Healthy Kids

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Healthy Kids provides comprehensive health care (health, dental, vision, and mental health services) to children from birth to age 18, living at or below 300% of the federal poverty level. The program is funded by the First 5 LA commission (formerly known as the Los Angeles County Children and Families First: Proposition 10 Commission) and the Children's Health Initiative (CHI).

Contents

Who is eligible?

  • Children from birth to age 18
    Due to the fact that there is a shortage of funds, beginning on June 2005, only children under the age of 5 will be allowed to submit a new application for Healthy Kids until more funds become available. If you are already enrolled for Healthy Kids, and do not need to re-apply, this policy shall not affect you.
  • Children who are not eligible for no-cost Medi-Cal or Healthy Families
  • Families residing in LA County
What are the income limits?

Healthy Kids uses the Federal Income Guidelines (FIG) to determine eligibility.

Family income at or below 300% of the FIG.

What about resource limits?

Resources are things that families own, such as cars, houses, and jewelry. Savings and checking accounts also count as resources.

There are no resource limits for this program. The cost of items that families own does not count towards eligibility for this program.

Does immigration status matter?

No. Undocumented children within the income limits for this program are eligible to receive services.

What benefits are covered?

This program offers health, dental, vision, prescription, and mental health services.

How do families apply?

Families may apply at agencies participating in Healthy Kids enrollment.

Click here for application.

What does it cost?

There are no monthly premiums or co-payments for families with income levels at or below 133% of the FIG.

For families with incomes above 133% of the FIG, there are two costs for this program:

  1. Monthly premiums
    • $4 per child for families with incomes between 134% and 150% of the FIG.
    • $6 per child for families with incomes between 151% and 300% of the FIG.
    • Families can receive a 25% discount on their premiums if they pay six months worth of premiums in advance (semi-annual payment). The prepayment costs are $18 per child for families with incomes between 134% and 150% of the FIG or $27 per child for families with incomes between 151% and 300% of the FIG.
    • Note: Regardless of family size, families will only have to pay for the first two children. Any additional children will be covered at no cost.
  2. Co-Payments
    • $5 co-payment(maximum co-payment of $250 per family per year) is charged for most outpatient services, such as doctor's visits. There is no charge for preventive care, such as immunizations and dental check-ups.
    • Payments can be made by personal check, cashier's check, or money order.
    • Cash payments or partial premium payments will not be accepted.
    • Note: Payments should not be sent in with the application.

Website

Can information on the Healthy Kids Program be found online?

The website for L.A. Care Health Plan is www.lacare.org.

Frequently Asked Questions

What if families miss their premium payments?

If families miss their premium payments, L.A. Care will contact them six times over a 60-day time period to assist them in getting enrolled in the premium assistance program. If L.A. Care is unable to make contact with the families within these 60 days, a 30-day disenrollment notice will be sent to these families.

What if children have other health insurance?

Children may be eligible for Healthy Kids even if they receive Restricted (Emergency) Medi-Cal or Share-of Cost Medi-Cal.

Children receiving California Children Services (CCS) and who do not have no-cost Medi-Cal may be eligible for Healthy Kids as well.

Children do not qualify for Healthy Kids if they currently have employer-sponsored health insurance.

Children currently enrolled in Medi-Cal or Healthy Families are not eligible for Healthy Kids.

What documents are required?
  • Proof of income
  • Proof of residency in Los Angeles County
What if the children were enrolled in California Kids?

Children ages 0-5-1/2 who were enrolled in California Kids were given the option to transfer to Healthy Kids when Healthy Kids began. Children ages 6 and older enrolled in California Kids were given the option to transfer to Healthy Kids starting in April 2004.

California Kids is no longer available to children in Los Angeles County, beginning June 1, 2004.

How do families apply for Healthy Kids?

Families must submit an application by the 20th of the month in order for their children to be enrolled the next month. If applications are received after the 20th of the month, children may not be able to be enrolled until the second consecutive month.

After children are enrolled, families will receive welcome packages in the mail. The welcome packages will include:

  • A list of provider directories for the families to choose their primary care physicians
  • The premium amounts families will pay each month.
How do children receive services?

Children are covered through L.A.Care providers.

Children will receive dental coverage through Health Net and vision coverage through VSP. Health Net will send a list of directories to the families.

If families wish to change their children's Primary Care Provider (PCP), they can call 1-888-452-5437. All changes will occur on the 1st of the following month if the request is received by the 20th of the month. If the request is received after the 20th of the month, then the change will not go into the effect until the 1st of the second consecutive month.

For example: if a request is made on July 2nd then the change will go into effect August 1st. If the request is made on July 25th, then the change will go into effect September 1st.

Contact

Who can parents contact if they have problems receiving services or have questions?

They can call the LA care Heath Plan member services at 1-888-4-LAKIDS or 1-888-442-5437. If parents have complaints or concerns, grievances can be filed in person, by phone or in writing to: L.A. Care Health Plan Grievance Manager 555 W. Fifth Street, 18th Floor Los Angeles, CA 90013 1-888-452-5437

For income eligibility guidelines, please contact the Korean Resource Center at 323. 937. 3718.

Application Assistance Services

Korean Resource Center 323-937-3718, Certified Application Assistant (CAA) Healthy Kids Hotline 1-888-452-5437 (English and Spanish)

For more information, you can also call or look up:

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