Healthy Kids
Healthy Kids was launched in 2001 as part of the Santa Clara County Children's Health Initiative. It operates as a locally funded health insurance program that fills the gap for children who do not qualify for the Medi-Cal or Healthy Families programs.
Healthy Kids was created by a public-private partnership, which included Santa Clara Family Health Plan. It is funded entirely through premiums, local support and foundation money. SCFHP administers Healthy Kids and oversees fundraising for the program through the Santa Clara Family Health Foundation.
Healthy Kids functions like any other managed health care plan. It is regulated by the California Department of Managed Health Care, and offers the same benefits and provider networks as the Healthy Families program. It covers children in families with incomes up to 300% of the federal poverty level. Unlike the government-run Medi-Cal and Healthy Families programs, the Healthy Kids program accepts members regardless of their immigration status. Children are covered from birth to age 19; cost is $4 to $21 a month per child, with a maximum cost of $63 per family.
For a child to be eligible, he or she must
- be a Santa Clara County resident
- not be covered by Medi-Cal or Healthy Families
- not have been covered by private health insurance in the past three months
- be a member of a family whose annual income falls within the prescribed guideline, which currently is no more than 300% of the Federal Poverty Level
For instance, income guidelines for a child in a family of four are as follows:
| Child's Age | Family's Monthly Income |
|---|---|
| Birth to 19 years | $0 to $5,764 |
You may qualify even if your income exceeds that given in the guideline. Family income will be adjusted by taking deductions if you pay child support and/or alimony, or pay for childcare.
Parents who are under 18 may apply for Healthy Kids for both themselves and their children.
Summary of Benefits
The Healthy Kids program offers many benefits to members, including:
- complete health, dental, and vision coverage, including preventive check ups
- specialist care
- acupuncture and 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 calendar 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. In Spanish | In Vietnamese
Review the Medi-Cal/Healthy Families/Healthy Kids Formulary document for details of these and other benefits
Review the Liberty Dental Provider Directory
Review the VSP Provider Directory
How To Apply
One can apply by calling one of the following:
- Children's Health Initiative at 1-888-244-5222
- Family Health Plan Member Services at 1-800-260-2055