 {"id":243,"date":"2018-12-24T21:36:37","date_gmt":"2018-12-24T21:36:37","guid":{"rendered":"https:\/\/charitablehealth.kaiserpermanente.org\/mid-atlantic\/?page_id=243"},"modified":"2026-03-30T16:24:52","modified_gmt":"2026-03-30T16:24:52","slug":"apply","status":"publish","type":"page","link":"https:\/\/charitablehealth.kaiserpermanente.org\/mid-atlantic\/apply\/","title":{"rendered":"Apply Now"},"content":{"rendered":"<div class=\"wpb-content-wrapper\">[vc_row center_row=&#8221;yes&#8221; bg_type=&#8221;no_bg&#8221; bg_grad=&#8221;&#8221; bg_image_repeat=&#8221;no-repeat&#8221; bg_image_size=&#8221;cover&#8221; bg_img_attach=&#8221;fixed&#8221; parallax_sense=&#8221;30&#8243; animation_direction=&#8221;left-animation&#8221; animation_repeat=&#8221;repeat&#8221; bg_override=&#8221;0&#8243; parallax_content_sense=&#8221;30&#8243; fadeout_start_effect=&#8221;30&#8243; overlay_pattern_opacity=&#8221;80&#8243; seperator_type=&#8221;none_seperator&#8221; seperator_position=&#8221;top_seperator&#8221; seperator_shape_size=&#8221;40&#8243; seperator_svg_height=&#8221;60&#8243; seperator_shape_background=&#8221;#ffffff&#8221; seperator_shape_border=&#8221;none&#8221; seperator_shape_border_width=&#8221;1&#8243; icon_type=&#8221;no_icon&#8221; icon_size=&#8221;32&#8243; icon_style=&#8221;none&#8221; icon_color_border=&#8221;#333333&#8243; icon_border_size=&#8221;1&#8243; icon_border_radius=&#8221;500&#8243; icon_border_spacing=&#8221;50&#8243; img_width=&#8221;48&#8243; css=&#8221;.vc_custom_1755648811399{background-image: url(https:\/\/charitablehealth.kaiserpermanente.org\/mid-atlantic\/wp-content\/uploads\/sites\/14\/2018\/12\/p_ch_applying_for_chap.jpg?id=231) !important;background-position: center !important;background-repeat: no-repeat !important;background-size: cover !important;}&#8221; el_class=&#8221;home-widephoto&#8221;][vc_column][\/vc_column][\/vc_row][vc_row center_row=&#8221;yes&#8221; bg_type=&#8221;no_bg&#8221; bg_grad=&#8221;background: -webkit-gradient(linear, left top, left bottom, color-stop(0%, #FBFBFB), color-stop(50%, #E3E3E3), color-stop(100%, #C2C2C2));background: -moz-linear-gradient(top,#FBFBFB 0%,#E3E3E3 50%,#C2C2C2 100%);background: -webkit-linear-gradient(top,#FBFBFB 0%,#E3E3E3 50%,#C2C2C2 100%);background: -o-linear-gradient(top,#FBFBFB 0%,#E3E3E3 50%,#C2C2C2 100%);background: -ms-linear-gradient(top,#FBFBFB 0%,#E3E3E3 50%,#C2C2C2 100%);background: linear-gradient(top,#FBFBFB 0%,#E3E3E3 50%,#C2C2C2 100%);&#8221; bg_image_repeat=&#8221;no-repeat&#8221; bg_image_size=&#8221;cover&#8221; bg_img_attach=&#8221;fixed&#8221; parallax_sense=&#8221;30&#8243; animation_direction=&#8221;left-animation&#8221; animation_repeat=&#8221;repeat&#8221; bg_override=&#8221;0&#8243; parallax_content_sense=&#8221;30&#8243; fadeout_start_effect=&#8221;30&#8243; overlay_pattern_opacity=&#8221;80&#8243; seperator_type=&#8221;none_seperator&#8221; seperator_position=&#8221;top_seperator&#8221; seperator_shape_size=&#8221;40&#8243; seperator_svg_height=&#8221;60&#8243; seperator_shape_background=&#8221;#ffffff&#8221; seperator_shape_border=&#8221;none&#8221; seperator_shape_border_width=&#8221;1&#8243; icon_type=&#8221;no_icon&#8221; icon_size=&#8221;32&#8243; icon_style=&#8221;none&#8221; icon_color_border=&#8221;#333333&#8243; icon_border_size=&#8221;1&#8243; icon_border_radius=&#8221;500&#8243; icon_border_spacing=&#8221;50&#8243; img_width=&#8221;48&#8243; css=&#8221;.vc_custom_1774633215879{background-position: