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Shopping for 2013 Plans?

Call (888) 568-3560 to get a quote and apply for a 2013 plan.

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Individual, Family and Dental Plans:
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Health Plans for Children Under the Age of 19

Eligibility Requirements

If you only need health coverage for your child(ren) under the age of 19, Blue Shield offers 15 plans to choose from. An application -- as well as information on plan benefits, limitations and exclusions, and rates -- is available below.

Your child is eligible for coverage if he or she is under age 19, a California resident, and ineligible for Medicare.

In compliance with the Affordable Care Act as supplemented by California law, a child can enroll for individual coverage on a guaranteed-acceptance basis during his or her birth month. California law also establishes other special enrollment periods upon the occurrence of certain qualifying events:

  • Birth or adoption of a child
  • Loss of group coverage
  • Loss of an employer's contribution toward an employee or dependents' coverage
  • Loss of coverage because of a legal separation, divorce, or death of the person through whom the child was covered as a dependent
  • Loss of coverage under the Healthy Families Program, the Access for Infants and Mother’s Program, or the MediCal Program
  • The child becomes a California resident
  • Coverage is mandated by a state or federal court order

In order to qualify for coverage under one of the qualifying events, an application for coverage must be received within 63 days of the qualifying event.

You may also apply for coverage of your child outside of an open enrollment or special enrollment period on a guaranteed-issue basis; however, you may be subject to higher rates.

Effective Dates

The effective date of coverage is based on the date we receive your child’s completed application, the date we approve the application, and the type of coverage being requested. The effective date of coverage will always be at least 15 days following the receipt date of the application.

The effective date for PPO plans will be 15 days following the receipt date of the application. If it takes more than 15 days to medically underwrite the application, the effective date will be the day following the approval date.

Examples:
  • Coverage for an application received on October 9 and approved on October 11 will become effective October 24.
  • Coverage for an application received on October 1 and approved on October 20 will become effective October 21.

The effective date for HMO plans will be the first day of the month following approval, so long as that date is at least 15 days after the receipt date of the application. If the first day of the month following approval is less than 15 days from the receipt date of the application, the effective date will be the first day of the following month.

Examples:
  • Coverage for an application received on September 9 and approved on September 11 will become effective October 1.
  • Coverage for an application received on September 14 and approved on October 5 will become effective November 1.
  • Coverage for an application received on September 18 and approved on September 20 will become effective November 1.

Compare Coverage and Benefits

Plan Benefit Matrices (PDF, 2MB)

The Benefit Matrices provide a summary of plan benefits to help you compare coverage and benefit options. These are only summaries, and are subject to change.

Application

Download 3-Person Application (PDF 700KB) -- print, fill out, and return
Download 6-Person Application (PDF 940MB) -- print, fill out, and return

Applications can be faxed to (888) 386-3420 or mailed to:
Blue Shield of California
Installation & Membership
P.O. Box 3008
Lodi, CA 95241

Legal Information

Legal Disclosure (PDF, 1.3MB)

Rates

March 2013 Rates (PDF, 477KB)

Applicants under the age of 19 who apply for individual coverage during open enrollment or a special enrollment period will be offered a rate no higher than two times the published rate. Applicants under the age of 19 who apply for coverage outside of open enrollment or a special enrollment period may be offered a rate higher than two times the published rate.

In addition, if you apply for coverage of your child at any time other than during a special enrollment period, and your child did not maintain health coverage during the 90-day period prior to the signature date of the application, a 20% surcharge will apply for the first 12 months of coverage.