Alyssa Lane
If you are a resident of California and are looking to apply for medical insurance for your child, there are a few options available. The first is Covered California, which offers health insurance plans for families. The second is Medi-Cal, which provides free or low-cost coverage for children under the age of 19 in families with low to moderate incomes. This includes services such as doctor visits, teeth cleanings, eye exams, and prescriptions. In some cases, children may qualify for a separate program like CCHIP or CCS, which offer healthcare services for children and young adults under the age of 21. Applying for medical insurance can be done online or over the phone, and typically takes about half an hour.
| Characteristics | Values |
|---|---|
| Name of the program | Medi-Cal |
| Who is eligible? | Children and young adults under the age of 21 from families with low and moderate incomes |
| Cost | Free or low-cost |
| Services offered | Medical care, vision care, mental health support, ambulance and emergency room services, doctor visits for sickness, injuries or other concerns, teeth cleanings, fillings, eye exams and glasses, prescriptions, counseling and treatment |
| Additional benefits | Non-emergency and non-medical transportation services for minors |
| Application process | Apply online or by phone |
| Time taken | Approximately 30 minutes |
| Documents required | Necessary documents should be kept on hand |
| Support | Free, confidential help available by phone |
| Enrollment centers | Hundreds of enrollment centers available statewide |
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What You'll Learn
Medi-Cal: free or low-cost coverage for children under 19
In California, Medi-Cal, also known as Medicaid, offers free or low-cost health insurance for children and teens under the age of 19 in families with low and moderate incomes. Eligibility depends on household size and income and varies by state. In most states, children up to the age of 19 with a family income of up to $50,000 per year (for a family of four) may qualify for Medi-Cal. In many states, the family income threshold can be even higher for a child to qualify.
Blue Shield of California Promise Health Plan offers Medi-Cal, providing healthcare services for children and young adults under the age of 21. This includes medical care, vision care, and mental health support. The California Children's Services (CCS) program is available for children and young adults under 21, and the Early Start program supports infants and toddlers with disabilities.
Covered California™ offers health plans with financial assistance, and parents who qualify may find out their children are eligible for Medi-Cal. Parents cannot add their children to their Covered California plan if they qualify for Medi-Cal.
Applying for Medi-Cal can be done online or over the phone through Covered California. The same application is used for both programs, and applicants will find out which program they qualify for. Some households may qualify for both. The application takes about half an hour to complete, and it is recommended to have the necessary documents on hand before starting.
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Apply online or by phone
You can apply for medical insurance for your child in California online or by phone. To apply online, visit the Covered California website. Here, you can apply for both Covered California and Medi-Cal. The application process takes about half an hour to complete, and you can save your application and return to it later if needed. Before starting your application, make sure you have all the necessary documents to ensure a seamless enrollment process. You can also make an appointment to get free help with signing up for a plan.
If you would prefer to apply by phone, you can call Covered California and receive free, confidential help with your application. After submitting your application, you will receive a call from a certified enroller, usually within 30 minutes. Make sure you have the necessary documents on hand before the call.
Medi-Cal, also known as Medicaid, offers free or low-cost health insurance for children and teens up to the age of 19 or 21, depending on the program, in families with low and moderate incomes. Eligibility is dependent on household size and income and varies by state. In most states, children up to the age of 19 with a family income of up to $50,000 per year (for a family of four) may qualify for Medicaid. In many cases, family income can be higher, and children can still qualify.
The Blue Shield of California Promise Health Plan offers Medi-Cal and provides healthcare services for children and young adults under the age of 21. This includes medical care, vision care, mental health support, and more. The Children's Health Program (CHP) provides medical care for children with special healthcare needs, including regulatory compliance, staff education, and case management services.
In San Francisco, San Mateo, and Santa Clara counties, parents who qualify for Covered California and financial aid may be informed that their children are eligible for a separate program called CCHIP. While parents may wish to decline CCHIP and add their children to their Covered California plan, this is not permitted. If parents decline CCHIP enrollment, their children can only be enrolled in a separate, full-cost plan through Covered California.
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Eligibility: household size and income
When applying for medical insurance for a child in California, eligibility is primarily determined by household size and income. These factors play a crucial role in assessing your child's eligibility for public health insurance programs or subsidies for private insurance. Here's an overview of the considerations regarding household size and income:
Household Size:
- Include all individuals who live with you and share living expenses. This typically encompasses family members, such as a spouse, children, or other relatives, but it can also include non-relatives who permanently reside in your household.
- In California, the household size is a significant factor in determining eligibility for programs like Medi-Cal, which provides health coverage for low-income individuals and families.
- When calculating household size, include your child for whom you are seeking insurance coverage.
Income Considerations:
- The total annual income of your household is a critical factor in determining eligibility for various health insurance programs.
- Include all sources of income for each member of your household, such as wages, salaries, interest, dividends, and any other monetary benefits received.
