Federal Income Guidelines for Joining Healthy Families

Healthy Families is a California plan created to provide insurance to the children of working families who otherwise would be unable to afford health care. This program is funded by the federal and state governments and certain factors, such as the family's income, is taken into consideration.

History

• The Healthy Families plan was signed into law in October of 1997 as a way to offer health insurance to families who made too much money to qualify for Medi-Cal, the state's health care, but not enough to purchase their own plan. The income level cutoff was originally set at between 100 and 200 percent of the nation's poverty threshold. The plan came into effect in July of 1998, and was still active as of 2009. However, the income guidelines increased to 250 percent of the poverty line in June of 1999.

Time Frame

• Every April, when the new poverty income levels are determined, the income guidelines for participation in the Healthy Families program reflect that change. In April of 2009, a family of two would have to earn between $2,430 and $3,036 to qualify for an infant up to 1 years old; between $1,616 and $3,036 for children between 1 and 5 years old; and between $1,216 and $3,036 for children 6 through 8 years old. A family of four would have to make less than $4,594 per month, with the lower end being $3,676 for infants; $2,445 for children 1 to 5 years of age; and $1,839 for children ages 6 through 18. For families earning less than the specified amounts, they qualify for no-cost Medi-Cal, which means they have no out-of-pocket costs.

Significance

• Families earning more than the federal poverty level can usually afford a Healthy Families policy that costs the family between $4 and $17 per child, up to $51 per family each month. The exact cost of your monthly premium will be determined on what part of the income bracket you fall into. However, discounts are offered if you sign up for your premium to be automatically paid each month. Co-pays are usually $5.

Benefits

• Participants get to choose from a list of plans depending on which county you live in, then you choose which doctor you want your child to see. Once your family is enrolled in the program, after proving your income, your eligible children will have health, dental and vision coverage.

Considerations

• Once your children are accepted into the Healthy Families program, they are covered for one year, provided you pay your premiums. Each year, a renewal form that supplies your current income information must be submitted. If your income has changed, putting you above the guidelines, your family will be removed from the program. However, if changes have occurred putting you below the income guidelines, your family will be moved to Medi-Cal instead of Healthy Families. Check the Healthy Families website for specific guideline information and to keep up with the changes every April (see Resources).