center !important;background-repeat: no-repeat !important;background-size: cover !important;}&#8221; local_scroll_id=&#8221;special-enrollment&#8221;][vc_column width=&#8221;2\/3&#8243;][vc_column_text css=&#8221;&#8221;]\n<h3><strong>Important Update: The Mid-Atlantic Community Health Coverage Program has met program capacity and is no longer accepting applications for the 2026 enrollment period. Please continue to check the website for opportunities to apply in the future.<\/strong><\/h3>\n[\/vc_column_text][\/vc_column][vc_column width=&#8221;1\/3&#8243;]<div class=\"templatera_shortcode\"><div class=\"vc_row wpb_row vc_row-fluid wpex-relative\"><div class=\"wpb_column vc_column_container vc_col-sm-12\"><div class=\"vc_column-inner\"><div class=\"wpb_wrapper\">\n\t<div class=\"wpb_text_column wpb_content_element boxed\" >\n\t\t<div class=\"wpb_wrapper\">\n\t\t\t<p><b>Have questions?<\/b><\/p>\n<p>Call us toll-free at<\/p>\n<p><b>1-800-777-7902<\/b> (TTY <b>711<\/b>)<\/p>\n<p>Monday through Friday, from 7:30 a.m. to 9 p.m. Eastern time<br \/>\n(closed major holidays)<\/p>\n\n\t\t<\/div>\n\t<\/div>\n<\/div><\/div><\/div><\/div><\/div>[\/vc_column][\/vc_row][vc_row disable_element=&#8221;yes&#8221; center_row=&#8221;yes&#8221; bg_type=&#8221;no_bg&#8221; bg_grad=&#8221;background: -webkit-gradient(linear, left top, left bottom, color-stop(0%, #FBFBFB), color-stop(50%, #E3E3E3), color-stop(100%, #C2C2C2));background: -moz-linear-gradient(top,#FBFBFB 0%,#E3E3E3 50%,#C2C2C2 100%);background: -webkit-linear-gradient(top,#FBFBFB 0%,#E3E3E3 50%,#C2C2C2 100%);background: -o-linear-gradient(top,#FBFBFB 0%,#E3E3E3 50%,#C2C2C2 100%);background: -ms-linear-gradient(top,#FBFBFB 0%,#E3E3E3 50%,#C2C2C2 100%);background: linear-gradient(top,#FBFBFB 0%,#E3E3E3 50%,#C2C2C2 100%);&#8221; bg_image_repeat=&#8221;no-repeat&#8221; bg_image_size=&#8221;cover&#8221; bg_img_attach=&#8221;fixed&#8221; parallax_sense=&#8221;30&#8243; animation_direction=&#8221;left-animation&#8221; animation_repeat=&#8221;repeat&#8221; bg_override=&#8221;0&#8243; parallax_content_sense=&#8221;30&#8243; fadeout_start_effect=&#8221;30&#8243; overlay_pattern_opacity=&#8221;80&#8243; seperator_type=&#8221;none_seperator&#8221; seperator_position=&#8221;top_seperator&#8221; seperator_shape_size=&#8221;40&#8243; seperator_svg_height=&#8221;60&#8243; seperator_shape_background=&#8221;#ffffff&#8221; seperator_shape_border=&#8221;none&#8221; seperator_shape_border_width=&#8221;1&#8243; icon_type=&#8221;no_icon&#8221; icon_size=&#8221;32&#8243; icon_style=&#8221;none&#8221; icon_color_border=&#8221;#333333&#8243; icon_border_size=&#8221;1&#8243; icon_border_radius=&#8221;500&#8243; icon_border_spacing=&#8221;50&#8243; img_width=&#8221;48&#8243; css=&#8221;.vc_custom_1762031887966{background-position: center !important;background-repeat: no-repeat !important;background-size: cover !important;}&#8221; local_scroll_id=&#8221;special-enrollment&#8221;][vc_column width=&#8221;2\/3&#8243;][vc_column_text css=&#8221;&#8221; visibility=&#8221;hidden&#8221;]\n<h1>Thank you for your interest.