About Healthy Families

We are an authorized Enrollment Entity for the State of California Healthy Families and Medi-Cal for Children and Expectant Mothers, (EE - 89481) We are not a State agency.

About Healthy Family

The Healthy Families Program is a low cost insurance that provides health, dental and vision coverage to children who do not have insurance and do not qualify for no-cost Medi-Cal.

How will Healthy Families provide health care for my children?
Once you have been approved and your children are enrolled into The Healthy Families Program, you will choose a health, dental and vision insurance plan; these will provide medical doctors, dentists, specialists and eye doctors for your children. The plans will pay for most of your children’s visits cost. They have contracts with community-based clinics, laboratories, pharmacies and hospitals for your children’s continued health care.

Joining Healthy FamiliesTo join The Healthy Families Program, simply complete the Pre-Qualification Assessment below. A friendly and experienced Certified Application Assistant (CAA) will contact you within the next business day after the submission of your information or at a time that is convenient for you during regular business hours (M-F 8:00am-6:00pm). You may also contact us directly Toll-free at: 1-866-682-9903.

Pre-Qualification Assessment

* Required Fields

Parent's Personal Information

First Name *	Middle Initial	Last Name *

Applicant Date of Birth		Email Address

Contact Information

Please ensure that you are entering the correct phone number. We will contact you using this number.

Home Address 1 *
Home Address 2
Home City *
Home State *
Home five-digit Zip Code *

Please enter your 10 digit phone number in this format : (123) 456-7890

Preferred Phone *	Phone 2	Phone 3
( ) -	( ) -	( ) -
Preferred time to call

Children

Number of Children Under 19 *:

Family Information

Language preference	Family monthly gross income (before tax)	Family size *
		(including yourself and an unborn child, if you have a pregnant mother at home)
Comments/Notifications