Healthy Kids: For a healthy Oregon

Answers

I just applied for Healthy Kids. Who will contact me and when?

The Oregon Health Authority (OHA) processes the applications and should contact you within 45 days from the date you requested and/or submitted your application.

If you do not receive anything after 45 days, please call the OHP Statewide Processing Center at 1.800.699.9075 to inquire about the status of your application.

My children are now enrolled in Healthy Kids. Who do I contact if I have questions about what services are covered or how to find a doctor?
 

  • No-cost option OHP Client Services at 1.800.273.0557
  • Low-cost option KidsConnect at 1.888.260.4555
  • Full-cost option KidsConnect at 1.888.260.4555

Which medical providers are under the Healthy Kids plan and what benefits are included?

All children enrolled in the plan will have a health coverage card and will gain access to services from the provider network on the plan for which they are enrolled. The benefit books that list providers and benefits are included below.

Do I have to be unemployed for my children to get Healthy Kids?

No. Eligibility is based on age, residency and income. The child or teen must be under the age of 19, live in Oregon and be a legal resident. Family income will determine if a child qualifies for the no-cost, low-cost or full-cost option. Please note that the program is for uninsured children although there are exceptions.

What if my family income is too high?

No family earns too much for Healthy Kids. If your family does not qualify for the no-cost or low-cost programs, you can purchase Healthy Kids coverage at full-cost.

How long does coverage last and can I reapply?

Coverage lasts for one full year. You should receive a letter in the mail letting you know that your coverage will be ending and that you should update certain information on your application in order to reapply. If you have not received a letter please call 1-877-314-5678.

What happens when my child turns 19?

Before your child's 19th birthday, have your child fill out an OHP Standard Application. Have them note on the application that they are currently on the Healthy Kids program and would like to continue receiving coverage as an adult. Your child should not be put on the OHP waiting list.

OHP Standard website

My organization would like to partner with Healthy Kids to help enroll children into Healthy Kids. How can we help?

Please visit our Partners Page to find out more about helping families apply for Healthy Kids!

Is this the Oregon Health Plan?

Healthy Kids is a new program which offers more health coverage options to children and teens. The no-cost option builds on the success and expansion of the Oregon Health Plan for families who earn up to $46,300 annually. Due to the expansion, no child can be put on a waiting list or be turned away due to pre-existing conditions.

What is the difference between OHP Standard and Healthy Kids?

Oregon Health Plan Standard is for very low-income adults 19 or older while Healthy Kids covers children and teens under the age of 19.

To be eligible for OHP Standard, adults must have been without insurance for six months and earn less than $22,050 a year for a family of four (below 100 percent of the Federal Poverty Level). The OHP Standard program does require interested adults to put their name on a reservation list, which can be found here.

What if I’m pregnant?

Pregnant women who are eligible for the Oregon Health Plan (women who make no more than $20,000 per year as an individual and up to $40,000 as a family of four) may be eligible for coverage that extends through their pregnancy and the following 2 months after birth. Their expected child may also be eligible for automatic coverage beginning at birth.

You can apply for yourself and your expected child in the same way: by filling out the Oregon Health Plan and Healthy Kids application. When you apply, be sure to mark on the application that you are pregnant (Question 3) and send a copy of a letter from a doctor or clinic saying that you are pregnant.

If you know that you don't qualify for Oregon Health Plan coverage for yourself, and would be applying for your expected child only:
Applications for expected newborns should not be submitted more than 45 days before the expected due date. Apply within 45 days of the due date, and then let us know as soon as possible when your child is born. If you have a case worker, please call them, otherwise call 1-800-699-9075.

Oregon MothersCare
If possible, we suggest that you work with an Oregon MothersCare (OMC) staff member so that your application is processed quickly. OMC also offers free pregnancy testing and can help provide you with proof of pregnancy you need for the application. To find the OMC site nearest you, visit the Oregon MothersCare website or call 211 Info (dial 2-1-1) and ask to be connected with your local OMC site.

Please Note: You can ALWAYS re-apply at any time.

You may want to re-apply right away if:

  • Your income has gone down since your last application
  • Your due date has changed
  • Your child was born early
  • The number of people in your household has changed
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