<\/h1>\n<p><strong>The Community Health Coverage Program (CHCP) is currently closed to new enrollment. When the Program opens for new enrollment, this site will be updated with information on how to apply.<\/strong>[\/vc_column_text][\/vc_column][vc_column width=&#8221;1\/3&#8243;]<div class=\"templatera_shortcode\"><div class=\"vc_row wpb_row vc_row-fluid wpex-relative\"><div class=\"wpb_column vc_column_container vc_col-sm-12\"><div class=\"vc_column-inner\"><div class=\"wpb_wrapper\">\n\t<div class=\"wpb_text_column wpb_content_element boxed\" >\n\t\t<div class=\"wpb_wrapper\">\n\t\t\t<p><b>Have questions?<\/b><\/p>\n<p>Call us toll-free at<\/p>\n<p><b>1-800-777-7902<\/b> (TTY <b>711<\/b>)<\/p>\n<p>Monday through Friday, from 7:30 a.m. to 9 p.m. Eastern time<br \/>\n(closed major holidays)<\/p>\n\n\t\t<\/div>\n\t<\/div>\n<\/div><\/div><\/div><\/div><\/div>[\/vc_column][\/vc_row][vc_row disable_element=&#8221;yes&#8221; remove_bottom_col_margin=&#8221;true&#8221; center_row=&#8221;yes&#8221; el_id=&#8221;open-enrollment-MD-ended-VA-open&#8221;][vc_column width=&#8221;2\/3&#8243;][vc_column_text css=&#8221;&#8221;]\n<h1>Open Enrollment 2026<\/h1>\n<p>You may apply for CHCP during the open enrollment period, which began November 1, 2025. Please note that the open enrollment period varies by state:<\/p>\n<ul>\n<li><strong>Maryland: <\/strong>open enrollment ended January 15, 2026<\/li>\n<li><strong>Virginia: <\/strong>open enrollment ends January 30, 2026<\/li>\n<\/ul>\n<p><strong>Virginia<\/strong><\/p>\n<table width=\"790\">\n<tbody>\n<tr>\n<td><strong>To start coverage on:<\/strong><\/td>\n<td><strong>Send your completed paperwork by:<\/strong><\/td>\n<\/tr>\n<tr>\n<td>February 1, 2026<\/td>\n<td>January 30, 2026<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>You must apply through a CHCP Navigator. <a href=\"https:\/\/charitablehealth.kaiserpermanente.org\/mid-atlantic\/contact\/\">Find a CHCP Navigator near you.<\/a>[\/vc_column_text][\/vc_column][vc_column width=&#8221;1\/3&#8243;]<div class=\"templatera_shortcode\"><div class=\"vc_row wpb_row vc_row-fluid wpex-relative\"><div class=\"wpb_column vc_column_container vc_col-sm-12\"><div class=\"vc_column-inner\"><div class=\"wpb_wrapper\">\n\t<div class=\"wpb_text_column wpb_content_element boxed\" >\n\t\t<div class=\"wpb_wrapper\">\n\t\t\t<p><b>Have questions?