Healthy Kids covers all the health care kids need, including:

• Medical, dental and vision care

• Regular checkups and preventive care

• Prescription medicines and medical equipment

• Mental health and chemical dependency services

Coverage lasts for at least one full year and can be longer so long as the child is still eligible.

We believe every kid in Oregon should be a healthy kid and our goal is to make sure they have health coverage.

Depending on family income, children may be eligible for free or low-cost health coverage for doctor visits, dental care, vision, medicines and more through the Healthy Kids program.

Our site has information about Healthy Kids, including eligibility, services covered, and how to apply. There's also a place to find out how to help us spread the word and/or to partner with us to help families apply.

PLEASE NOTE: The no-cost option is available NOW. The low-cost and affordable options are available Jan. 1, 2010.

Three key things determine if your child qualifies for no-cost or low-cost coverage:

1. age; 2. residency; and 3. income

• Child must be under the age of 19 (19th birthday).
• Child must live in Oregon and be a legal resident.
• Your child must have been without health insurance for two months (though there are exceptions to this rule for special circumstances, like a parent’s job loss or a child’s serious medical need).
• For free or low-cost coverage, household income can’t be more than 300 percent of the federal poverty level, which is about $66,000 for a family of four. Income level depends on family size, so for smaller families, income is less. For larger families, income is more. For households with income greater than 300 percent of federal poverty level, there is an option for affordable option coming soon.

Q. How is Healthy Kids different from the Oregon Health Plan?

A. The Healthy Kids program expands on the success of the Oregon Health Plan by offering more health coverage options. It doesn’t replace it.

 

Q. What will Healthy Kids cost me?

A. Healthy Kids cost ranges from free to an affordable fee. If you qualify for the no-cost option, health coverage is free. If you qualify for the low-cost option, you’ll pay between 15-25 percent of the premium. If you do not qualify for no-cost or low-cost, you can still benefit from Healthy Kids’ affordable rates for health coverage.

Q. My kids qualify because I lost my job, but what happens when I get a new one?

A. Once your children are enrolled, coverage is for one full year even if your income goes up. Your children may still qualify for Healthy Kids even when your finances improve.

Information and text listed below from DHS and Oregon Healthy Kids website.

We believe every kid in Oregon should be a healthy kid and our goal is to make sure they have health coverage.

Depending on family income, children may be eligible for free or low-cost health coverage for doctor visits, dental care, vision, medicines and more through the Healthy Kids program.

Our site has information about Healthy Kids, including eligibility, services covered, and how to apply. There's also a place to find out how to help us spread the word and/or to partner with us to help families apply.

Healthy Kids is free or low-cost health care coverage for Oregon children who don’t have health insurance.

Even kids with current health conditions can enroll.

Coverage lasts for at least one full year and can be longer so long as the child is still eligible.

Healthy Kids is based on a family’s income and there are three health coverage options: no-cost, low-cost and affordable.

OHP Information for applicants

You will find eligibility and application information about the OHP programs that DHS provides, as well as links to other health resource information.

• Are you eligible?
• How to apply
• For more information
• Other resources

The Oregon Helps Web site can tell you whether your family might be able to get help from various state and federal assistance programs, including the Oregon Health Plan. This online calculator is only a general guideline.

If you have any questions about how to apply for the Oregon Health Plan, contact the OHP Application Center at 800-359-9517 or your local DHS branch office.

Q. What are the differences between FHIAP, OHP Standard and OHP Plus?

A. FHIAP (we pronounce it "fee-op") is a program that pays part of the premium charged to people enrolled in private health insurance. The Office of Private Health Partnerships (OPHP) administers this program. The amount FHIAP pays depends on the family income and number of family members. You can learn more by visiting the FHIAP Web site or by calling FHIAP at 1-888-564-9669.

OHP Standard and OHP Plus are Medicaid benefit packages DHS administers.

OHP Plus is a full benefit package provided to children and adults who are eligible for traditional Medicaid programs or for the Children's Health Insurance Program (CHIP). The OHP Plus benefit package does not have premiums. Some adults have small copayments for some outpatient services and prescription drugs.

