This program is administered
by the Managed Risk Medical Insurance Board (MRMIB).

Frequently Asked Questions

I need help applying for Healthy Families for my children. Where can I go?

To learn about what organizations can help you fill out applications, see: Joining Healthy Families. You can search for an organization in your area that can find a Certified Application Assistant (CAA) to help you fill out your application.

How do I know if my children are eligible (if they can join)?

Children in Healthy Families must live in California and:

• Be age 18 or younger.
• Not be eligible for no-cost Medi-Cal.
• Children in families with incomes within the Healthy Families Guidelines.
• Live in families without health insurance from an employer for the past three months.
• Meet citizenship or immigration requirements.

To learn more, see Who can join Healthy Families?

How soon after I apply will I know if my children are eligible?

Healthy Families will send you an answer in 10 days or less after they get your application, as long as your application is complete.

What are some of the benefits (services) children can get from Healthy Families?

• Hospital care when it is medically necessary
• Care from doctors, including surgeons
• Prescription drugs
• Well Child services to prevent disease
• Family planning (birth control)
• Mental health care
• Alcohol and drug treatment service
• Physical, speech and occupational therapy
• Lab and X-ray services
• Dental care
• Eye care
• Immunization Schedule (pdf 243 KB)
• Preventive Health Screenings (pdf 345 KB)

To learn more, see What does Healthy Families cover?

How much does Healthy Families cost?

Members pay a premium ( bill ) each month. It costs $4 to $24 for each child, or no more than $72 for a family. Members also pay a co-payment (usually $5 to $15) when they go to the doctor or get other services. Some services are free.

To learn more, see How much does Healthy Families Cost?

How can I save money on Healthy Families?

You can choose the Community Provider Plan. It is the least expensive plan in your area. It offers the same services as the more expensive plans. You can also save by paying premiums three months at a time, or by paying with electronic fund transfer .

To learn more, see Save money on your premiums!

Do I get to choose my children's health plan?

Yes. You choose one of the plans that is offered in the county where you live. See Choosing Plans to find out what choices you have.

How do I pick a health plan?

Look at descriptions of the plans offered in your county. The plans are similar but not exactly the same. Go to Choosing Plans and find the plans in your county. You can see what your choices are and how much the plans cost. The page about your county also has information that can help you pick the best plan for your family.

What if my child doesn't qualify for Healthy Families? Is there other health coverage I can get?

• If your income is below the limit for Healthy Families, you may qualify for no-cost Medi-Cal. You can let Healthy Families send your application to the county office near you to find out if you qualify for Medi-Cal.
• If your income is above the limit for Healthy Families, there may be other programs you can use. Call 1-800-880-5305 for more information. The call is free.

Does my child have to be a U.S. citizen to join Healthy Families?

No. Children joining Healthy Families must be one of these:

• A U.S. citizen.
• A U.S. non-citizen national.
• An eligible qualified immigrant.

I don't speak English. Can I get information in my own language?

For information on Healthy Families. Information is available in several languages besides English. Call 1-800-880-5305 (the call is free) to ask for information in any of these languages:

For help applying in your language: Many community groups have people who have been trained to help you apply. Learn about Certified Application Assistants in Joining Healthy Families.

For insurance plan information in your language: All plans have some information in Spanish, and many plans have information in several languages other than English. This chart shows which plans have written materials in which languages.

I am self-employed. How do I show proof of income?

Your "net profit" is what determines your income for Healthy Families. Check your 1040 federal tax return, Schedule C, or your quarterly profit/loss statement.

What income does not count?

You can't count income from these sources:

• SSI/SSP payments
• Foster care payment
• CalWORKS (AFDC replacement)
• General Relief payment
• Grants/scholarships used for school
• Earnings from a job of a child under 14 years old or who attends school
• Some government benefit payments
• Loans
• College work study

Please check with your local county welfare office for more detailed information.

Can my children join Healthy Families even if I don't live in California?

Yes, but your children (the children you are applying for) must live in California.

Do children have to live in the same home as the applicant in order to enroll?

No, but only the income of the household where the child lives can be used to determine eligibility.

What if I don't like the plan we're in? Can I switch plans?

Yes. You can change plans at any time after joining Healthy Families.

To learn more, see Changing health, dental plans and vision.

What if I have a disagreement with the Healthy Families program or my health plan?

You can appeal a decision (ask that the decision be reconsidered) if you think Healthy Families was wrong about:

• Your eligibility (whether you can join).
• The date your coverage should start.
• Disenrollment (being taken out of Healthy Families).

Healthy Families has steps you must follow to appeal a decision.

You can also appeal decisions from your health plan. Your plan has steps you can follow to do that.

To learn more, see Making an appeal.

Do I apply just once, or do I have to re-apply every year?

Once a year Healthy Families will make sure your children still qualify for (can be members of) the program. This is called the Annual Eligibility Review (AER). If you still qualify, you can stay in Healthy Families for at least another year, until the next AER.

To learn more, see Annual Eligibility Review.

Can I sign up my newborn baby?

Yes. You may apply as early as three months before the baby is due. Read If you are pregnant for more information.