Child Health Program
three kids
grandpa with child

Four steps to apply for Child Health Program


      See the Applications Instruction Guide for detailed instructions on how to apply to Child Health Program.

      Applications Instruction Guide-English
      Applications Instruction Guide-Spanish

      1. Print and fill out the KPIF application

      KPIF Application - English
      KPIF Application - Spanish
      •Fill it out completely EXCEPT for Steps 2, 7, 8, and 9.
      •Sign and date it.

      2. Print and fill out the Community Benefit application
      Community Benefit Subsidy Application - English
      Community Benefit Subsidy Application - Spanish
      •Fill it out completely.
      •Sign and date it.

      3. Include copies of proof of income

      4. Mail to Kaiser Permanente
      Mail* both applications and required information to:

      Charitable Health Coverage Operations
      Kaiser Permanente
      PO Box 12904
      Oakland, CA  94604

      *Please use the address above. The address on the Community Benefit application is incorrect.

      Please keep a copy of your applications for your records.

      Completion of these applications does not guarantee that you will be approved for the Kaiser Permanente Community Benefit subsidy that helps pay monthly payment amounts and cost sharing for KP CA Platinum 0/20 health coverage. You may be asked to provide additional information to confirm your child’s eligibility for the subsidy.

      For questions, contact Member Services at:

      800-464-4000 (toll free)

      800-777-1370 (toll-free TTY for the hearing/speech impaired)

      * If your child is not eligible for Kaiser Permanente Child Health Program, you can still enroll in him or her in a Kaiser Permanente Individuals and Families (KPIF) plan, but you will have to pay to the full price of the premium. You can enroll your child in a KPIF plan as long you live in one of the Kaiser Foundation Health Plan, Inc. service areas.

      For more information about Kaiser Foundation Health Plan, Inc. service areas, go to: http://info.kaiserpermanente.org/html/childhealthprogram/serviceareas.html.

      If you wish to enroll your child in a KPIF plan, please call our National Direct Sales Center at 1-800-307-5945 to get more information about plan choices.