Call 800-359-9517 to have an application packet mailed to you.
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Yes. If you are enrolled in Healthy KidsConnect and qualify for a subsidy (premium payment assistance) there is a limit. Your share of health care related costs will not be more than 5% of your annual income.
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Enrollment For Healthy KidsConnect:
Completed enrollment paperwork has to be received by 5 p.m. on the 23rd of the month, or the last business day prior to the 23rd of the month, to be processed for an effective date of the first of the following month. For example, completed enrollment paperwork received on April 23, 2010 would result in coverage being effective May 1, 2010. Please note: Coverage with HKC is not retroactive.
You will receive your insurance identification cards directly from the insurance company of your choice. This process may take a couple of weeks. If you don't receive your cards and need to schedule an appointment with your doctor, please feel free to contact the insurance company directly or contact a HKC Benefit Analyst at 888-260-4555.
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Your eligibility period is for one year. It begins on the date you are approved for health insurance coverage by the Department of Human Services. After you are approved, you will need to enroll in Healthy KidsConnect. This means your insurance coverage may not run for a full year, depending on when you enroll in Healthy KidsConnect.
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Your payment must be received and posted by the payment due date or the last business day of the month, which is approximately 30 days before the coverage begins. Please mail your premium payments to:
Healthy KidsConnect
P.O. Box 4463
Portland, OR 97208-4463
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Yes. A child covered by a school-related health program, like the Kaiser Child Health Program or basic athletic insurance, can still apply for Healthy KidsConnect. There is a two-month period of no insurance for the Healthy KidsConnect program. However, a child who is in one of these school-related health programs is seen as uninsured for the Healthy KidsConnect application and can still apply. There are some cases where the two-month period of no insurance is waived, so be sure to ask when you apply.
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No, Healthy KidsConnect is for uninsured children. Your child cannot have other health insurance coverage while enrolled in Healthy KidsConnect. If your child has any other health insurance, the child is no longer eligible. Exceptions to this are very rare, so contact us with questions.
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Once a member completes
eligibility with the Oregon Health Authority (OHA)/Department of Human Services
(DHS) and is determined eligible for HKC, are the members automatically
enrolled into HKC?
No. HKC must receive the referral from OHA/DHS before enrollment
documents are sent to the member.
The member must complete and return
enrollment documents and payment to HKC by the 23rd of the month or
the last business day prior to the 23rd of the month before HKC
coverage may start on the first of the following month.
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Yes, except the income levels differ. If your monthly gross
income is over the guidelines for Healthy Kids, you may qualify for a subsidy
with HKC
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No. HKC
provides comprehensive health care coverage that includes medical, dental,
vision, mental health and prescriptions.
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Yes. You will
be sent a 945 form from OHA/DHS. Eligibility must be redetermined by OHP staff,
even if you are on an HKC plan.
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Insurance
carriers are contracted with the HKC program. Members can choose an HKC insurance carrier if the carrier
serves the area where they live based on their zip code. The member is provided
the insurance carrier options in their Welcome Packet. The insurance carrier members may have
chosen on the original OHA/DHS application is not the same as the one that a
member will choose with HKC.
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No. HKC
coverage will not begin coverage as of the date of request (DOR).
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Can I have both HKC and OHP?
Yes, but only
during a brief transition, typically less than 30 days, when an HKC member is
changing to or from OHP.
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It could take
up to 72 hours for your payment to post to your HKC account. Payments must be posted to your account
by the last business day of each month.
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Yes, you can
pay your premium share with a debit or credit card by calling OHA/DHS Fiscal
Services at 855-255-4304.
**To avoid
potential late payments, you can set up automatic recurring payments by calling
855-255-4304. If your
monthly premium share changes, you will have to contact OHA/DHS Fiscal Services
to update your automatic recurring payments. It can take up to one month to set up recurring payments. You will receive a confirmation letter when the recurring payments are ready to begin.
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A. If there are no other HKC covered siblings on the case or there is a one-member pregnant teen, the family or parent must be pre-enrolled for HKC coverage.
1. Apply for medical services within 45 days before the scheduled delivery date;
2. Be determined eligible for HKC coverage.
3. Complete, sign and return required HKC enrollment paperwork by the 23rd or the last business day prior to the 23rd of the month prior to the delivery month.
4. Coverage of the pre-enrolled newborn will be effective the first of the month following enrollment or the date of birth, whichever is later.
B. If a child is born to a covered HKC member or a family in which there is a covered HKC sibling, the family or parent must:
1. Apply for medical services within 45 days before the scheduled delivery date.
2. Returns all enrollment paperwork within 31 days of the scheduled delivery date.
3. If the request to enroll in HKC is received beyond the scheduled delivery date, the coverage effective date will be the first of the month following the date of enrollment request.