We're excited to partner with The Kaiser Permanente Bridge Program at First African Community Development Corporation. The Kaiser Permanente Bridge Program is uniquely designed to help uninsured and/or low-income persons pay for a standard Kaiser Permanente for Individuals and Families (KPIF) plan. The program will subsidize the full monthly premium for up to 12 months. Coverage includes preventive services, hospitalization, comprehensive pharmacy, etc.
Eligibility Requirements
• The applicant must participate in First African CDC's Life Skills training program.
• All applicants, and applying dependents, must live in one of the following counties: Bartow, Butts, Cherokee, Clayton, Cobb, Coweta, DeKalb, Douglas, Fayette, Forsyth, Fulton, Gwinnett, Henry, Lamar, Newton, Paulding, Pike, Rockdale, Spalding, or Walton counties ( counties are subject to change).
• The annual aggregate household income for the applicant must be less than the current income guidelines of 100% Federal Poverty Level for enrollment.
• 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 age 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 Bridge Program.
• The applicant must participate in First African CDC's Life Skills training program.
• All applicants, and applying dependents, must live in one of the following counties: Bartow, Butts, Cherokee, Clayton, Cobb, Coweta, DeKalb, Douglas, Fayette, Forsyth, Fulton, Gwinnett, Henry, Lamar, Newton, Paulding, Pike, Rockdale, Spalding, or Walton counties ( counties are subject to change).
• The annual aggregate household income for the applicant must be less than the current income guidelines of 100% Federal Poverty Level for enrollment.
• 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 age 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 Bridge Program.
Verification requirements - MUST HAVE
-Unemployment compensation (most recent Dept. Of Labor letter indicating tier of support & gross benefit) -Child/Spousal support (provide documentation or written note if child(ren) in household and no support) -Social Security Award Letter
-Other proof of income assistance (family support, student aid such as Pell Grant Refund, etc.)
-If self-employed please provide page 1 of your Form 1040 (highlight adjusted gross income) from last year’s federal income tax return or complete the Kaiser Permanente Profit & Loss Statement form (available upon request).
-If you and/or your spouse are currently without income – provide last date of employment and a signed Declaration of Zero Income Affidavit Verification/Attestation Letter (to be provided by First African Community Development Corporation)
FOR MORE INFORMATION CONTACT [email protected] - 404.990.3451
- Proof of ID (driver’s license, photo id or passport
- Proof of Residency (if address different from ID, provide current utility bill, lease or mortgage coupon)
- Proof of Income (you and your spouse/dependents*)
-Unemployment compensation (most recent Dept. Of Labor letter indicating tier of support & gross benefit) -Child/Spousal support (provide documentation or written note if child(ren) in household and no support) -Social Security Award Letter
-Other proof of income assistance (family support, student aid such as Pell Grant Refund, etc.)
-If self-employed please provide page 1 of your Form 1040 (highlight adjusted gross income) from last year’s federal income tax return or complete the Kaiser Permanente Profit & Loss Statement form (available upon request).
-If you and/or your spouse are currently without income – provide last date of employment and a signed Declaration of Zero Income Affidavit Verification/Attestation Letter (to be provided by First African Community Development Corporation)
FOR MORE INFORMATION CONTACT [email protected] - 404.990.3451
