente's Dual Complete Plan. It's currently May, and I have been trying to get some decent help with vertigo and dizziness issues since the end of last 2025. Normally, the assumption is that the person has BPPV (inner ear canal issues), so the Audiology department needs to be consulted with first. Just getting an initial appointment with Audiology took a few weeks due to the hoops one must jump through to see any department other than Internal Medicine, but then I was put through a basic physical examination by a Physician's Assistant and he decided I should be evaluated with a videonystagmography test. More weeks went by before I went through that hellish test (anyone who has had one knows what I mean). It took me a good week to get back to the level of dizziness with vertigo episodes that I had before the test. Anyway, the technician found some type of BPPV in the right ear canal. But I raised the issue with the Physicians Assistant that testing on my left ear canal was actually even more vertigo inducing than with the right. He thought that was unusual and OK'd me to be seen by a Neurotologist, of which there is only one in my area. And that exam was set for June - about 5 months away. After one month the appointment was then canceled on me, and I had to reschedule - this time for mid-September! Seven months away from the day I was making the appointment!

My feeling is that I need to know exactly what is going on inside my ear canals, first of all. There is more than one possible condition to be ruled in/out. And then I likely have a form of central nervous system vertigo as well (that was something a Physical Therapist specializing in dizziness/vertigo felt). I certainly have symptoms of that, but there is no plan to investigate it further by any Kaiser doctor. Figuring out the BPPV situation and deciding on an appropriate therapy would seem to be the first thing to do.

Since Kaiser can't offer me any diagnostics and therapy until at least September, I'm wondering if I would be able to see an out-of-network doctor to expedite things.

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u/Much-Swordfish6563 — 10 days ago