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How much does Healthy Families cost?
Premiums
The monthly premium for
children is determined by income
category, which includes family
size, family income, and the
health plan you choose. You pay a
monthly premium between $4 and
$15 for each child, up to a
maximum of $45 for all children
in a family enrolled in the
Healthy Families Program.
Is there an additional cost
for my child to get these
services?
Yes. In addition to the monthly
premiums, you pay a co-payment
of $5 at the time of services for
children’s benefits. Some services
are free. No individual charge will
exceed $5 for children’s benefits.
The maximum co-payment
amount per benefit year that you
pay for health care services is
$250 per family. A benefit year is
from July 1 to June 30. Keep all
your receipts for the co-payments
you make at the time of receiving
health care services. Let your
health plan know if you reach the
maximum $250 for the benefit
year of coverage. Then you will
not have to make any more $5 co-payments
for health care services
until the next benefit year of
coverage.
How do I determine my
monthly premium?
To determine the monthly
insurance premium for the
children in your family, you must
first determine whether your
monthly income falls in category
A, B or C. You will need the
following information:
- Number of family members
living in the household.
- Net monthly income (gross
income minus deductions
allowed).
Deductions allowed
Deduct the following expenses from your gross monthly income:
- If you pay court-ordered child
support or alimony, deduct the
amount you pay from your
gross income.
- If you receive court-ordered
child support and/or alimony,
you can deduct up to $50 from
your family income.
- For each working parent,
deduct $90 for work-related
expenses. If your income is
less than $90 a month, deduct
only what you earned.
- For each person receiving
Temporary Workman’s
Compensation or State
Disability Insurance, deduct
$90. If you receive less than
$90 a month, deduct only the
amount received.
- Subtract the child day care
expenses you pay for each
child or the amount of disabled
dependent care paid. The
maximum deductible amounts
allowed for each child and
disabled dependent are:
- Child under the age of
2 = $200
- Child 2 years old and
over = $175
- Disabled dependent, any
age = $175
To determine net income
- Figure out your gross monthly
income. Add up the gross
amounts on your pay stubs.
If you are self-employed; call
1-800-880-5305 for help in
determining your premium.
- Add up your total monthly
deductions allowed by the
program.
- Subtract your deductions from
your gross income.
The difference is your monthly
net income.
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