Charterhouse Center *CHAP*

5665 N. Pershing Ave., C-1

Stockton, CA 95207

Office (209) 476-1106

Fax (209) 476-8253

Email: info@charterhousecenter.org

Community Health Access Program (CHAP)

(formerly HIAK)

Certified Application Assistants (CAA) are available to assist uninsured individuals complete and submit applications for Medi-Cal, Healthy Families and Healthy Kids. Our CAA's have been specially trained to use the new One-E-App system. This exciting new web-based application system will streamline the process for submitting applications while providing a comprehensive tracking for each person applying for coverage.

Charterhouse Center is proud to be one of the agencies involved with the development and testing of the One-E-App system. After several months of rigorous testing, the system went live on March 5, 2007. The CHAP program will continue its efforts in enrolling uninsured residents of San Joaquin County while collaborating with all partnering agencies involved in this process.

CHAP will also continue in assisting with renewals for Medi-Cal, Healthy Families and Healthy Kids. Our CAAs can also assist in many of the required forms when updating or changing family information.

For assistance in completing an application, feel free to contact us at (209) 476-1106. Application assistance is limited to residence of San Joaquin County. If you are not sure which program you should apply for, our CAAs will assist in predetermining which program you are potentially eligible for.

HOW DO I QUALIFY?

Our CAAs will help you in determining which program you are potentially eligible for. The following table should be used as a guide only and does not guarantee eligibility. Final eligibility is determined by the insurance provider not by Charterhouse Center for Families or its staff. If your monthly income falls within these ranges based on your family size, you may be eligible.

Family Size	Child Age 0 to 1 or Pregnant Woman Medi-Cal	Child Age 0 to 1 Healthy Families	Child Age 1 thru 5 Medi-Cal	Child Age 1 thru 5 Healthy Families	Child Age 6 thru 18 Medi-Cal	Child Age 6 thru 18 Healthy Families
1	$0 - $1,734	$1,735 - $2,167	$0 - $1,153	$1,154 - $2,167	$0 - $867	$868 - $2,167
2	$0 - $2,334	$2,335 - $2,917	$0 - $1,552	$1,553 - $2,917	$0 - $1,167	$1,168 - $2,917
3	$0 - $2,934	$2,935 - $3,667	$0 - $1,951	$1,952 - $3,667	$0 - $1,467	$1,468 - $3,667
4	$0 - $3,534	$3,535 - $4,417	$0 - $2,350	$2,351 - $4,417	$0 - $1,767	$1,768 - $4,417
5	$0 - $4,134	$4,135 - $5,167	$0 - $2,749	$2,750 - $5,167	$0 - $2,067	$2,068 - $5,167
6	$0 - $4,734	$4,735 - $5,917	$0 - $3,148	$3,149 - $5,917	$0 - $2,367	$2,368 - $5,917
7	$0 - $5,334	$5,335 - $6,667	$0 - $3,547	$3,548 - $6,667	$0 - $2,667	$2,668 - $6,667
8	$0 - $5,934	$5,935 - $7,417	$0 - $3,946	$3,947 - $7,417	$0 - $2,967	$2,968 - $7,417
9	$0 - $6,534	$6,535 - $8,167	$0 - $4,345	$4,346 - $8,167	$0 - $3,267	$3,268 - $8,167
10	$0 - $7,134	$7,135 - $8,917	$0 - $4,744	$4,745 - $8,917	$0 - $3,567	$3,568 - $8,917
Add the following dollar amount for each additional family member:
	$600	$601 - $750	$399	$400 - $750	$300	$301 - $750

Some children may be eligible for the Healthy Kids program.

Call our CAAs today to make an appointment. Children between the ages of 6 and 18 who qualify for Healthy Kids will be placed on a waiting list.

(209) 476-1106

Bilingual Spanish assistance available.

CHAP is funded in part by:

Tracy Hospital Foundation

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A 501 (c) (3) Corporation