Kaiser Permanente - Available only in the following counties (in Georgia):
Barrow, Bartow, Butts, Cherokee, Clayton, Cobb, Coweta, Dekalb, Douglas, Fayette, Forsyth, Fulton, Gwinnett, Hall, Henry, Newton, Paulding, Rockdale, Spalding, and Walton

Apply online

1. Complete the Personal Plans detailed health questionnaire for the primary applicant, the applicant's spouse (if applicable), and for each member of your family applying for coverage.

Be sure to answer all questions carefully and accurately. Questionnaire must be completed and submitted by applicant or parent/guardian only. Licensed agents may not fill out applications for clients.

.2. Submit your credit card information. Your credit card will be charged for your/your family's first month's premium. Also, each month's premium will be automatically charged to your credit card at the beginning of every month unless you arrange another form of payment by calling (770) 396-9517. Your credit card will be charged only if you are accepted for membership.

3. Do not cancel your current coverage. Receipt of your premium check does not imply acceptance. Kaiser Permanente will notify you by mail upon acceptance.

Apply by mail

You can download the medical questionnaire. You will need Adobe Acrobat Reader to read this file. There must be a separate application filled out for each family member to be covered.

1. Using a black or blue ink pen, complete one of the Personal Plans detailed health questionnaire for yourself and for each member of your family applying for coverage.

Do not use a photocopy of the form. Be sure to answer all questions carefully and accurately. Questionnaire must be completed and signed by applicant or parent/guardian only. Licensed agents may not fill out applications for clients.

2. Enclose a check for your/your family's first month's premium. This check will be deposited only if you are accepted for membership. If you are not accepted, it will be returned to you. If you are paying by credit card, your credit card will be charged for your/your family's first month's premium. Also, each month's premium will be automatically charged to your credit card at the beginning of every month. Your credit card will be charged only if you are accepted for membership.

4. Make checks payable to Kaiser Permanente. Do not send cash. Mail questionnaire to: Insurance Now 5 Dunwoody Park South, Suite 110, Atlanta, Georgia 30338.

5. Do not cancel your current coverage. Receipt of your premium check does not imply acceptance. Kaiser Permanente will notify you by mail upon acceptance.

Questions?

Call (770) 396-9517 Outside of the Atlanta area, call toll-free: 1-877-711-8376.