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    MomWontGiveUp's Avatar
    MomWontGiveUp Posts: 179, Reputation: 9
    Junior Member
     
    #1

    Feb 6, 2011, 08:02 PM
    Eligibility for Oregon Healthy Kids
    I'm not clear on the guidelines for eligibility for Oregon children (under age 19); specifically if they currently have group health coverage through one parent already and there has been no lapse in coverage.

    http://oregonhealthykids.net/eligible.htm

    I'm a non-custodial parent and am court ordered to provide health care coverage. However, I recently discovered that my ex has enrolled at least one of my children in this plan. There has never been a lapse in coverage.

    I understand that it's possible to have private or group insurance at the same time as the Oregon Plan but the private/group insurance would be billed first, then the State plan would pick up the co-pay.

    My ex falls under the No-cost category but I have my doubts that he provided complete information at the time of the application.

    If my kids have been continually covered under my plan, would they qualify for the State Plan too?
    cdad's Avatar
    cdad Posts: 12,700, Reputation: 1438
    Internet Research Expert
     
    #2

    Feb 6, 2011, 08:15 PM

    According to what the site says. It is lainly clear that the program is intended for children that have no other insurance.
    MomWontGiveUp's Avatar
    MomWontGiveUp Posts: 179, Reputation: 9
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    #3

    Feb 6, 2011, 08:36 PM
    Dad - that's how I read it also but when I phoned the State, I was told that it is possible to have two coverages. Scratching my head on that, given that the children are guaranteed coverage for 12 months after coverage is approved, that means (to me) that if the parent's situation changes and/or the children are able to get onto another plan, they can keep the State plan as a secondary plan.

    My kids have always had coverage. But there is a deductible to meet for anything non-preventive and my ex is liable for 50% of all out-of-pocket expense. One provider has been notified and will be reprocessing the last three bills so that they go through my insurance first.

    I provided the state with my policy information and will let them do with the information what they choose. I did not want this cropping up several years from now in the form of a lien on my property once the State figured out the kids had coverage all along.

    I'm just wondering how my ex got the kids signed up to begin with; that's IF he was completely truthful.
    OHKAssister's Avatar
    OHKAssister Posts: 1, Reputation: 2
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    #4

    Feb 14, 2011, 12:52 PM
    Dear MomWontGiveUp,

    I just ran across your posting about Healthy Kids. As one of hundreds of Healthy Kids' application assisters who help families apply throughout Oregon, I'd like to share some information that I hope may help. It is true that some children with private insurance may qualify for Healthy Kids based on family income. However, eligibility is determined based on the situation of each specific family.

    While it sounds like you have been in contact with the State with your questions, I would like to make sure you have direct information about Healthy Kids and thus encourage you to check out the Healthy Kids website at www.oregonhealthykids.gov; or to call their office at 1-877-314-5678. I also am available to answer questions and can be reached via [email protected] or at the Oregon School-Based Health Care Network at (503) 813-6480.


    MomWontGiveUp's Avatar
    MomWontGiveUp Posts: 179, Reputation: 9
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    #5

    Feb 14, 2011, 12:59 PM
    Comment on OHKAssister's post
    Thank you. I've been to the site, etc. I can't get specific info. On their application. It's unclear to me why they would qualify if I'm already providing coverage and it costs their dad (custodial parent) nothing. The DA's office seemed confused, as well. With a custody order, health insurance must be addressed. My ex hasn't worked for 6 years and is not ordered to provide coverage; only I am. There's a deductible and co-pay that must be met so maybe that's why he qualified to get them on the plan. BTW - I found out that it is NOT HealthyKids they're on; it's just the Oregon State Health Plan so probably an add-on to my ex's coverage. At any rate, still seems fishy how he added them without providing them with all the required information.

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