Healthy Kids - Frequently Asked Questions

Frequently Asked Questions

1. What is the Healthy Kids program?
The Healthy Kids Health Plan is a locally developed and funded plan that provides comprehensive health coverage for children of low and middle income families in Santa Cruz County. Children who don't qualify for the state sponsored programs (Medi-Cal or the Healthy Families program) are eligible for Healthy Kids.

2. What does the Healthy Kids plan cover?
The Healthy Kids program provides comprehensive health, dental, vision and mental health services.

3. Who is eligible for Healthy Kids?
All children are eligible for Healthy Kids if they are:
• Under the age of 19
• Residents of Santa Cruz County
• Living in families with incomes below 300 percent of the Federal Poverty Level (for example, $60,000 for a family of four)
• Not insured through their families' employer-sponsored insurance within the last three months
• Not eligible for Medi-Cal or the Healthy Families program.

4. How many children are enrolled in Healthy Kids?
Nearly 2,000 children are currently enrolled into Healthy Kids, about 85% of our goal to cover 2,300 children. Funds are currently limited and so there are over 200 children age 6-18 on a waiting list. The Healthy Kids enrollment process has also funneled an additional 7,000 children into the state sponsored Medi-Cal and the Healthy Families insurance programs.

5. Do families pay a share of costs?
Families pay a share of costs, depending on their income level. Premiums range from $12-$36 per child per quarter. There are $5 co-payments for some medical, dental and vision services with a co-payment maximum of $250 per family per year for medical services. No co-payments are required for preventive or inpatient services.

6. How do families enroll their children?
Healthy Kids has partnered with the Santa Cruz County Healthcare Outreach Coalition to help families enroll their children. Specially trained Certified Application Assistors (CAAs) are assigned to districts throughout the County to provide application assistance at no charge. CAAs are available to families at local health fairs, clinics, community centers, schools and medical offices.

7. How does the Healthy Kids program differ from the Healthy Families and Medi-Cal programs?
Healthy Kids extends health coverage to children not eligible for Medi-Cal and Healthy Families programs, but whose families cannot afford private insurance. First, Healthy Kids raises the income eligibility limit to $60,000 for a family of four or 300% of the Federal Poverty Level. Second, unlike the other public insurance programs, Healthy Kids does not consider immigration status when determining eligibility for enrollment. Finally, Medi-Cal and Healthy Families are publicly funded programs, whereas Healthy Kids funding comes from both public and private sources.

8. Who manages and administers Healthy Kids?
Healthy Kids is managed by the Central Coast Alliance for Health, a locally governed and operated public health plan already serving over 84,000 Medi-Cal and Healthy Families enrolled members of Santa Cruz and Monterey Counties. The Alliance maintains linkages to a vast network of both public and private medical providers and employs a professional staff with the expertise necessary to effectively manage the Healthy Kids Health Plan.

9. Will children be linked to a Primary Care Physician?
Healthy Kids program members have an option to choose their Primary Care physician, or one will be assigned to them. Healthy Kids reimbursement rates are competitive so that the program has attracted the participation of 410 local providers. Healthy Kids is endorsed by the Santa Cruz County Medical Society, local hospitals and leading physicians.

10. How much does the Healthy Kids program cost, and where does the funding come from?
The Healthy Kids program costs approximately $2.5 million for premiums, outreach and enrollment. Funding for the Healthy Kids Program comes from a combination of public and private sources. Generous commitments have been made by the First 5 of Santa Cruz County, the County of Santa Cruz, the Community Foundation of Santa Cruz County, the Pajaro Valley Community Health Trust, United Way of Santa Cruz County, Dominican Hospital, Sutter Maternity and Surgery Center and other foundations. A fundraising committee works to further help finance the program.

11. What does the future hold for Healthy Kids?
There are currently 19 Healthy Kids programs in California, serving 24 counties, but there is growing advocacy to expand these programs to all counties in order to serve all California's children. Children's advocates, State legislators (including Assemblymember John Laird), and our local Healthy Kids coalition support an expansion of Healthy Kids to all California kids, which would be maintained and operated by the State of California. Healthy Kids supports legislation that assures funding to cover all children beginning in 2008. Our kids can't wait any longer.