OHP with Limited Drug offers the same benefits as OHP Plus, except it does not cover prescription drugs that Medicare Part D pays for. This package is for people who are eligible for both Medicaid and Medicare Part D (a national prescription drug plan). The OHP with Limited Drug benefit package does not have premiums. Some adults have small copayments for some outpatient services and prescription drugs.

OHP Standard is a limited benefit package provided under a specific medical program. The program covers only a limited number of uninsured adults who are not eligible for traditional Medicaid programs. Most people who get OHP Standard pay monthly premiums. OHP Standard does not have copayments.

Some members of your household may get the OHP Plus benefit package and some members may get the OHP Standard benefit package. The coverage letter you receive with your DHS Medical Care ID tells you who gets which benefit package.

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Q. What choice do I have in source of coverage?

A. You may apply for help to pay for private health insurance premiums through FHIAP. You may also apply for medical assistance (OHP Plus and Standard benefit packages) through DHS. However, you cannot get benefits from both programs at the same time.

If you are eligible for the OHP Plus benefit package and are found eligible for FHIAP, you will have to choose the program you want.

If you are eligible for the OHP Standard benefit package and are found eligible for FHIAP, you will not have a choice. Your OHP eligibility will end when the FHIAP payments begin.

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Q. Does access to employer-sponsored coverage affect my eligibility for OHP and FHIAP? If so, how?

A. It depends. If you are receiving the OHP Plus benefit package and have access to employer-sponsored health coverage, you can choose to remain on OHP and not apply for FHIAP. If you apply and are found eligible for FHIAP, you will have to choose what program you want. You cannot get benefits from both programs at the same time.

If you are receiving the OHP Standard benefit package and have access to employer-sponsored health coverage, you will be required to work with FHIAP. If you are found eligible for FHIAP, your OHP Standard benefits will end when the FHIAP payments begin as your employer coverage begins.

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Q. How do I apply for OHP and FHIAP?

A. To apply for OHP, you use DHS application forms. You can get them from our local DHS branches. You can also get them from our outreach sites and the OHP Application Center by calling 1-800-359-9517 or TTY 1-800-621-5260.

To apply for FHIAP, call the FHIAP program office to learn about the application process and get on a reservation list. The toll-free number is 1-888-564-9669. The Salem number is 503-373-1692. Or click here to go to the FHIAP Web site.

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Q. After I apply, when will I find out if I'm accepted?

A. If you applied for medical assistance from DHS, your DHS worker will let you know within 45 calendar days of getting a completed application. If DHS has to determine if you qualify for medical assistance based on a disability, it may take longer to make a decision. To ask about the status of your application, you can contact the office where you applied. If you applied for medical assistance by mailing in your application to the Oregon Health Plan branch, you can call toll free at 1-800-943-9249.

If you applied for help from FHIAP, your FHIAP worker will let you know if you are eligible within 30 calendar days of getting a completed application. To ask about the status of your FHIAP application, you can call 1-888-564-9669.

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Q. Who might be eligible for medical assistance under the OHP Standard benefit package?

A. When a person applies for medical assistance, his or her worker will evaluate that person's eligibility for the traditional Medicaid programs or the Children's Health Insurance Program, which provide the full OHP Plus benefit package. If he or she is not eligible for any of those programs, the worker may evaluate the person's eligibility for a program that provides a limited OHP benefit package. To be evaluated for OHP Standard, the program must be open to new applicants.

If the program is open to new applicants, the person may be eligible if the person is:

• An adult (19 years or older)
• Not getting Medicare
• An Oregon resident
• A U.S. citizen or a non-citizen who meets the immigration status requirement Currently without major health insurance coverage and has been without coverage for six months. The six-month waiting period is waived in some cases.
• Under the income limit set at the federal poverty level
• Under the resource limit set at $2,000
• Paid up on OHP premiums billed in the past 

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Q. Who might be eligible for the OHP with Limited Drug benefit package?

A.This package is for people who are eligible for both Medicaid and Medicare Part D (a national prescription drug plan).

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