<\/b><\/p>\n<p>Call us toll-free at<\/p>\n<p><b>1-800-777-7902<\/b> (TTY <b>711<\/b>)<\/p>\n<p>Monday through Friday, from 7:30 a.m. to 9 p.m. Eastern time<br \/>\n(closed major holidays)<\/p>\n\n\t\t<\/div>\n\t<\/div>\n<\/div><\/div><\/div><\/div><\/div>[\/vc_column][\/vc_row][vc_row disable_element=&#8221;yes&#8221; remove_bottom_col_margin=&#8221;true&#8221; center_row=&#8221;yes&#8221; el_id=&#8221;open-enrollment&#8221;][vc_column width=&#8221;2\/3&#8243;][vc_column_text css=&#8221;&#8221;]\n<h1>Open Enrollment 2026<\/h1>\n<p>You may apply for CHCP during the open enrollment period, which begins November 1, 2025. Please note that the open enrollment period varies by state:<\/p>\n<ul>\n<li><strong>Maryland: <\/strong>open enrollment ends January 15, 2026<\/li>\n<li><strong>Virginia: <\/strong>open enrollment ends January 30, 2026<\/li>\n<\/ul>\n<p><strong>\u00a0<\/strong><strong>Maryland <\/strong><\/p>\n<table width=\"790\">\n<tbody>\n<tr>\n<td><strong>To start coverage on:<\/strong><\/td>\n<td><strong>Send your completed paperwork by:<\/strong><\/td>\n<\/tr>\n<tr>\n<td>January 1, 2026<\/td>\n<td>December 31, 2025<\/td>\n<\/tr>\n<tr>\n<td>February 1, 2026<\/td>\n<td>January 15, 2026<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><strong>Virginia<\/strong><\/p>\n<table width=\"790\">\n<tbody>\n<tr>\n<td><strong>To start coverage on:<\/strong><\/td>\n<td><strong>Send your completed paperwork by:<\/strong><\/td>\n<\/tr>\n<tr>\n<td>January 1, 2026<\/td>\n<td>December 31, 2025<\/td>\n<\/tr>\n<tr>\n<td>February 1, 2026<\/td>\n<td>January 30, 2026<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>You must apply through a CHCP Navigator. <a href=\"https:\/\/charitablehealth.kaiserpermanente.org\/mid-atlantic\/contact\/\">Find a CHCP Navigator near you.<\/a>[\/vc_column_text][\/vc_column][vc_column width=&#8221;1\/3&#8243;]<div class=\"templatera_shortcode\"><div class=\"vc_row wpb_row vc_row-fluid wpex-relative\"><div class=\"wpb_column vc_column_container vc_col-sm-12\"><div class=\"vc_column-inner\"><div class=\"wpb_wrapper\">\n\t<div class=\"wpb_text_column wpb_content_element boxed\" >\n\t\t<div class=\"wpb_wrapper\">\n\t\t\t<p><b>Have questions?<\/b><\/p>\n<p>Call us toll-free at<\/p>\n<p><b>1-800-777-7902<\/b> (TTY <b>711<\/b>)<\/p>\n<p>Monday through Friday, from 7:30 a.m. to 9 p.m. Eastern time<br \/>\n(closed major holidays)<\/p>\n\n\t\t<\/div>\n\t<\/div>\n<\/div><\/div><\/div><\/div><\/div>[\/vc_column][\/vc_row][vc_row disable_element=&#8221;yes&#8221; remove_bottom_col_margin=&#8221;true&#8221; center_row=&#8221;yes&#8221; el_id=&#8221;special-enrollment&#8221;][vc_column][vc_column_text css=&#8221;&#8221;]Open enrollment for 2026 has ended, but you can add an eligible dependent during a special enrollment period if you experience a qualifying life event.<\/p>\n<hr \/>\n<h1>Special Enrollment Period<\/h1>\n<p>You can add an eligible dependent to your account if you have a certain type of event in your life \u2014 called a qualifying life event. A qualifying life event is when something important in your life changes. For example, if you get married or divorced, give birth, or lose health coverage because you lost your job or no longer qualify for Medicaid, Maryland Children&#8217;s Health Program, FAMIS, or Medicare, you can apply for coverage through CHCP.<\/p>\n<p>In general, the special enrollment period lasts <strong>60 days after a qualifying life event.