Complete an enrollment form
In order to stay with Kaiser Permanente, you will need to complete a Kaiser Permanente Medicare health plan for individuals enrollment form
You can either complete the form online or download and print the enrollment form. We will also be sending you one in the mail.
To help ensure your enrollment into the Kaiser Permanente Medicare health plan for individuals goes as smoothly as possible, please be sure to indicate on your enrollment form, or to our Kaiser Permanente Medicare specialist, the date your employer sponsored coverage will end.
After we receive your completed form and verify your eligibility, we will inform Medicare that you’ve applied to join our Medicare health plan. If Medicare accepts your enrollment, you’ll be enrolled in our Medicare health plan for individuals. There will be no lapse between your old group plan and your new individual plan.
Know your enrollment period
You need to sign up during your group’s specific enrollment period. To find out when this is, ask your employer or trust fund's benefits administrator or call 1-877-231-4833 (toll free) (TTY 711), 8 a.m. to 8 p.m., 7 days a week.
In order for your Medicare health plan for individuals to be effective once your group coverage ends, generally, you can submit an enrollment request no earlier than 90 days before your group coverage ends.
Check your mail for important documents
You should already have received Your Guide to Keeping Your Kaiser Permanente Medicare Health Plan. Keep this guide handy as it contains specific information related to your transition.
We’ll be sending you the following important documents to help with your transition to a new plan:
- Advance Notice of Termination Letter (the envelope is marked "Important Plan Information")
- A packet containing your enrollment form and plan benefit and cost information
- Certificate of Creditable Coverage (keep this for your records)
You may be contacted by other health plans
You may be contacted by other health plans offering you their Medicare health plan coverage. To learn all the reasons to stay with Kaiser Permanente, call 1-877-231-4833 (toll free) (TTY 711), 8 a.m. to 8 p.m., 7 days a week.
A note about Reimbursement Accounts and Subsidies
You and your Medicare eligible dependents may be able to use funds from a Health Reimbursement Account (HRA), Retirement Reimbursement Account (RRA) or subsidy to help pay for premiums and approved medical costs with your new individual plan. Information about these financial options should be available in the transition materials provided to you from your group. Please contact your benefits administrator directly to discuss options, if available, based on your eligibility.
Next Steps after You Enroll
You’ll get your new Kaiser Permanente ID card in the mail about 2 weeks after your new Medicare health plan for individuals coverage starts. Your membership won’t be interrupted, and you can continue to get care and services as usual.
Your Health/Medical Record number will stay the same. Use your current ID card for any care you need until the new ID card arrives.
You should also contact your employer’s benefits administrator directly to:
- Let them know you’re staying with Kaiser Permanente
- Discuss financial options that may be available to you and your Medicare eligible dependents based on your eligibility
- Discuss how this change affects your non-Medicare-eligible dependent(s)
Questions? Ready to enroll?
If you’re ready, you can enroll now.
If you have questions, please call 1-877-231-4833 (toll free) (TTY 711), 8 a.m. to 8 p.m., 7 days a week.
Please mention to the Kaiser Permanente Medicare specialist that you will be losing your group coverage through your employer.
You can also view our questions and answers page.