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Insurance Information for San Francisco Residents

 

Medi-Cal
Healthy Families
Healthy Kids and Young Adults
Child Health and Disability Prevention Program (CHDP)

Access for Infants and Mothers (AIM)


Medi-Cal

 

(Click here for Medi-Cal information - if that link does not work, try this link.)

Whom is it for?
Many low-income families and individuals. There are multiple eligibility categories for full-scope Medi-Cal, including those who qualify for CalWORKS and Supplemental Security Income (SSI).

Eligibility Criteria:
There are multiple elibility categories, including:

  • persons 65 years or older
  • persons who are under 21
  • certain adults between 21 and 65, if they have minor children living with them
  • persons who are blind or disabled
  • pregnant women
  • persons receiving nursing home care
  • qualified immigrants

Description
Medi-Cal is California's Medicaid program, which provides health care services for low-income families and individuals. A partial list of services covered include hospital inpatient and outpatient care, skilled nursing care, doctor visits, lab tests and X-rays, family planning, and regular and illness-related examinations, outpatient drugs, dental care, and occupational therapy.

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Healthy Families

(Click here for Healthy Families website)

Whom is it for?
Low-income children and families who have incomes above the eligiblity level for Medi-Cal but do not have incomes above 250% of the Federal Poverty Level. The program does not have an immigration status requirement.

Description:
The Healthy Families program provides low cost health, dental, and vision coverage for children up to age 19.
People who qualify for Healthy Families get 12 months of health coverage, as long as they pay the monthly premiums. There are different health plans for different areas of California.

Eligibility Criteria:

  • Children in families with incomes at or below 250% of Federal Poverty Level
  • The children must not qualify for no-cost Medi-Cal
  • The children must be:
    • U.S. citizens
    • U.S. non-citizen nationals
    • Qualified immigrants

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Healthy Kids and Young Adults

(Click here for official Healthy Kids and Young Adults website)

Who's it for?
Children and Young Adults (19-24), who do not fit under the category of Healthy Kids, MediCal, or Healthy Families.

Description:
The Healthy Kids and Young Adults program provides complete medical, dental, and vision coverage, including mental health services, prescription drugs, hospital care, family planning, substance abuse, and preventive care.

Enrollment premiums are $48 for a 12-month period.

Eligibility Criteria:

Children aged 0-18 who are:

  • SF Residents
  • Live with low-moderate income family
  • An undocumented or legal immigrant, or U.S. citizen

Young Adults 19-24:

  • SF Residents
  • Earning a low-moderate income
  • An undocumented or legal immigrant, U.S. citizen
  • Not eligible for MediCal

Young Parents 19-24 who are:

  • SF Residents
  • Parents of a child enrolled in a Medi-Cal, Healthy Families, or Healthy Kids & Young Adults
  • Not eligibile for MediCal
  • An undocumented or legal immigrant, U.S. citizen

Child Health and Disability Prevention Program (CHDP)

(Click here for the CHDP website)

Whom is it for?
Low income children and youth.

Description:
The CHDP program is a preventive health program that makes early health care available to children and youth. Eligible children and youth receive periodic preventive health assessments. Those with suspected problems are then referred for diagnosis and treatment.

Eligibilty Criteria:
CHDP provides periodic preventive health service to:

  • Children under age 21 with Medi-Cal
  • Non-Medi-Cal-eligible children and youth from birth to age 19 whose family income is equal to or less than 200% of the Federal Poverty Level. They are eligible for health assessments based on the same schedule as Medi-Cal eligible children and youth.
  • Children enrolled in Head Start and State Preschool programs

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Access for Infants and Mothers (AIM)

(Click here for the AIM website)

Whom is it for?
Low-income pregnant women and their children who have incomes above Medi-Cal levels. There is no immigration status requirement for the AIM program.

Description:
The AIM program provides low-cost health insurance coverage to uninsured, low-income pregnant women and their infants. It has been designed for families who don't have health insurance and whose income is too high to qualify for no-cost Medi-Cal. The average subscriber is a married woman, living in a household family with a family income between 200-300% of the Federal Poverty Level.

Eligibility Criteria:

  • You must be pregnant, but not more than 30 weeks pregnant, as of the application date
  • You must hae lived in California for the last 6 months
  • You cannot be receiving no-cost Medi-Cal or Medicare Part A and B benefits as of the application date
  • You cannot have maternity benefits through private insurance, unless your coverage has a deductible or co-payment specifically for maternity services that is more than $500 as of the app. date
  • You must have a monthly household income (after income deductions) within AIM income guidelines.
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Do NOT email the Community Health Network if you wish to inquire about ANY medical situation or problem. Instead, please call San Francisco General Hospital at 415-206-8000 


Any email question may not be read right away. For issues or questions other than medically related, you may email the Community Health Network