California has many health programs that serve the needs of children and families. They range from comprehensive coverage programs, such as Medi-Cal and Healthy Families, to specialized and low-cost health care for specific populations. Also, new insurance reforms will make it easier and more affordable for children to gain coverage in the private market.
Read below for links with more information about health coverage options available to California children and instructions on how to apply.
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Children in families with income of up to roughly $46,000 annually (for a family of three) may qualify for these primary coverage programs:
- Medi-Cal provides comprehensive medical, dental, and vision coverage for the lowest-income children under age 21 with no cost-sharing
- Healthy Families (HFP) provides low-cost health coverage for children whose families earn too much to qualify for Medi-Cal but don’t make enough to afford private coverage.
Children not eligible for Medi-Cal or Healthy Families may qualify for these other programs, regardless of their immigration status:
- Healthy Kids provides comprehensive coverage of medical, dental, vision and behavioral health services to children in certain counties who do not qualify for Medi-Cal or Healthy Families and who meet income guidelines.
- In some counties, CaliforniaKids, provides low-cost comprehensive outpatient and primary health care (no hospital coverage) for children.
Pregnant women or couples in need of family planning services may qualify for these programs:
- Access for Infants and Mothers provides health coverage to pregnant women without health insurance throughout their pregnancy and 60 days after the child is born. After the baby is born, infants are automatically eligible for Healthy Families coverage for up to two years.
- Family PACT provides comprehensive family planning services to low-income families in California without other family planning coverage.
Children with a pre-existing condition (such as asthma or diabetes) or a serious medical problem (such as a chronic illness or disease) may qualify for these programs:
- California Children's Services provides treatment and case management services for low-income children under 21 years of age who have serious medical problems, such as chronic illnesses, genetic diseases, physical handicaps, major injuries due to violence and accidents, congenital defects, and conditions requiring treatment in neonatal intensive care units.
- New health care law brings change: Children in California can no longer be denied coverage or treatment in the private market due to a pre-existing condition. Also, if a child with a pre-existing condition is enrolled during the open enrollment period, their premiums will be more affordable than if they enroll at any other time. Open enrollment is 60 days beginning January 1, 2011, the month after a child’s birthday every year, and after certain “trigger events” such as when a family loses other coverage, like a parent losing dependent coverage through their employer’s insurance.) Share this poster with families for information about ways to get children covered and the new rules for children's coverage in the private market.
- Download this flyer to learn more about health care and coverage options for children with special health care needs and pre-existing health conditions (also available in Spanish and Chinese).
Native American children may qualify for the Indian Health Program:
- Indian Health Program provides no-cost comprehensive health insurance for some Native American children in California.
Young adults under age 26 can get coverage by staying on their parents’ health insurance policies:
- New health care law brings change: Insurance companies are now required to cover young adults on their parent’s insurance until age 26, even those who are not full-time students or not living with their parents. For information on how young adults can stay covered, click here.
Starting in 2014, families with incomes up to roughly $88,000 for a family of four will qualify for affordable private insurance options under the Exchange:
* If you can't find what you are looking for, please call Michael Odeh for assistance, at 510-763-2444 x 122.