When your circumstances change, Kaiser Permanente can offer you a wide variety of options to continue your health care coverage. But where do you begin?
The information below will help you navigate through the options and choose the plan thatís best for you and your family.
Do you prefer a plan that doesn't require a medical review? Do you want coverage that's the same or similar to what you had through your employer without a lapse in coverage?
If you lose your group coverage, your employer group may offer COBRA continuation coverage. If your employer group does not offer COBRA coverage, you may be eligible for other group continuation coverage. Both types of group continuation coverage require no medical review. For more information, check with your employer group.
General information about COBRA eligibility, and potential financial assistance that may be available, may be found at the U.S. Department of Labor Web site.
Depending upon your eligibility qualifications, Georgia law may provide you with individual "Enhanced Conversion Options" or the "Basic Conversion Option," which are available without requiring that you pass a medical review. The rates and benefits for these individual conversion plans are different than your group coverage.
The Enhanced Conversion plan offers two options: Standard Plan and Low Plan. However, if you are eligible for COBRA or Georgia Continuation benefits, you first must have elected and exhausted those continuation benefits before you can be accepted into an Enhanced Conversion plan. If you are eligible for an Enhanced Conversion plan, we must receive a completed application and an initial premium payment no later than 63 consecutive days after the date of exhaustion of COBRA or state continuation coverage.
Kaiser Permanente also offers a Basic Conversion plan to all Kaiser Permanente members who lose group coverage. A completed application and the initial premium payment must be received no later than 30 days after the date of termination of your group coverage.
For more information, call Member Services at 404-261-2590 for benefit and rate information on all conversion plans. If you apply for a conversion plan, you must submit a completed application with premium payment within the time frames indicated above. Otherwise, you will have forfeited your privileges to enroll in the Enhanced Conversion plans and the Basic Conversion plan.
Your rights to a conversion policy guarantee you, and any qualified dependents, comprehensive coverage without pre-existing condition exclusions. You also have the right to seek coverage under other individual health insurance plans, either through Kaiser Permanente or through another insurer, but your rights under Georgia law to guaranteed coverage without pre-existing condition limitations applies only to the Enhanced and Basic Conversion plans.
Purchase Your Own Coverage
If you would like to purchase health care coverage for you and your family, Kaiser Permanente offers many plans that provide comprehensive care for monthly premiums that won't break your budget. For more information, call your broker or call us directly at 1-888-740-7917.
Want a savings plan for medical expenses? Do you see a doctor mostly for preventive care?
If you want lower premiums or want more control over health care costs, then check out our Individuals and Families HSA-Qualified Deductible Plans. They offer traditional medical coverage, lower premiums, and a tax-free* way to help you build savings for qualified medical expenses. Medical review is required.
Are you a Senior Advantage member or a Medicare-eligible member?
Please visit our overview section for more information or call Senior Advantage Customer Service at 404-233-3700, 800-232-4404 (toll free), or 800-255-0056 (toll-free TTY for the hearing/speech impaired), seven days a week, 8 a.m. to 8 p.m.
Not sure if you can afford health coverage? Think you might qualify for aid from the government?
Medicaid plans provide health insurance coverage to low-income parents, children, seniors, and people with disabilities.
PeachCare for Kids provides health insurance coverage to uninsured children from families whose income levels are too high to be eligible for Medicaid.
If you are uninsured and low-income, Kaiser Permanente's own Charitable Health Coverage programs may be able to help.
Charitable Health Coverage (CHC) is Kaiser Permanente's unique approach to caring for uninsured, income-eligible persons in our communities. CHC programs provide access to health care coverage when the following criteria are met:
- The Applicant must be an actively enrolled student/client participant, in a training program as applicable, with a participating community partner.
- The Applicant and all applying dependents** must live in Kaiser Permanenteís metro Atlanta 28 county service area.
- The annual aggregate household income of the Applicant and all dependents must be at or less than the current income guidelines for enrollment in the Kaiser Permanente Bridge Program.
- The Applicant and all applying dependents cannot be eligible for or enrolled in any other type of health insurance program, including Medicaid, Medicare, PeachCare or employer-sponsored health care.
- Must be age 64 or under.
- No Applicant and/or applying dependent(s) shall have been previously enrolled in the Kaiser Permanente Bridge Program.
The Kaiser Permanente Bridge Program ♦ subsidizes 95 percent of the premium, for up to 24 months—as long as all eligibility requirements continue to be met. Coverage includes preventive services, hospitalization, comprehensive pharmacy, and more. If you have previously enrolled in the Kaiser Permanente Bridge Program, you are no longer eligible.
For information on the Bridge Program, e-mail email@example.com or call 404-364-3811.
You might be eligible for assistance through Kaiser Permanente's Medical Financial Assistance (MFA) program. This program provides temporary financial assistance to low-income people in need of health care services, regardless of whether they have coverage or are uninsured.
The MFA program ♦ is generally available to those persons in greatest financial need and for whom no other community resources are available. Financial assistance may be limited based on available funding.
A case-by-case review of your situation may occur at any income level and may result in financial assistance. If you qualify for free care, you must receive it at Kaiser Permanente facilities and through our providers, even if you have coverage elsewhere. In the event you do not qualify for free care, you may be offered a discount if your income meets certain federal poverty guidelines.
Get information about our Medical Financial Assistance program or call 404-949-5112, Monday through Friday, 8:30 a.m. to 4 p.m.
How do I know if my income falls under the guidelines?
View the federal poverty guideline charts. To calculate income level at 200 percent of the federal poverty guidelines, multiply by 2; for 300 percent, multiply by 3; and so on.
Interested in finding resources available to you in your community?
We can help put you in touch with many resources, such as food, energy, tax, pharmacy, and health care assistance, and provide easy access to applications for these programs.
To complete this confidential assessment, please go to the BenefitsCheckUp Web site.
Federally funded health centers care for you, even if you have no health insurance. You pay what you can afford, based on your income. To locate a center near you, visit the Health Resources and Services Administration Web site.
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