A collaborative effort of The Children's Partnership, Children Now, and Children's Defense Fund created to ensure that all of California's children obtain the health coverage they need to grow up strong and healthy

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Wednesday, July 24, 2013

What Families Should Know About Changes to the Healthy Families Program

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Is your family encountering problems with the Healthy Families transition to Medi-Cal?  Please tell us about your experience.

 

Download the statewide factsheet:

 

Download county-specific factsheets for counties transitioning in Phase 3:



 

What Families Should Know About Changes to the Healthy Families Program

 

In last year’s state budget, Governor Brown and state lawmakers decided to move all 875,000 children enrolled in the Healthy Families Program into the Medi-Cal program in order to combine the state's health care services for children into one program. Medi-Cal is a state program that provides comprehensive medical, dental and vision coverage to millions of Californian children.

 

Healthy Families children began moving to MediCal on January 1, 2013.

  • The move is happening in a number of phases – individual move dates will vary depending on where the child lives and the child’s current health plan.
  • Families will receive a notice from the state at least two months before any change in their child’s coverage.

 

Children will not lose health coverage.

  • Children currently in Healthy Families should continue to have comprehensive health insurance, with no gap in coverage.
  • Some families will have to change their doctor and most will have to change their dentist.
  • Children have a right to continuous care throughout the transition. Families with children who are in the middle of receiving treatment for a serious illness or health condition may ask for a delay of up to 12 months before this change will take place. Should you have any questions or concerns about your child’s care through the transition, or to submit a continuity of care request, call 1-888-452-8609.
  • Medi-Cal coverage includes all the benefits of Healthy Families coverage. Some mental health services – such as Applied Behavioral Analysis for children with Autism – may be delivered via a different provider source than your primary care provider. Your health plan should direct you to the correct service entity.  
  • Premiums will not increase, and families with incomes below 150 percent of the federal poverty line will no longer be charged premiums once they move to Medi-Cal.

 

Medi-Cal is open for enrollment and families can still apply today.

Children who would have been eligible for Healthy Families are now eligible for Medi-Cal. Families can apply for free or low-cost health coverage for their children in Medi-Cal. To apply, families can:

 

Parents with children in Healthy Families should watch for a series of mailed letters from the state, which will provide information about any steps families need to take before moving to Medi-Cal. Families who receive renewal notices for their Healthy Families coverage should continue the renewal process to ensure they maintain continuous coverage.


Families should also continue to pay their Healthy Families monthly premiums to maintain continuous coverage. If you experience issues with your premium payments or disputes regarding your billing record, please call the Healthy Families Program at 1-866-848-9166.

 

Questions or problems with accessing children’s health care or coverage should be directed to the Medi-Cal Ombudsman office at 1-888-452-8609.