California SCHIP Application Information

The California SCHIP program offers affordable health insurance for children and teenagers living in California that do not qualify for Medi-Cal. Usually, the monthly premium for children is determined by family income and size. Mandatory monthly premiums range between $4 and $17 per child, however, charges do not exceed a maximum of $51 for all under age children in a family enrolled in the Healthy Families Program. Members are obliged to pay a co-payment of $5 each time they visit the doctor or receive other medical services. Services such as preventive health care are not charged. These charges should never exceed $5 for children's benefits.

It is mandatory for every family to pay a maximum of $250 in co-payment benefit per year. (i.e. Every July 1st to June 30th of each year for health care services). Remember to keep all co-payments receipts made at the time of receiving health care services safe. Never forget to notify your health plan if you reach the maximum $250 for the benefit year of coverage. You will not be required to make any more $5 co-payments for health care services until the beginning of next benefit year of coverage.

Program Enrollment, Length and Renewal

After every 12 months, you will be required to fill a renewal form to determine if you still meet the qualification guidelines so that your premiums can be adjusted accordingly. A renewal form will be mailed to you 3 months before the 12 month renewal period expires. The health plan verifies the size of your family and income through the renewal notice. Remember, you can always change your health plans during open enrollment period which runs from April 15th to May 31st of each year. Once you choose a new insurance plan during the open enrollment period, all children in the household are automatically transferred to the new insurance plan. Coverage in the new plan starts every July 1st.

Services and benefits offered by California SCHIP

California (SCHIP) covers the following medical services:

  • Physician Services Category - Office and home visits, allergy testing and treatment
  • Preventative Care Category - Routine health tests, family planning services, prenatal care, vision and hearing testing, immunizations, STI testing, health education services, annual pap smear exams and confidential AIDS and HIV testing and counseling
  • Skilled maternity care
  • Inpatient/Outpatient hospital services
  • Prescription Drugs - usually a 30 day supply, 90 day maintenance supply
  • Laboratory and X-ray services
  • Durable Medical Equipment
  • Mental Health
  • Dental & Vision Care
  • Alcohol and substance abuse
  • Physical, Occupational, Speech Therapy
  • Emergency and Non-emergency medical transportation
  • Emergency health care services
  • Home based health care
  • Professional nursing care

Application Process

Clicking here will direct you to a California SCHIP Program office near you to further assit you in applying.

Eligibility Requirements

The California SCHIP healthy program only offers affordable insurance for children living in California under the age of 19 and whose family income ranges between 0% and 300% of the Federal Poverty Level (FPL). These families must have been without an employer-sponsored health insurance for a period not less than three months.

Applicants must also be legal citizens or meet the required immigration guidelines. Children born to mothers enrolled in the AIM program are also accommodated in this program. Minors and their siblings without parents qualify on their own; however, guardians and foster parents of such children are exempted from the income guidelines.

Income Guidelines

Family Size Income Level
1 $27,925
2 $37,825
3 $47,725
4 $57,625
5 $67,525
6 $77,425
7 $87,325
8 $97,225

Note: For families with more than eight people, add $9,900 for each member.

Waiting Period

You can join California Healthy Families program anytime but not before a waiting period of three months after coverage from a previous employer-sponsored plan expires.

SCHIP Application Instructions

The California SCHIP office is always open for enrollment. Please choose one of the following ways to apply:

Apply Online

You can apply online by visiting: http://www.healthyfamilies.ca.gov

Apply by Mail

You can download and print application from here. This link will take you to where you can download the needed application package. This package is available in twelve different languages.

The mailing address for your completed application is:

Healthy Families/Medi-Cal for Children & Pregnant Women
PO Box 138005
Sacramento, CA 95813-8010

Contact Information - Further Help

If you would like to speak with a program representative regarding the program and/or to obtain a list of SCHIP agencies in California kindly call 1-880-5305 weekdays from 8 am to 8 pm or Saturday 8 am to 5 pm.

Or send an email to: HealthyFamilies@maximus.com

Clicking here will direct you to a California SCHIP Program office near you to further assit you in your application.