<\/strong><\/p>\n<hr \/>\n<h2>Add an eligible dependent to your account<\/h2>\n<p>You can add an eligible dependent to your account by completing an Account Change Form:<\/p>\n<ul>\n<li><a href=\"https:\/\/charitablehealth.kaiserpermanente.org\/mid-atlantic\/wp-content\/uploads\/sites\/14\/2026\/02\/1616665392_MD-KPIF-NGF-Change-Form-2026_MAS_2025_BrchBklt_R6a_ATC_lh_Fillable_ADA.pdf\" target=\"_blank\" rel=\"noopener\">Maryland<\/a><\/li>\n<li><a href=\"https:\/\/charitablehealth.kaiserpermanente.org\/mid-atlantic\/wp-content\/uploads\/sites\/14\/2026\/02\/1616674300_VA-KPIF-NGF-Change-Form_MAS_2025_BrchBklt_R2D_ATV_rl_ADA.pdf\" target=\"_blank\" rel=\"noopener\">Virginia<\/a><\/li>\n<\/ul>\n<p>For more information about your proof of qualifying life event, look at the <a href=\"https:\/\/charitablehealth.kaiserpermanente.org\/mid-atlantic\/wp-content\/uploads\/sites\/14\/2026\/02\/1667534764_CA_KPIF-SEP-Quick-Guide_NATL_2025_BrchBklt_r1a_ATC_AS_RGB_ADA.pdf\" target=\"_blank\" rel=\"noopener\">Special Enrollment Period Guide<\/a> or visit <a href=\"http:\/\/www.kp.org\/chcspecialenrollment\" target=\"_blank\" rel=\"noopener\">kp.org\/chcspecialenrollment<\/a>.[\/vc_column_text][\/vc_column][\/vc_row][vc_row disable_element=&#8221;yes&#8221; center_row=&#8221;yes&#8221; el_id=&#8221;oep-and-sep-where-to-submit&#8221;][vc_column][vc_column_text css=&#8221;&#8221;]\n<hr \/>\n<h2>Where to submit your forms and proof<\/h2>\n[\/vc_column_text][vc_row_inner remove_bottom_col_margin=&#8221;true&#8221;][vc_column_inner][vc_column_text css=&#8221;&#8221;]<strong>By email (preferred)<\/strong><\/p>\n<p><strong><a href=\"mailto:CHC-Applications@kp.org\" target=\"_blank\" rel=\"noopener\">CHC-Applications@kp.org<\/a><\/strong><\/p>\n<p><strong>By mail<\/strong><\/p>\n<p>Kaiser Foundation Health Plan, Inc.<br \/>\nCalifornia Service Center<br \/>\nP.O. Box 939095<br \/>\nSan Diego, CA 92193-9095<\/p>\n<p><strong>By fax<\/strong><\/p>\n<p><strong>1-855-355-5334<\/strong><\/p>\n<p>Note: Sending your forms to us does not guarantee that you will be approved for CHCP. We may ask you for more information to determine your eligibility.[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row][vc_row center_row=&#8221;yes&#8221; el_id=&#8221;oep-and-sep-when-youll-hear-from-us&#8221;][vc_column][vc_row_inner remove_bottom_col_margin=&#8221;true&#8221;][vc_column_inner][\/vc_column_inner][\/vc_row_inner][vc_column_text css=&#8221;&#8221;]\n<hr \/>\n<h2>When you\u2019ll hear from us<\/h2>\n<p>Submitted applications are processed in order of receipt. We\u2019ll let you know if we can include you in CHCP after we receive and review your completed forms and proof of income.<\/p>\n<p>*Continued eligibility for CHCP is not guaranteed. We reserve the right to close enrollment or change the CHCP eligibility rules at any time. If you are approved for CHCP, the subsidy period is limited, and we will contact you in the future to confirm that you still qualify.