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Optional Health Benefits in Healthy Families

The Healthy Families Program covers all medically necessary health, dental and vision services for children and teens. While enrolled in Healthy Families, your child's coverage includes medical services plus the optional, vision and dental services listed below:

Optional Health Benefits in Healthy Families
NOTE: Not all health insurance plans provide these benefits. Please refer to the Healthy Families handbook or go to http://www.healthyfamilies.ca.gov/ for information on which insurance plans cover these services.
NOTE: Benefits are provided if the insurance plan determines them to be medically necessary.
Healthy Families Benefits Services for Children Costs to Member (co-payment)
Category A

Costs to Member (co-payment)
Category B & C
Acupuncture
  • 20 visits per benefit year
  • $5 per visit
  • $10 per visit
Chiropractic
  • 20 visits per benefit year
  • $5 per visit
  • $10 per visit
Biofeedback
  • 8 visits per benefit year
  • $5 per visit
  • $10 per visit
Vision Benefits in the Healthy Families Program
NOTE: Benefits are provided if the insurance plan determines them to be medically necessary.
Healthy Families Vision Benefits Services for Children Costs to Member
(co-payment)
Category A 		Costs to Member
(co-payment)
Category B & C
Eye Examinations
  • Once every 12 months
  • $5 per examination
  • $10 per examination
Prescription Glasses
  • Once every 12 months
  • $5 per glasses, frames, or lenses
  • $10 per glasses, frames, or lenses
Dental Benefits in the Healthy Families Program
NOTE: Benefits are provided if the insurance plan determines them to be medically necessary.
Healthy Families Dental Benefits Services for Children Costs to Member (co-payment)
Category A 		Costs to Member
(co-payment)
Category B & C
Preventive Care (Teeth Cleanings, Topical Fluoride)
  • Every 6 months
  • No charge
  • No charge
Fillings
  • As needed
  • No charge
  • No charge
Sealants
  • As needed only for permanent 1st and 2nd molars
  • No charge
  • No charge
Diagnostic Services
  • X-rays (Bitewing, Full-mouth, and Panoramic)
  • Consultations
  • No charge
  • No charge
Major Services
  • Root canals
  • Oral surgery
  • Crowns and bridges
  • Dentures
  • $5
  • $5
  • $5
  • $5
  • $10
  • $10
  • $10
  • $10
Orthodontia Services
  • Provided to subscribers under the age of 19 through the California Children's Services program (CCS) when condition meets the CCS program criteria
  • No charge
  • No charge

Note: The Benefits charts on this Web site are only a summary of benefits provided by each health plan in the AIM and Healthy Families programs. These summaries are for information only. This is not a contract. For exact terms and conditions of the health care benefits, provisions, exclusions, and limitations for each plan, refer to the Evidence of Coverage booklet or Certificate of Insurance available from each health plan. Call the phone number listed on each health plan's description page in Plans and Providers.

See medical benefits in Healthy Families