Healthy Families Government Program

The Healthy Families Program was developed in California, so families in lower income brackets would not lose access to a government-subsidized health plan for their children or teens, up to age 19.

The Healthy Families Program offers low cost insurance for children and teens who do not have insurance and do not qualify for programs such as Medi-Cal, California's Medicaid program. Healthy Families offers low cost dental, health, pharmacy and vision coverage.

Income Requirements

• The income guidelines for the Healthy Families Program changes annually and guidelines are available each year. As of April 2009, the income bracket for a family of two with the child being from ages 1 to 5 is $1,616 - $3,036, with an increase of about $400 per person in the household, while ages 0 to 1 for a family of two is $2,430 to $3,036, with an increase of about $600 for each additional person in the household.

  If your income is lower than these amounts, it may indicate that your children qualify for Medi-Cal. You will most likely need to submit an application and receive subsequent denial from the Medi-Cal program before you can be enrolled in the Healthy Families Government program.

  If you are self employed, you may still be eligible to apply for your children to receive benefits from the Healthy Families Program. The state will require that you submit a federal tax return or a quarterly profit/loss statement.

Citizenship

• Children who need medical assistance and apply through Healthy Families need to be U.S. citizens, U.S. non-citizen nationals or qualified immigrants, who are able to show paperwork of citizenship and immigration with date of entry to the United States. Paperwork for citizenship needs to be submitted within two months from enrollment, or you will need to reapply and submit all paperwork again.

Cost

• Although some services are free, members are required to pay a monthly premium. The maximum amount is $51 for a family or $4-$17 per child. Co-pays for physician visits are normally $5 per visit. The amount of the premium can also decrease depending on how often you choose to pay or if you choose electronic fund transfer with set dates.

Benefits

• The benefit of the Healthy Families Program is that you get to choose what health plan your children have. It is important to look at plans in your county and how much the plans cost before making a decision regarding the health care plan that is right for your family.

  Be sure to check what hospitals in your area participate in the plan and that they are "in network" in order to reduce medical expenses. Out-of-network providers are those that do not participate in the state program and may charge more for medical care. You can avoid higher out-of-pocket expenses by considering these issues before deciding on an insurance plan for your children.

  If you decide that a specific plan is not the right one for you, you can change plans or add members during the enrollment period or in the first three months of joining.

Continued Funding

• The Healthy Families program was approved for continued federal funding in February 2009. The federal State Children's Health Insurance Program (SCHIP) provides two-thirds of the funding for Healthy Families and similar state programs. This reauthorization kept 900,000 children on the California program. The California Legislature also has approved continued funding for the program.