[\/vc_column_text][\/vc_column][\/vc_row][vc_row disable_element=&#8221;yes&#8221; center_row=&#8221;yes&#8221; bg_type=&#8221;no_bg&#8221; bg_grad=&#8221;background: -webkit-gradient(linear, left top, left bottom, color-stop(0%, #FBFBFB), color-stop(50%, #E3E3E3), color-stop(100%, #C2C2C2));background: -moz-linear-gradient(top,#FBFBFB 0%,#E3E3E3 50%,#C2C2C2 100%);background: -webkit-linear-gradient(top,#FBFBFB 0%,#E3E3E3 50%,#C2C2C2 100%);background: -o-linear-gradient(top,#FBFBFB 0%,#E3E3E3 50%,#C2C2C2 100%);background: -ms-linear-gradient(top,#FBFBFB 0%,#E3E3E3 50%,#C2C2C2 100%);background: linear-gradient(top,#FBFBFB 0%,#E3E3E3 50%,#C2C2C2 100%);&#8221; bg_image_repeat=&#8221;no-repeat&#8221; bg_image_size=&#8221;cover&#8221; bg_img_attach=&#8221;fixed&#8221; parallax_sense=&#8221;30&#8243; animation_direction=&#8221;left-animation&#8221; animation_repeat=&#8221;repeat&#8221; bg_override=&#8221;0&#8243; parallax_content_sense=&#8221;30&#8243; fadeout_start_effect=&#8221;30&#8243; overlay_pattern_opacity=&#8221;80&#8243; seperator_type=&#8221;none_seperator&#8221; seperator_position=&#8221;top_seperator&#8221; seperator_shape_size=&#8221;40&#8243; seperator_svg_height=&#8221;60&#8243; seperator_shape_background=&#8221;#ffffff&#8221; seperator_shape_border=&#8221;none&#8221; seperator_shape_border_width=&#8221;1&#8243; icon_type=&#8221;no_icon&#8221; icon_size=&#8221;32&#8243; icon_style=&#8221;none&#8221; icon_color_border=&#8221;#333333&#8243; icon_border_size=&#8221;1&#8243; icon_border_radius=&#8221;500&#8243; icon_border_spacing=&#8221;50&#8243; img_width=&#8221;48&#8243; css=&#8221;.vc_custom_1755650010136{background-position: center !important;background-repeat: no-repeat !important;background-size: cover !important;}&#8221; el_id=&#8221;OLD-CONTENT&#8221;][vc_column width=&#8221;2\/3&#8243;][vc_column_text]\n<h1>How to Apply for Community Health Access Program &#8211; Important Deadlines<\/h1>\n<p>There&#8217;s a deadline to apply for Community Health Access Program.<br \/>\n<b><\/b><\/p>\n<p><b>Open Enrollment 2019<br \/>\n<\/b><\/p>\n<p>You may apply for CHAP during the open enrollment period, which runs from November 1, 2018 through December 15, 2018.<\/p>\n<div style=\"width: 35%; padding: 0 10px 0 0; float: left;\">\n<p>Send completed paperwork by:<br \/>\nDecember 15, 2018<\/p>\n<\/div>\n<div style=\"width: 55%; padding: 0 10px 0 0; float: right;\">\n<p>To start coverage on:<br \/>\nJanuary 1, 2019<\/p>\n<\/div>\n<hr style=\"clear: both;\" \/>\n[\/vc_column_text][vc_column_text]\n<h3>Apply for the Community Health Access Program in 3 steps<\/h3>\n<h3>1. Fill out this application for health coverage<\/h3>\n<p><strong>Kaiser Permanente for Individual and Families Application<\/strong> &#8211; <a href=\"https:\/\/charitablehealth.kaiserpermanente.org\/mid-atlantic\/wp-content\/uploads\/sites\/14\/2018\/12\/MD-KPIF-English.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Maryland<\/a> | <a href=\"https:\/\/charitablehealth.kaiserpermanente.org\/mid-atlantic\/wp-content\/uploads\/sites\/14\/2018\/12\/VA-KPIF-English.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Virginia<\/a><\/p>\n<p>For the Summary of Benefits and Coverage for the the Gold 0\/20 \u2013 HMO plan, click <a href=\"https:\/\/charitablehealth.kaiserpermanente.org\/mid-atlantic\/wp-content\/uploads\/sites\/14\/2018\/12\/KP_MD_Gold_0_20_Dental.