		Frequently Asked Questions 1. What is the Healthy Kids program? The Healthy Kids Health Plan is a locally developed and funded plan that provides comprehensive health coverage for children of low and middle income families in Santa Cruz County. Children who don't qualify for the state sponsored programs (Medi-Cal or the Healthy Families program) are eligible for Healthy Kids. 2. What does the Healthy Kids plan cover? The Healthy Kids program provides comprehensive health, dental, vision and mental health services. 3. Who is eligible for Healthy Kids? All children are eligible for Healthy Kids if they are: • Under the age of 19 • Residents of Santa Cruz County • Living in families with incomes below 300 percent of the Federal Poverty Level (for example, $60,000 for a family of four) • Not insured through their families' employer-sponsored insurance within the last three months • Not eligible for Medi-Cal or the Healthy Families program. 4. How many children are enrolled in Healthy Kids? Nearly 2,000 children are currently enrolled into Healthy Kids, about 85% of our goal to cover 2,300 children. Funds are currently limited and so there are over 200 children age 6-18 on a waiting list. The Healthy Kids enrollment process has also funneled an additional 7,000 children into the state sponsored Medi-Cal and the Healthy Families insurance programs. 5. Do families pay a share of costs? Families pay a share of costs, depending on their income level. Premiums range from $12-$36 per child per quarter. There are $5 co-payments for some medical, dental and vision services with a co-payment maximum of $250 per family per year for medical services. No co-payments are required for preventive or inpatient services. 6. How do families enroll their children? Healthy Kids has partnered with the Santa Cruz County Healthcare Outreach Coalition to help families enroll their children. Specially trained Certified Application Assistors (CAAs) are assigned to districts throughout the County to provide application assistance at no charge. CAAs are available to families at local health fairs, clinics, community centers, schools and medical offices. 7. How does the Healthy Kids program differ from the Healthy Families and Medi-Cal programs? Healthy Kids extends health coverage to children not eligible for Medi-Cal and Healthy Families programs, but whose families cannot afford private insurance. First, Healthy Kids raises the income eligibility limit to $60,000 for a family of four or 300% of the Federal Poverty Level. Second, unlike the other public insurance programs, Healthy Kids does not consider immigration status when determining eligibility for enrollment. Finally, Medi-Cal and Healthy Families are publicly funded programs, whereas Healthy Kids funding comes from both public and private sources. 8. Who manages and administers Healthy Kids? Healthy Kids is managed by the Central Coast Alliance for Health, a locally governed and operated public health plan already serving over 84,000 Medi-Cal and Healthy Families enrolled members of Santa Cruz and Monterey Counties. The Alliance maintains linkages to a vast network of both public and private medical providers and employs a professional staff with the expertise necessary to effectively manage the Healthy Kids Health Plan. 9. Will children be linked to a Primary Care Physician? Healthy Kids program members have an option to choose their Primary Care physician, or one will be assigned to them. Healthy Kids reimbursement rates are competitive so that the program has attracted the participation of 410 local providers. Healthy Kids is endorsed by the Santa Cruz County Medical Society, local hospitals and leading physicians. 10. How much does the Healthy Kids program cost, and where does the funding come from? The Healthy Kids program costs approximately $2.5 million for premiums, outreach and enrollment. Funding for the Healthy Kids Program comes from a combination of public and private sources. Generous commitments have been made by the First 5 of Santa Cruz County, the County of Santa Cruz, the Community Foundation of Santa Cruz County, the Pajaro Valley Community Health Trust, United Way of Santa Cruz County, Dominican Hospital, Sutter Maternity and Surgery Center and other foundations. A fundraising committee works to further help finance the program. 11. What does the future hold for Healthy Kids? There are currently 19 Healthy Kids programs in California, serving 24 counties, but there is growing advocacy to expand these programs to all counties in order to serve all California's children. Children's advocates, State legislators (including Assemblymember John Laird), and our local Healthy Kids coalition support an expansion of Healthy Kids to all California kids, which would be maintained and operated by the State of California. Healthy Kids supports legislation that assures funding to cover all children beginning in 2008. Our kids can't wait any longer. Home \| About Us \| Support Us \| Enroll \| Press \| Contact Us \| FAQ \| Our Stories ©2008 Healthy Kids of Santa Cruz County