Recently I was contacted by Oregon Health Action Campaign, an organization providing outreach and assistance to the Healthy Kids program, wanting to share with Frugal Living NW readers about the State of Oregon’s new no-cost and low-cost health insurance option for uninsured children. I know that many of you are struggling financially and may really benefit from information on how to get free or affordable health insurance for your kids.
I asked the Oregon Health Action Campaign the following questions that their Healthy Kids Coordinator answered:
What is Healthy Kids ? Is this the same as the Oregon Health Plan?
The no-cost option builds on the success of the Oregon Health Plan for families who earn up to $44,900 annually. The low-cost and full-cost options are available through a public/private partnership between the State of Oregon and the Office of Private Health Partnerships.
What types of things are covered (medical, vision, dental, etc)?
Healthy Kids covers all the care kids need including regular check-ups, dental, vision, mental and behavioral health care and more.
How is Healthy Kids funded?
Funding for the Healthy Kids expansion comes from a one percent premium on insurance companies and from matching federal funding for children’s health
Who can qualify for Healthy Kids?
Eligibility is based on age, residency and income. The child must be under the age of 19, live in Oregon and be a legal resident.
No family makes too much for Healthy Kids. Family income will determine whether the child qualifies for the no-cost or low-cost option. Healthy Kids has options for families at every income level; even middle-income families can qualify for the low-cost option. For example, a family of four earning as much as $67,200 annually may still qualify for the low-cost option.
How does a family apply for Healthy Kids?
Families can apply online (www.OregonHealthyKids.gov), call the Healthy Kids hotline (1-877-314-5678), find assistance by contacting us at Oregon Health Action Campaign – Helpline@ohac.org or by connecting with one of Healthy Kids’ many community partners across the state (a list of partners can be found on the Healthy Kids website). They may also pick up an application at any DHS office.
If your kids are already insured (say through individual coverage with minimal coverage/high deductibles), can they get on Healthy Kids? If so, how?
Although there are exceptions, in order to be eligible for the Healthy Kids program, the child must be without health insurance for two months prior to the date you apply. The Healthy Kids program was created for children and teens that do not have health coverage. Exceptions to this requirement include:
- Having a condition that could be life threatening or cause permanent loss of function or disability if not treated
- Loss of insurance due to a family member’s loss of employment or reduction in work hours
- Family is on or eligible for COBRA
- Child or family member is a victim of domestic violence
- If the child or family is currently receiving reimbursements from the state to help pay for their health insurance
However, any family interested in Healthy Kids should still apply. Their eligibility will be determined by eligibility workers and there is no harm in applying for Healthy Kids coverage.
Does Healthy Kids cover pregnant women as well?
If the pregnant woman is under the age of 19, Healthy Kids can cover her. If she is over the age of 19, Healthy Kids does not provide any health coverage for the unborn child or mother but many women can be helped with the assistance of programs like Oregon Mother Care.
OHAC can assist pregnant women through our Helpline services to discover what programs may be able to assist them. (Helpline@OHAC.org)
It is very important to note that an unborn child can be covered under Healthy Kids after delivery and the mother (regardless of her age) should apply before giving birth.
Can we stay with our current family doctor/pediatrician with Healthy Kids?
The answer to this question will be based on which coverage option the child gets enrolled in (no-cost, low-cost or full-cost). Please visit the following links to find out more information.
- No-cost option Oregon Health Plan Handbook
- Low-cost option Healthy KidsConnect Handbooks
- Full-cost option Healthy KidsConnect Handbooks
It looks like we qualify. What do we do next? Is there someone available to help us through the process of applying?
There are multiple organizations around the state that can help families apply. Our organization is the Oregon Health Action Campaign. We provide services in both English, Russian and Spanish. To contact us, please send an e-mail to Helpline@ohac.org or call our Helpline phone @ 503.485.6487 or 866.458.4457.
For an additional list of assistance organizations, please visit the Healthy Kids website: www.oregonhealthykids.gov And be sure to check Healthy Kids out here on Facebook too!
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