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">here<\/a> or visit <a href=\"http:\/\/kp.org\/sbc\" target=\"_blank\" rel=\"noopener noreferrer\">kp.org\/sbc<\/a>, choose from Maryland or Virginia, then select Gold 0\/20 HMO. A paper copy can be obtained at any time without charge by calling Kaiser Permanente Member Services at 1-800-464-4000, TTY 711, 24 hours a day, seven days a week. You\u2019ll need the plan name, which is stated above.<\/p>\n<p><strong>Note:<\/strong> Social Security numbers (SSN) or tax identification numbers (TIN) are NOT required to apply for the Community Health Access Program, but if you have an SSN or TIN please include it on the application.[\/vc_column_text]<div class=\"vcex-spacing wpex-w-100 wpex-clear\"><\/div>[vc_cta h2=&#8221;&#8221;]\n<p style=\"text-align: center;\">Need more help filling out the application?<br \/>\nReview our <strong>Community Health Access Program Instructions Guide<\/strong> &#8211; <a href=\"https:\/\/charitablehealth.kaiserpermanente.org\/mid-atlantic\/wp-content\/uploads\/sites\/14\/2018\/12\/CHAP-Application-Completion-Instructions-MD.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Maryland<\/a> | <a href=\"https:\/\/charitablehealth.kaiserpermanente.org\/mid-atlantic\/wp-content\/uploads\/sites\/14\/2018\/12\/CHAP-Application-Completion-Instructions-VA.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Virginia<\/a> for specific instructions.[\/vc_cta][vc_column_text]\n<h3>2. Fill out this form for the Kaiser Permanente Community Health Access Program subsidy.<\/h3>\n<p><strong>Kaiser Permanente Subsidy Eligibility form<\/strong> &#8211;\u00a0<a href=\"https:\/\/charitablehealth.kaiserpermanente.org\/mid-atlantic\/wp-content\/uploads\/sites\/14\/2018\/12\/MD-Subsidy-English.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Maryland<\/a> | <a href=\"https:\/\/charitablehealth.kaiserpermanente.org\/mid-atlantic\/wp-content\/uploads\/sites\/14\/2018\/12\/VA-Subsidy-English.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Virginia<\/a><\/p>\n<p>Be sure to include proof of income when you mail in your application. Here are the best ways to show proof of your income:<\/p>\n<p>If you get a paycheck or direct deposit, we need:<\/p>\n<ul>\n<li>your last 2 paycheck stubs, or<\/li>\n<li>your most recent W-2, or<\/li>\n<li>your most recent wage or tax statement<\/li>\n<\/ul>\n<p>If you work for yourself, we need:<\/p>\n<ul>\n<li>a Schedule C and page 1 of your last federal tax return (showing your adjusted gross income), or<\/li>\n<li>a completed Profit and Loss Statement form<\/li>\n<\/ul>\n<p>If you get paid in cash, we need:<\/p>\n<ul>\n<li>a signed letter of income from your employer on company letterhead<\/li>\n<\/ul>\n<p>If you have income from other sources (e.g. social security, unemployment benefits):<\/p>\n<ul>\n<li>include documentation showing proof (e.g. a benefit statement)<\/li>\n<\/ul>\n<p>Need help completing the Subsidy Eligibility form? <a href=\"https:\/\/charitablehealth.kaiserpermanente.org\/mid-atlantic\/contact\/#assistance\">Find a local organization near you that can help<\/a>.