Healthy Families Program
for Children in California
Healthy Families program is a
state subsidized health, dental,
and vision insurance program to
get our uninsured children
covered. It is designed to fill
the gap in our system for
families who need a little
assistance but make too much
money to not qualify for Medi-Cal.
Once enrolled you still pay a
low level of premiums and you
still utilize and insurance
carrier- it’s just a less
expensive way to get covered and
a potential path for an approval
if a child has been declined to
health reasons.
Who is qualified
for the Healthy Families
program?
There are several factors for
qualification in Healthy
Families. Your children must be
below 19 years old without Group
health insurance for the last
three months and California
residents currently. Your child
cannot be enrolled or eligible
for Medi-Cal. You must also
meet
income guidelines
established by the Healthy
Families program.
Benefits
Offered
The State of
California Healthy Families
program offers comprehensive
medical, dental, and vision
coverage regulated by the
department of insurance to cover
medically necessary expenses
just like a plan you offer your
employees. You can read more
about the benefits on the
Healthy Families
website.
Healthy Families will not deny
your child due to a pre-existing
medical condition. The benefits
offered through Healthy Families
are pretty amazing. Office
Visits to the doctor are $5
co-pays. Hospitalization is
covered at no charge as is
outpatient surgery, lab, &
x-ray. Prescription drugs are
covered at $5 for generic
versions. (Benefits subject to
change)
What does Healthy
Families Cost?
Healthy Families
is very inexpensive. Children
cost $4-$15 up to a total of no
more than $45 per month. The
cost is so low because the
program is state subsidized with
our tax dollars. Also, most
children are not very expensive
to insure which helps to keep
the numbers down. Determining
your premium is solved through a
series of available factors such
as number of children, total
income, and income deduction
credits which account for a
variety of cost factors.
Fortunately the premiums are
capped very low and assistance
is available if you need help
figuring out what you’d pay if
you qualify. More information
is found at the
Healthy Families
cost guide.
Or you can call
them directly for assistance
with cost or qualification at
1-800-880-5305.
Annual
Eligibility Review
Healthy Families is a 12 month
program at which time you can
provide evidence of your current
income. If you qualify for the
program for another year your
children can continue for the
next 12 months until the next
eligibility review. Your
premium may change upon
re-qualification. If your
income drops below the Healthy
Families Guideline you may be
referred to Medi-Cal free of
charge temporarily until your
application for Medi-Cal is
approved or declined. Annual
eligibility review packets are
sent out about 60 days prior to
the 12 month renewal point and
request specific documents from
the subscriber relating to
income and alternate available
health insurance coverages.
Other
important
resources:
California
Small Group
health quote
California
Small Group
online
doctor
listing
California
Group
Enrollment
and
Eligibility
Center
