How do you apply?

First, you should read Who can join Healthy Families?

There are 3 ways to apply. To apply you can

1. fill out an application
2. apply by phone, or
3. get help with your application from a Certified Application Assistant

Fill out an application

To apply, fill out a joint Medi-Cal and Healthy Families application. You may call to get an application, or you may download the application:

• To get the application, call 1-800-880-5305. The call is free. You may call between 8 a.m. and 8 p.m. Mondays through Fridays and 8 a.m. to 5 p.m. Saturdays.
• You may also download a copy of the application.

Mail the application along with papers that are asked for such as proof of income and expenses. Instructions about mailing are on the form.

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Apply by phone

You can call Healthy Families and have a customer service representative fill out an application for you. The representative will ask you questions, fill out a form, then mail the form to you so you can sign it.

To apply by phone, call 1-800-880-5305. The call is free. You may call between 8 a.m. and 8 p.m. Mondays through Fridays and 8 a.m. to 5 p.m. Saturdays.

The phone call will take about 20 minutes. You will need to have these items when you call:

• A pen or pencil and paper to write down information.
• A pay stub you received within 45 days or last year’s Federal Income Tax Form 1040 for everyone receiving income in your household.
• If someone is self-employed, the most recent 3-month profit and loss statement or last year’s Federal Income Tax Form 1040 and Schedule C.
• Birth dates for every child applying in your household.
• Amounts for child daycare expenses.
• Amounts for disabled dependent care.
• Amounts for any child support or alimony either paid or received.

After the call, Healthy Families will mail you a pre-printed application. You will need to make sure that the information is correct and sign the application. Mail the application back to Healthy Families along with papers that are asked for, such as proof of income, expenses, and citizenship documentation.

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Get help in person from a Certified Application Assistant

Certified Application Assistants (CAAs) are people from community organizations who have been trained to help you fill out the joint Medi-Cal and Healthy Families application. The community organizations that CAAs work with are called Enrollment Entities (EEs). You can search for an Enrollment Entity in your area. The Enrollment Entity will find a CAA who can help you prepare your application.

How long will it take to process my child’s complete application?

When we receive a complete application, Healthy Families will determine eligibility within 10 calendar days. You will be notified by letter and will also receive a welcome telephone call.

When will coverage begin?

The letter gives the date the insurance coverage will begin for each enrolled child. The first day of coverage begins 10 days from the date Healthy Families determines that a child qualifies for the program. Healthy Families does not offer retroactive coverage.

How long will it take if my application is missing information?

If your application is not complete, we will notify you in writing. We will also try to reach you by phone. Healthy Families will not be able to determine if your child is eligible if you do not send in the information requested. You must submit all requested information within 20 days from the date Healthy Families received your application. You will have to reapply (send in a new application) if the information is not received within 60 days from the date that Healthy Families denies your application.

If your income is below the Healthy Families income levels, your application will be forwarded to the Department of Social Services in your county. They will contact you within 45 days to inform you of your family’s Medi-Cal eligibility.

If you believe we made a mistake in not enrolling your child, you can request a review. See the Appeals section of this handbook, or call 1-866-848-9166. The call is free.

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