[\/vc_column_text][vc_column_text]\n<h3>3. Mail your completed forms and proof of income to:<\/h3>\n<p>Kaiser Foundation Health Plan, Inc.<br \/>\nCalifornia Service Center<br \/>\nP.O. Box 939095<br \/>\nSan Diego, CA 92193-9095<\/p>\n<p>Note: Mailing your forms to us does not guarantee that you or your family will be approved for the Community Health Access Program. We may ask you for more information to determine your eligibility.<\/p>\n<p>We\u2019ll let you know if we can include\u00a0you in the Community Health Access Program\u00a0after we receive and review your completed forms and proof of income.[\/vc_column_text][vc_column_text]* Continued eligibility for the Community Health Access Program is not guaranteed. We reserve the right to close enrollment or change the CHAP eligibility requirements at any time.[\/vc_column_text][\/vc_column][vc_column width=&#8221;1\/3&#8243;]<div class=\"templatera_shortcode\"><div class=\"vc_row wpb_row vc_row-fluid wpex-relative\"><div class=\"wpb_column vc_column_container vc_col-sm-12\"><div class=\"vc_column-inner\"><div class=\"wpb_wrapper\">\n\t<div class=\"wpb_text_column wpb_content_element boxed\" >\n\t\t<div class=\"wpb_wrapper\">\n\t\t\t<p><b>Have questions?<\/b><\/p>\n<p>Call us toll-free at<\/p>\n<p><b>1-800-777-7902<\/b> (TTY <b>711<\/b>)<\/p>\n<p>Monday through Friday, from 7:30 a.m. to 9 p.m. Eastern time<br \/>\n(closed major holidays)<\/p>\n\n\t\t<\/div>\n\t<\/div>\n<\/div><\/div><\/div><\/div><\/div>[\/vc_column][\/vc_row]\n<\/div>","protected":false},"excerpt":{"rendered":"Important Update: The Mid-Atlantic Community Health Coverage Program has met program capacity and is no longer accepting applications for the 2026 enrollment period. Please continue to check the website for opportunities to apply in the future. Have questions? Call us toll-free at 1-800-777-7902 (TTY 711) Monday through Friday, from 7:30 a.m. to 9 p.m. Eastern&hellip;","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"inline_featured_image":false,"footnotes":""},"class_list":["post-243","page","type-page","status-publish","hentry","entry","no-media"],"_links":{"self":[{"href":"https:\/\/charitablehealth.kaiserpermanente.org\/mid-atlantic\/wp-json\/wp\/v2\/pages\/243","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/charitablehealth.kaiserpermanente.org\/mid-atlantic\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/charitablehealth.kaiserpermanente.org\/mid-atlantic\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/charitablehealth.kaiserpermanente.org\/mid-atlantic\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/charitablehealth.kaiserpermanente.org\/mid-atlantic\/wp-json\/wp\/v2\/comments?post=243"}],"version-history":[{"count":0,"href":"https:\/\/charitablehealth.kaiserpermanente.org\/mid-atlantic\/wp-json\/wp\/v2\/pages\/243\/revisions"}],"wp:attachment":[{"href":"https:\/\/charitablehealth.kaiserpermanente.org\/mid-atlantic\/wp-json\/wp\/v2\/media?parent=243"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}