Children are eligible if they:

1. Live in Santa Cruz County
2. Are under 19 years of age
3. Have not been covered by employer paid insurance in the last 3 months
4. Have a family income of no more than 300% of the federal poverty level

What You Will Need to Enroll:

Proof of Income

1. Copy of most recent pay stub, covering one month of gross income dated within 45 days of application
2. Signed letter from employer with gross amount and time period it covers
3. Employer statement of gross monthly income and the time period it covers
4. Copy of last year's tax return
5. Self-employed persons can include last year's federal income tax return. Including schedule C or use three month's three month net profit and loss statement
6. Explanation of cash aid benefits

Proof of Age

1. Birth Certificate

Proof of Santa Cruz County Residency

1. Utility bill to child/applicant/household member at child's address dated within the last 45 days
2. Rent receipt for child/applicant/household member at child's address dated within the last 45 days
3. Official(non-personal) postmarked mail to child/applicant/household member
4. Pay stub or copy of pay stub with applicant's address printed on it
5. Letter from a shelter
6. Signed letter from landlord or person providing housing for applicant. The letter must be accompanied by postmarked mail/bill addressed to the person who has written he letter

Proof of Deductions - Child Care, Alimony and Child Support

1. Signed letter from recipient of payment dated within the last 45 days
2. Document showing the amount of child support paid, self reported or court ordered
3. Other reliable documentation consistent with Healthy Families guidelines

Proof of Citizenship or Legal Residence

Social Security card required only for US Citizens and Legal Residents (optional)

Family Size and Monthly Family Income Eligibility:

Families that are eligible for enrollment must meet the Monthly family Income eligibility, shown below. To determine if your family is eligible, ensure that your family's total monthly income is less than or equal to the listed Monthly Family Income value below, based on your family's size.

For example, a family of 3 (Mother, Father, and 1 child), must have a total family income less than or equal to $4,578.

Family Size	Monthly Family Income
1	$0 - $2,709
2	$0 - $3,645
3	$0 - $4,578
4	$0 - $5,514
5	$0 - $6,450
6	$0 - $7,383
7	$0 - $8,319
8	$0 - $9,255

For more Information

If you want more information on eligibility or how to enroll in Healthy Kids, Healthy Families or Medi-Cal, please call (831) 763-8568 or (831) 454-2515 or call or visit one of our Enrollment Assistance Locations below.

If you want to contact the Healthy Kids Health Plan administrator, please visit Central California Alliance for Health

If you have questions or need further information about the Healthy Kids program and our coalition, please contact us