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Health Share - Kaiser Permanente HRSN Climate Request Form

Health Share – Kaiser Permanente HRSN Climate Request Form

You should use this form to request climate supports. Please note, we are currently experiencing a high volume of requests & calls that may delay initial response time.

Please allow 15-20 business days before following up on your request.

To be eligible to receive assistance, all the following must be true:

  • You must be a current Health Share member with Kaiser Permanente coverage.
  • You must have a verified qualifying medical condition*
  • You are not able to get the item/service through any other benefit or means
  • The item or service must help with your medical condition and
  • Your health plan will need to verify your qualifying medical condition (for example hospital or doctor visit or records) before approving your request.

There are multiple steps involved in reviewing requests for the HRSN benefit:

  • Initial screening with 211 (phone call to you to verify information and collect documentation if needed)
  • Not all requested items or services are granted/funded. Standard requests are processed within 14 days of receipt.