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Healthy Families Program Monthly Premiums will Increase February 1, 2009
I have already paid for February’s premium; will I have to pay the difference?
Yes, you will have to pay the difference. In your January monthly billing statement, it will show any balance owed for February. Any difference will still be due by February 20th, or your account will be considered past due.
Can I just pay the difference later?
No, the difference is due by February 20, 2009, the same as your regular monthly premium. If you do not pay the difference before February 20th, your account will be past due. If your account is past due and not paid in full by 60 days, your children will be disenrolled from Healthy Families.
When will I get my first bill with the new premium increase?
The monthly billing statement that is sent in January will show your new premium amount for February 2009.
I am currently in AIM. If I enroll my baby in Healthy Families, will their premium increase?
Yes. Babies enrolled in Healthy Families from AIM moms are billed in Category C. Category C will be having a premium increase. If you already have children enrolled in Healthy Families, your monthly premium will be adjusted based on their premium Category.
I would like to have my income reviewed now; do I have to wait for Open Enrollment?
No, you may submit a Premium Re-evaluation Form at anytime. Please remember that Healthy Families will need current valid income documents to see if you qualify for a lower premium. You can review the Family Members andIncome Brochure or view samples of some income and deduction documentations under For Certified Application Assistants and Enrollment Entities: Information and Forms
I have free months; if my premium goes up do I lose them?
No, you will keep any free months you have already earned before January 20th. However you will have to pay any difference in premiums by February 20th. If your children are disenrolled before the free month earned, you will loose the free month.
Are there options to lower my premium?
Yes, you may:
- Enroll in Electronic Fund Transfer (EFT). Please allow 6-8 weeks to process EFT requests. You will automatically receive a 25% discount on your monthly premium if you pay by EFT.
- You can sign up for monthly automatic credit card payments online or by calling 1-877-267-3729. You will automatically receive a 25% discount on your monthly premium.
- Pay three full months in advance (premiums are due by the 20th every month) and earn the fourth month free. Your account has to be paid in full plus three months of premiums paid in advance.
- During Open Enrollment, you can choose your county’s Community Provider Plan, which has a lower premium of $3 per child.
- You can submit a Premium Re-Evaluation Form if your income has changed.
Do you offer help for those who can’t afford the increase?
Healthy Families offers ways to help lower your monthly premium. You may also try to find help through the Family Contribution Sponsorship.
I have EFT, what will be the new amount coming out of my account?
If your premium has increased, your total amount will be reduced by 25%. For questions on your account, please call Healthy Families for assistance at 1-866-848-9166.
I signed up for recurring credit card payments; do I need to change the amount?
No, you do not need to change the amount authorized on your credit card. When you signed up, you authorized Healthy Families to adjust the monthly automatic payment amount to equal the new premium.
What if I changed my plan during Open Enrollment to lower my premium, but don’t like it, can I change again?
Yes. If you changed your plan during Open Enrollment, you may request an additional transfer within 30 days from the effective date. For Open Enrollment transfers effective February 1, 2009, the request must be received by March 2, 2009.
Will I be able to change plans after Open Enrollment to lower my premium?
No. After Open Enrollment, you may only transfer plans if you have started with a new plan on February 1, 2009. Then you are allowed to transfer within 30 days from the effective date. If you did not transfer plans during Open Enrollment, you will have to wait for the next Open Enrollment period.
I was told premiums are going up, does this impact me?
This may impact you. If you are in Category B or C you will be impacted. Please review the premium increase chart.
If your current premium amount is not listed on the chart you are probably in Category A and are not impacted.
I sent in a Premium Re-Evaluation Form to lower my premium, when will I know if it will get lowered?
You will be told within 30 calendar days if your premium will be lowered. Please remember that your form must be complete and have valid documentation to be approved. If all information is not provided, your request will be denied even if you were eligible.
Why did my premium go up $3 and not just $2?
Premium increases were based off of your income and premium category. The amount of the increase was based on the last increase Healthy Families experienced and your current income. Because you were not impacted last time there was an increase, your premium went up to $3 and not $2.
Why is my premium increasing?
Your premium is increasing because the last time your family’s income was reviewed, your income was either in Category B or Category C. Based on your income, California law requires for Healthy Families to increase your cost sharing in the program. You may have your income reviewed to see if you qualify for a lower premium. But all families in Category B and C are being told their premium will increase.
Can I appeal my premium increase?
No, you cannot appeal the increase as this is because of California law. You may submit a Premium Re-Evaluation Form to have your income reviewed for a lower premium.
Will the premium increase impact me if I have been sponsored?
No, you will not be required to pay the difference for your sponsored period. Your account will be credited the difference for the remainder of the period. After your sponsorship period ends, you will be required to pay the full premium amount.
Did everybody’s premium increase?
No, only if your premium is in Category B or C. If your premium is in Category A, your premium will not increase.
I would like to help families affected by the increase, how can I help?
Healthy Families has a Family Contribution Sponsorship program. This program does require that you apply to become a sponsor and payment for a full 12 months of Healthy Families coverage. There are some restrictions on who may be a sponsor. Anyone who receives any federal health care funds through any program and anyone with any other legal questions about sponsorship should consult with his or her attorney before becoming a sponsor.