- If you have varying income, such as seasonal work or fluctuating self-employment income, you may need to provide additional documentation to verify your income level.
- California uses a percentage of the Federal Poverty Level (FPL) as a benchmark to determine eligibility for certain programs. For context, the FPL is adjusted for family size and provides a standard metric for measuring financial need.
- When assessing income eligibility, some expenses may be deducted, such as child care or medical costs for certain family members with disabilities. These deductions can lower your countable income and increase your chances of qualifying for assistance programs.
- If your household income is above the limits for public insurance programs, you may still be eligible for subsidies or tax credits to help cover the cost of private insurance through Covered California, the state's health insurance marketplace.
It's important to provide accurate and up-to-date information about your household size and income when applying for medical insurance for your child. This ensures that you receive the correct determination of eligibility and facilitates access to the most suitable insurance options for your family.
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Blue Shield of California Promise Health Plan
In California, parents or caregivers can apply for medical insurance for their children through programs like Medi-Cal or Covered California. Medi-Cal is a program that offers free or low-cost health coverage for children under the age of 19. It provides a range of services, including doctor visits, emergency care, dental and vision care, prescriptions, and counselling. To apply for Medi-Cal or learn more about eligibility, you can visit the Covered California website or contact your county office.
One of the health plans available through Medi-Cal is the Blue Shield of California Promise Health Plan. Blue Shield of California is an independent licensee of the Blue Shield Association and is committed to transforming the healthcare system by improving quality outcomes, reducing health disparities, and driving innovation. The Blue Shield Promise is a managed care organisation that offers Medi-Cal and Cal MediConnect plans.
The Blue Shield of California Promise Health Plan provides a wide range of benefits to its members. It is contracted with the Department of Health Care Services (DHCS) in San Diego County to deliver Medi-Cal benefits to eligible individuals. They work with a broad network of professional physicians and community-based organisations to ensure quality care and improve health outcomes. Additionally, they offer health education and wellness programs to help members stay active, healthy, and informed.
To enrol your child in the Blue Shield of California Promise Health Plan through Medi-Cal, you can follow these steps:
- Visit the Covered California website or contact your county office to apply for Medi-Cal and determine your child's eligibility.
- If your child is determined to be eligible for Medi-Cal, you will be able to select a health plan. Choose the Blue Shield of California Promise Health Plan as your preferred option.
- Provide any necessary documentation and complete the enrolment process through Covered California or your county office.
- Contact Blue Shield of California Promise Health Plan directly using the contact information provided on their website or your county-specific details for any further questions or assistance.
Remember, if you reside in specific counties like San Francisco, San Mateo, or Santa Clara, and qualify for financial assistance through Covered California, your child may be eligible for programs like CCHIP instead of Medi-Cal. In such cases, you cannot add your child to your Covered California plan, and they must be enrolled in a separate program.
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Special enrollment periods
Loss of Coverage
- If you or your child lose qualifying health coverage, you may qualify for a Special Enrollment Period. This includes losing coverage through a parent, spouse, or family member.
- Losing Medicaid or the Children's Health Insurance Program (CHIP) coverage within the past 90 days may also qualify you for a Special Enrollment Period.
Change in Residence
- If you move to California from another state or a foreign country, you may qualify for a Special Enrollment Period.
- Moving within California can also qualify you if you gain access to at least one new Covered California health insurance plan.
Family Changes
- If you have a new dependent, such as through birth, adoption, or fostering, you may qualify for a Special Enrollment Period.
- Losing a dependent or your status as a dependent can also trigger a Special Enrollment Period.
Income Changes
- A change in household income that affects your eligibility for programs like Medicaid can qualify you for a Special Enrollment Period.
- If you experience a decrease in income that makes you eligible for savings on a Marketplace plan, you may be eligible for a Special Enrollment Period.
Other Qualifying Events
- Gaining citizenship, permanent legal residency, or another lawfully present status in the U.S. may qualify you for a Special Enrollment Period.
- If you are a member of a federally recognized American Indian tribe, you can enroll in health insurance at any time and change plans once per month.
- If you are required by court order to provide health insurance for a child who is ineligible for Medi-Cal and CHIP, you may qualify for a Special Enrollment Period.
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Frequently asked questions
Medi-Cal offers free or low-cost health insurance for children and teens up to the age of 19 in families with low and moderate incomes. Eligibility depends on household size and income and varies by state.
Services covered include ambulance and emergency room services, doctor visits for sickness or injuries, teeth cleanings and fillings, eye exams and glasses, prescriptions, counseling, and mental health support.
You can apply for Covered California online or get free confidential help by phone. You will need to have the necessary documents on hand before starting your application.
Some of the plans include the Blue Shield of California Promise Health Plan, which offers Medi-Cal, and the California Children's Services (CCS) program for children and young adults under 21.
