Kaiser Permanente Bridge Program

To be eligible for the Kaiser Permanente Bridge Program, you must be a Georgia State University Undergraduate or Graduate student, currently enrolled in one of the following programs:

  • Health Informatics (accepted into the program, not pre-health informatics)
  • Nursing (accepted into the nursing program, not pre-nursing students)
  • Nutrition (accepted into the program, not pre-nutrition students)
  • Occupational Therapy (accepted into the OTM program)
  • Respiratory Therapy (accepted into the program, not pre-RT students)
  • Social Work (accepted into the School of Social Work, not pre-social work students)
  • Physical Therapy (accepted into the DPT program)

Requirements for eligibility include:

  • The Applicant must be a GSU student currently enrolled in one of the above programs
  • The Applicant and all applying dependents* must live in Kaiser Permanente’s metro Atlanta 20 county service area
  • The annual aggregate household income of the Applicant and all dependents must be less than the current income guidelines of 100% of the federal poverty guidelines (chart below)
  • The Applicant and all applying dependents cannot be eligible for or enrolled in any other type of health insurance program, including Medicaid, Medicare, PeachCare for Kids or employer-sponsored health care
  • The applicant must be 64 or younger, and all child dependents must be younger than 26
  • No Applicant and/or applying dependent(s) shall have been previously enrolled in the Kaiser Permanente Bridge Program
  • Completion of an application and submission of required supporting documents
  • Signed Attestation/Verification Form with University designee’s signature (Contact Felisha Norrington at (404) 413-1000 or fnorrington@gsu.edu to schedule an appointment)

 

Family

Size*

Monthly Gross Income Annual Gross Income
1 $990 $11,880
2 $1,335 $16,020
3 $1,680 $20,160
4 $2,025 $24,300
5 $2,370 $28,440
6 $2,715 $32,580

 

Please follow these steps to learn more and/or to apply for the program:

  1. Review the Kaiser Permanente Bridge Program flyer and brochure
  2. Review the Bridge Program Overview PowerPoint which includes instructions for completing the application
  3. Complete the Kaiser Permanente for Individuals & Families (KPIF) Application AND the Community Benefit Subsidy Eligibility Form
  4. Print the Community Partner Verification Form
  5. Have the authorized Georgia State University staff member sign your Community Partner Verification Form
  6. Include all supporting documentation requested on the document check list with your applications
  7. Mail the completed KPIF Application, Community Benefit Subsidy Application and all supporting documentation to:

Charitable Health Coverage Operations

PO Box 24670
Oakland, CA  94623-9920
Fax: 1-877-705-6970

Email: CHCO-Georgia@kp.org

Please be patient and allow 30 days for your application to be processed.  If you have questions/issues, contact the Charitable Health Coverage Operations (CHCO) at 1-888-387-0180.

Kaiser Permanente Bridge Program Flyer

Kaiser Permanente Bridge Program Brochure

Kaiser Permanente Bridge Program Overview

KPIF Application: KP GA Gold 500/20 plan

Community Benefit Subsidy Eligibility Form

Document Checklist

Community Partner Verification Form

Affidavit of Domestic Partnership

Declaration of Zero Income

Profit & Loss Statement

KP GA Gold 500/20 Summary of Benefits

If you have any questions about the program or the application process, direct all queries to the Kaiser Permanente Bridge Program (404) 364-3811 or bridge@kp.org.