Children's Health Insurance Program (CHIP)

Healthy Steps - Frequently Asked Questions

• Who can be covered by Healthy Steps?
• How do I apply for Healthy Steps insurance coverage for my children?
• What services does Healthy Steps cover?
• What does Healthy Steps cost?
• I have a supplemental insurance policy that covers only major medical. Can I still apply for coverage for my kids?
• How soon after applying will I know if my child is eligible?
• Can I take my child in for a doctor’s appointment as soon as I receive the letter telling me my child qualifies?
• Are there any pre-existing condition rules in Healthy Steps?
• Under our divorce decree, my ex-spouse is supposed to cover my child’s health insurance, but that hasn't been done. Can I apply?
• If I send you my original pay stubs or tax forms, will you return them?
• Does Healthy Steps cover services in another state or in border towns?
• Is Indian Health Services considered to be health insurance?
• Is there a list of doctors to go to?
• Do I need to name a primary doctor?
• What is an asset and why is this on the application?
• What kinds of things are counted as income?
• Does a stepparent’s income count?
• How do you count seasonal employment?
• Once my child is enrolled in Healthy Steps insurance, do we need to reapply?
• Do you count my child's income if she has a job?
• What if I receive child support only four times a year, will that be counted?
• I am self-employed, and don't have three years worth of tax forms. What do I send?

Q. Who can be covered by Healthy Steps?

A. Children may be eligible for the children’s health insurance plan if:

• they are 18 years of age or younger,
• they are not eligible for or fully covered by Medicaid,
• they are not covered under other health insurance,
• they are U.S. citizens or qualified aliens,
• they are North Dakota residents, and
• their families meet the income guidelines

Q. How do I apply for Healthy Steps insurance coverage for my children?

A. Call our Toll Free phone number at 1-877-KIDSNOW (1-877-543-7669) to request an application by mail or for information. Healthy Steps brochures include a postage-paid reply postcard which can be used to send for an application. Applications are also available at most County Social Service Offices and on the ND State web site (pdf format).

[If individuals are using a computer, they can print out the application instead of calling our office or the county social service office].

Completed applications should be mailed to the Medical Services Division in Bismarck for processing. The mailing address is listed on the application. Face to face interviews are not necessary to apply for the children's health insurance plan.

Q. What services does Healthy Steps cover?

A. Clinic services, inpatient and outpatient hospitalization, prescriptions, mental health services, preventive well-child exams, immunizations, dental, and vision services are covered. For questions about coverage, please refer to the benefits handbook provided by Noridian Mutual Insurance, the Blue Cross Blue Shield Plan in North Dakota (BCBSND) or call their Toll Free number at (800) 342-4718.

Q. What does Healthy Steps cost?

A. There are no monthly premium costs to participating families. The only out-of-pocket costs are a $2 co-payment for each prescription, a $5 co-payment for each emergency room visit, and a $50 co-payment for each hospital admission. (NOTE: Because of the unique relationship between the Federal government and Tribal governments, Native American families will not be charged co-payments.)

Q. I have a supplemental insurance policy that covers only major medical. Can I still apply for coverage for my kids?

A. If you have a policy that covers only a specific service, like dental, vision, or cancer-only policies, you should apply.

Q. How soon after applying will I know if my child is eligible?

A. Applications are processed as quickly as possible, however, it may take one to two weeks. To speed up the processing time, parents should be sure to send in a completed application and to include copies of all household income verification.

Q. Can I take my child in for a doctor’s appointment as soon as I receive the letter telling me my child qualifies?

A. Not necessarily. It depends on the date the letter says your child's coverage begins. Under state law, Healthy Steps coverage begins on the first day of the next month after eligibility is determined. Please read the letter carefully.

Q. Are there any pre-existing condition rules in Healthy Steps?

A. No. Healthy Steps has no pre-existing condition rules. If a family meets the eligibility guidelines, a child's pre-existing medical condition does not exclude him or her from coverage.

Q. Under our divorce decree, my ex-spouse is supposed to cover my child’s health insurance, but that hasn't been done. Can I apply?

A. Yes. If your child does not have health insurance coverage, you can apply to cover the child.

Q. If I send you my original pay stubs or tax forms, will you return them?

A. Please send COPIES of your proof of income documents. The state's Medical Services Division will return originals if needed.

Q. Does Healthy Steps cover services in another state or in border towns?

A. Yes. However, you must have a referral (approved by BCBSND) from a Healthy Steps participating provider (Exception: emergency situation). Contact BCBSND if you have questions about coverage.

Q. Is Indian Health Services considered to be health insurance?

A. No. Indian Health Services is NOT health insurance.

Q. Is there a list of doctors to go to?

A. Yes. Once your child is determined eligible for Healthy Steps, BCBSND will mail you a list of participating providers that includes 99 percent of the physicians in North Dakota.

Q. Do I need to name a primary doctor?

A. No. You do not need to select a primary physician. However, you must seek services from a BCBSND participating provider.

Q. What is an asset and why is this on the application?

A. Assets can be checking or savings accounts, vehicles, campers, boats, snowmobiles, life insurance policies, land, a house, etc. Because there is no "asset test" for Healthy Steps insurance or Medicaid (children and family coverage group only), a family can own a house, two cars, and other assets and their children may still be eligible for Healthy Steps insurance or Medicaid. The question is included in the application because responses may help the state receive additional federal money for health care programs.

Q. What kinds of things are counted as income?

A. All income that a household receives must be reported as income (Examples: self-employment income or wages earned from an employer). Unearned income such as unemployment, child support and social security are all considered income. Verification of income should be submitted with the application. Families should send in copies of the previous month's paycheck stubs and report any expected income differences. If an individual does not receive paycheck stubs, Healthy Steps will accept a signed letter from an employer stating what the gross monthly salary and withholdings are.

Q. Does a stepparent’s income count?

A. A stepparent is not financially responsible for a stepchild, but he or she is responsible for his or her spouse. So, the income should be reported and verified.

Q. How do you count seasonal employment?

A. Healthy Steps looks at the previous month's income to determine eligibility. If anticipated income is different, a parent should indicate the difference. All income should be reported and verified.

Q. Once my child is enrolled in Healthy Steps insurance, do we need to reapply?

A. When a child is enrolled in Healthy Steps, the child is covered for a 12 month period, if he or she remains in the household and doesn't obtain other health coverage. Because the goal is to cover as many uninsured children as possible, families should report any changes in insurance coverage. Healthy Steps will contact each family by mail twice a year to verify that children are still living in the home and that they do not have other health coverage. Before the 12 month enrollment period ends, families will also be contacted about re-enrolling their children. NOTE: To keep health coverage in place, it is important for families to respond quickly to these three notifications.

Q. Do you count my child's income if she has a job?

A. If a child is attending school, his or her income is not counted. But families should still report all income in the household.

Q. What if I receive child support only four times a year, will that be counted?

A. To determine eligibility, Healthy Steps looks at family income from the month before they applied and the income a family expects to receive in the next month. Families need to report all income. If child support is only received four times a year, inform Healthy Steps when you last received it and what you anticipate receiving the next month.

Q. I am self-employed, and don't have three years worth of tax forms. What do I send?

A. Send Healthy Steps the income verification that you have. (Example: If you opened a daycare in your home six months ago, send a copy of the ledger showing income and expenses dating from the start of the business.)

For other questions about enrolling in Healthy Steps call 1-877-KIDSNOW (1-877-543-7669).

 

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