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Kaiser Permanente Individual Applications
Apply today for Kaiser Permanente health insurance coverage for individuals and families. There is no application fee and in most cases, no payment is needed up front. To qualify, you must complete a paper or online enrollment form and meet the eligibility criteria. The application will ask for medical history, but no physical examinations are necessary to apply. Kaiser Permanente requires a Social Security Number or Tax ID Number for those over the age of six months. This requirement does not pertain to babies under six months of age.
How do I apply?
To apply for private health insurance with Kaiser Permanente, use the links below. If you are seeking to enroll a child under age 19, please note that as a result of the Health Reform mandate, not all states are accepting child-only applications. Find state specific special instructions below.
To apply online, click on the name of the state.
- Applicants in California must complete a separate application for each individual.
- If you are enrolling a child under 19, you cannot apply online. Instead, complete a paper version and fax or mail it. See below for details.
- To apply in Spanish, please see below.
- If you are enrolling a minor, please note that an application for a child will be accepted only if one of the situations below is applicable:
- The child is applying together with at least one parent, or a legal guardian.
- There is a qualifying event. Then, the minor may enroll as a single subscriber. A qualifying event is an extenuating circumstance that necessitated obtaining new or replacement health insurance. Some examples are: a new baby, adoption, or loss of coverage.
- During open enrollment, when children can apply on a single subscriber basis without a qualifying event requirement. Open enrollment is in January for a March 1st effective date, and in July for a September 1st effective date.
- A kid younger than 19 may enroll under a family application only. At least one parent or a legal guardian must also apply.
- Child-only applications are not currently being accepted. The qualifying event exception is not applicable in Georgia.
To apply by fax or mail, click the name of the state and print the application.
- To enroll a child under 19, click Print CA Application.
- To apply in Spanish, click Solicitud en Español.
- To enroll a child under 19:
- Click Apply Online if applying during the open enrollment months of January or July.
- Click Print CO Application if you are applying within 30 days of a qualifying event.
- To apply in spanish, click Solicitud en Español.
- To apply by paper for an effective date of 2012, click Print GA Application.
- To apply in spanish, click Solicitud en Español.
Paper applications can be submitted as follows:
- Fax: 1-866-439-9993
- Mail: KaiserQuotes.com, 750 Mendocino Avenue, Suite 4, Santa Rosa, CA 95401
- Scan and email to: support@kaiserquotes.com
When is the deadline to submit my application?
Deadlines are listed below. We recommend applying well in advance of the deadline date to give underwriting enough time to evaluate your application. Be aware that denials are still allowed on adult applications for private health insurance.
The available effective dates and corresponding deadlines vary by state. See below for details.
| California Applicants | For coverage to be effective on this date: | You must submit the application by this deadline: |
| Adult applicants |
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| Children under age 19 |
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| Colorado Applicants | For coverage to be effective on this date: | You must submit the application by this deadline: |
| Adult applicants |
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| Children under age 19 |
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| Georgia Applicants | For coverage to be effective on this date: | You must submit the application by this deadline: |
| Adult applicants |
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| Children under age 19 |
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