"Healthy Families Program Summary"
Information from the California Managed Risk Medical Insurance
Board (MRMIB -- "Mister Mib")
SUMMARY OF HEALTHY FAMILIES PROGRAM
Child centered comprehensive benefits - health, dental and vision
- provided at low monthly premiums to low wage California
families.
Most families participating in the program will select a health
plan from a broad range of choices available in their community.
Families with access to employer sponsored coverage may be
eligible for assistance with the cost of dependent coverage.
ELIGIBILITY CRITERIA
Uninsured children (age 1-19) in families with incomes of less
than 200% of the federal poverty level who are not eligible for
no cost Medi-Cal. ($13,330 - $26,660 for a family of three).
MONTHLY PREMIUMS
All families participating in the program will pay monthly
premiums. Families selecting the lowest priced plan(s) available
in their area will pay from $7 -$27 per month depending on their
income and the number of children enrolled. Families selecting
more expensive plans may be asked to pay more. A discount of $3
per child per month will be offered to families selecting the
plan in each area that has done the best job of including
traditional and safety net providers in its provider network. In
addition, families that prepay three months of premium will be
entitled to a fourth month free.
BENEFITS
Children enrolled in the Healthy Families Program will receive
the same standardized benefits as are received by the children of
state and local government employees through the PERS and DPA
benefit programs. Modest copayments will be charged for most
non-preventive services.
Health Benefits:
Physician visits
Inpatient care
Prescription drugs
Emergency care
Preventive services, such as immunizations, well child visits and
periodic health exams
Mental health
Substance abuse
Dental Benefits:
Exams
Cleanings
Fillings
Sealants
Bridges and crowns
Medically necessary orthodontia
Vision Benefits:
Annual exams
Eyeglasses
SIMPLE APPLICATION PROCESS
Families will enroll by using a simple mail-in application
process. Applications and other program materials will be
available in several languages. A toll free phone number will
provide easy access to trained staff who will be able to help
families complete their application.
Entities such as school districts and day care centers, and
individuals such as insurance agents will be paid a fee for
assisting families in filling out their application.
WHEN WILL THE PROGRAM BE AVAILABLE?
The program will open to enrollment in May or June of 1998. The
first date of coverage for children will be July 1, 1998.
If you would like to be notified when program materials are
available please contact MRMIB at 916 324-4695.
September 19, 1997