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Healthy Families
  Plans & Rates
Benefits and Costs
Income eligibility
Service Areas
   Enrollment
   Producer Resources
   Help Current Clients
Plan type by service area
Plan type by service area
Blue Shield offers two different Healthy Families plans, depending on where the member lives. Please refer to the list of service areas below to find out which plan your client is eligible for.
 
In some counties, Blue Shield offers an HMO plan.  In other counties, Blue Shield offers an EPO plan. The benefits are the same in both plans, and the difference is how your client gets care.
 
 Getting care in our HMO plan  Getting care in our EPO plan
Your client will pick a Primary Care Provider (also known as a PCP) who will see the child each time he or she needs care. This doctor coordinates the child's care, including locating a specialist when needed.    Your client's child can see any doctor in our Blue Shield Healthy Families EPO network, even in another county, each time the child needs care. 
 
 
 
HMO Service Areas
Los Angeles1, 3, Orange, San Francisco, Santa Barbara, Tulare, and Ventura counties.
 
HMO Service Areas available only in certain zip codes2
Nevada, Riverside3, San Bernardino3 counties.


EPO Service Areas
Calaveras, Del Norte, Fresno, Glenn, Humboldt, Imperial, Lake, Mendocino, San Benito3, Shasta3, Tehama, Tuolumne and Yuba3 counties.

Network news update
The Healthy Families Program's Open Enrollment period in 2011, is from July 15 to August 31. This is the only time that a member is able to change health plans for any reason.
 
Current Healthy Families members in other health plans can switch to Blue Shield during Open Enrollment, using the paperwork sent to them from the Program. Or, they can call the Program directly at (866) 848-9166 and switch over the phone.
1. Except Catalina Island
2. For a list of ZIP codes, refer to the Healthy Families Program handbook
3. These counties are currently not accepting new enrollments
Downloads
Summary of covered medical benefits (PDF, 467KB)
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