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Healthy Families


Healthy Families was the low cost program offering medical, dental, and vision coverage for California’s children. It differed from Medi-Cal as the income guidelines were higher, and offered a larger network of contracted providers. Parents were able to obtain this comprehensive coverage with ease, and were able to rest easy knowing that both premiums and out of pocket expenses were so affordable. Once enrolled, children were covered for almost their entire medical, dental, and vision needs with little out of pocket for parents, both in premiums and in co-payments. The maximum out of pocket per year for a child on Health Families was $250.

Enrolling was a fairly simple process, most easily done over the phone with an assister. Income documentation, children’s birthdates, and deductions, such as day care expenses would determine the monthly premium. In most cases, the monthly premium would rarely exceed $10 per month per child. Parents also found that most providers were in the Healthy Families network, therefore utilizing the plan as needed was a stress-free procedure.

Eligibility for the Healthy Families Program:

  • Children from birth through to their 19th birthday
  • Children whose families are without employer sponsored health coverage for at least three prior months
  • Those meeting particular residency and legal/citizenship requirements

Income Guidelines would determine whether you could enroll in the program. If you earned too much you would be directed to the private market. If your income was too low your child would instead be placed onMedi-Cal. The income guidelines for a family of four for the year 2012 were as follows:

  • Child age birth – 1: monthly income would have to be between $3,926 – $4,907
  • Child age 1 – 5: monthly income would have to be between $2,612 – $4,907
  • Child 16 – 18:  monthly income would have to be between $1,964 – $4,907

However, the program lost funding in January of 2013, leaving families facing the choice of converting to a Medi-Cal plan or seeking coverage in the individual market. For children with pre-existing conditions this could mean an increased premium of up to 350% in the individual market in 2013, so this only leaves the option of changing to Medi-Cal and perhaps losing their current providers by doing so. However, a program called the Children’s Health Insurance Program Reauthorization Act (CHIPRA) has implemented an outreach program to assist families obtain coverage in alternate plans such as Medicaid and CHIP.

Let Health Exchange Quote Insurance Agency help you determine if an individual plan would better suit your child’s needs. Contact us today.

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30101 Town Center Drive, Suite 109
Laguna Niguel, CA 92677

Telephone: (800) 366 2751


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