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What is the Healthy Kids program?
The Healthy Kids Health Plan is a new locally developed and funded plan that will provide comprehensive health coverage for children of low and middle income families in San Luis Obispo County. Children who do not qualify for the state sponsored programs (Medi-Cal or the Healthy Families program), meet income guidelines and are county residents are eligible for Healthy Kids.
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| 2. |
What does the Healthy Kids plan cover?
The Healthy Kids program provides comprehensive health, dental, vision and mental health services.
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Who is eligible for Healthy Kids?
All children are eligible for Healthy Kids if they are:
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Under the age of 19 |
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Residents of San Luis Obispo County |
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Living in families with incomes below 300 percent of the Federal Poverty Level (for example, $58,080 for a family of four) |
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Not insured through their families’ employer-sponsored insurance within the last three months |
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Not eligible for Medi-Cal or the Healthy Families program. |
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How do families enroll their children?
Only one application is required to determine eligibility and enrollment for all three programs. The Children’s Health Initiative of San Luis Obispo County has partnered with the Department of Social Services [link] to help families enroll their children. Applications [link] and release forms [link] are available to families through out the county at clinics, community centers, schools and medical offices.
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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 300% of the federal poverty level - ($58,080 for a family of four). 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.
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How much will families have to pay?
Families will pay a share of costs, depending on their income level. Premiums range from no-cost premiums to $15 per child per month. The maximum that any one family would pay per month would be $45. There will be $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.
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Will children be linked to a Primary Care Physician?
Healthy Kids program members have an option to choose their Primary Care Physician, or the Santa Barbara Regional Health Authority will assign one to them.
A primary care physician provides the medical home for our Healthy Kids members. A medical home is the place where a child’s medical history is kept to provide continuity of care as children grow. The primary care physician becomes a trusted and familiar face to ask questions about your child’s care, to receive routine preventative care, and to take your child to when they are sick. Primary care physicians monitor the child’s overall development and well-being and is an integral part of maintaining a child’s good health.
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How many children will be enrolled in Healthy Kids?
Healthy Kids will provide health coverage to more than one thousand of the county’s children. In addition, the Children’s Health Initiative of San Luis Obispo County will educate parents through an extensive outreach program to identify and enroll the two thousand children who currently are uninsured and yet are eligible for state sponsored Medi-Cal and the Healthy Families insurance programs.
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Who administers Healthy Kids?
Healthy Kids is administered by the Children’s Health Initiative of San Luis Obispo County (CHISLO), a local non-profit established for the purpose of ensuring that all children in San Luis Obispo County have access to quality health care. CHISLO has contracted with three health plans to provide Healthy Kids coverage. The Santa Barbara Regional Health Authority will provide medical coverage. Delta Dental will provide dental coverage. SafeGuard Insurance will provide vision coverage.
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How much does the Healthy Kids program cost, and where does the funding come from?
The Healthy Kids program costs $1.3 million for premiums, outreach, enrollment and administration per year. Funding for the Healthy Kids Program comes for a combination of public and private sources. First 5 San Luis Obispo County, San Luis Obispo County Board of Supervisors, San Luis Obispo County Community Foundation, United Way of San Luis Obispo County, California HealthCare Foundation, The California Endowment and Blue Shield Foundation have made generous commitments.
Healthy Kids Insurance is publicly and privately funded. Together we can solve our local health care crisis. Join us!
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What is the difference between Children’s Health Initiative of San Luis Obispo County and the SLO Healthy Kids Health Plan?
More than ninety community organizations and partners have formed the Children’s Health Initiative of San Luis Obispo County to address the unique health care needs of all the children in our community. Our goal is to get children enrolled in existing health plans like Medi-Cal and Healthy Families in addition to the newly created SLO Healthy Kids Health Plan. The Healthy Kids plan is the new insurance product created to expand coverage beyond the state programs.
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Are there other Healthy Kids programs?
Yes, San Luis Obispo County is the 10th county in California to launch a Healthy Kids program. Santa Clara County was the first county in the nation to start this program. Other counties such as San Mateo, Santa Cruz, San Francisco, San Joaquin, Alameda and Los Angeles all have established programs. In addition, there are more than 21 other counties in the State in the process of planning a Healthy Kids program.
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