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How to Apply for the Community Health Access Program – Important Deadlines

Open enrollment for 2024 has ended, but you can still apply during a special enrollment period if you experience a qualifying life event.

Special Enrollment Period


You can apply for coverage if you have a certain type of event in your life — called a qualifying life event. A qualifying life event is when something important in your life changes. For example, if you get married, divorced or give birth, you can apply for coverage through Community Health Access Program.

In general, the special enrollment period lasts 60 days after a qualifying life event.

If you have a qualifying life event, you’ll need to send in these documents:

  • The Kaiser Permanente for Individual and Families Application
  • The Kaiser Permanente Subsidy Eligibility form and include proof of income
    • If you are self-employed, are paid in cash, or have other sources of income, complete the Reporting Form for Other Income
  • Proof of your qualifying life event

For more information about your proof of qualifying life event, look at the Special Enrollment Period Guide or visit

Where to submit your forms and proof:
By email:

By Mail:
Kaiser Foundation Health Plan, Inc.
California Service Center
P.O. Box 939095
San Diego, CA 92193-9095

By fax:

Note: Sending your forms to us does not guarantee that your child/children will be approved for the Community Health Care Program. We may ask you for more information to determine your child/children’s eligibility.

When you’ll hear from us: We’ll let you know if we can include you in the Community Health Care Program after we receive and review your completed forms and proof of income.

To learn more about the Kaiser Permanente MD Gold Value 0/20/Vision plan or VA Gold 0/20/Vision plan benefits, check out the Summary of Benefits and Coverage to see key features of the plan. You can also get a paper copy at any time without charge by calling Member Services at 1-800-777-7902 (TTY 711). Copays listed in these documents won’t apply for most care at KP facilities when you’re enrolled in CHAP.

* Continued eligibility for the CHAP is not guaranteed. We reserve the right to close enrollment or change the CHAP eligibility rules at any time. If you are approved for the CHAP subsidy, the subsidy period is limited, and we will contact you in the future to confirm that you still qualify.

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