Healthy Families Health Insurance California: Children Health Insurance

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.


Healthy Families Health Insurance in California

Children's Health Insurance in California

Healthy Families is a State of California sponsored low cost insurance for children, teens and pregnant mothers. We are an authorized Enrollment Entity for the State of California Healthy Families and Medi-Cal for Children and Expectant Mothers, (EE- 89481)

The enrollment services for the California Healthy Families Program are completely free of charge. You will be able to discuss your application on the phone with a State Certified Application Assistor who is knowledgeable about the Healthy Families Program and its application requirements. We will call at a time that is convenient for you and will be able to help you in completing the application correctly. Please complete the short Pre-Qualification Assessment below to allow us to have the necessary information to contact you. We will call you after receiving your Pre-Qualification Assessment.

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