Healthy Families
Healthy Families, launched in 1998, provides low-cost insurance coverage to children of moderate-income families that earn too much to qualify for Medi-Cal.
For a child to be eligible, he or she must
- be a U.S. citizen or legal immigrant *
- be under the age of 19
- be a California resident
- not be covered by Medi-Cal
- not have been covered by private health insurance during the past three months *
- be a member of a family whose annual income falls within the prescribed guideline, which currently is no more than 250% of the Federal Poverty Level; the guideline is a sliding scale dependent on the size of the family and the age of the child.
For instance, income guidelines for a child in a family of four are as follows:
| Child's Age | Family's Monthly Income |
|---|---|
| Birth to 1 year | $3,843 to $4,804 |
| 1 to 6 years | $2,556 to $4,804 |
| 6 to 19 years | $1,922 to $4,804 |
* Certain exceptions apply...
Income adjustments are made for those who pay child support, alimony, or childcare...
Expectant mothers may apply for the program up to three months before their due date.
For more information on Healthy Families, refer to the California Department of Health Care Services or California Healthy Families.
Summary of Benefits
The Healthy Families program offers many benefits to members, including:
- complete health, dental, and vision coverage, including preventive check ups
- specialist care
- chiropractic service
- inpatient and outpatient hospital services
- mental health care
- alcohol & substance abuse treatment
- prescriptions
- health education
- no co-payments for check-ups and other preventive services
- low co-payments for some services
- a capped maximum of $250 in co-payments per family in a benefit year
- parents under the age of 18 can apply for both themselves and their children
Review the Evidence of Coverage document for details of these and other benefits.
Review the Medi-Cal/Healthy Families/Healthy Kids Formulary document for details of these and other benefits
How To Apply
One can apply by calling one of the following:
- Santa Clara Family Health Plan at 1-877-680-6144
- Children's Health Initiative at 1-888-244-5222
- Family Health Plan Member Services at 1-800-260-2055