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Children's Health Insurance Program (CHIP)

Healthy Steps - Frequently Asked Questions

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

A. You can apply for coverage in one of three ways:

Face-to-face interviews are not necessary to apply for Healthy Steps.

Q. What services does Healthy Steps cover?

A. The program covers:

  • Inpatient hospital, medical, and surgical services
  • Outpatient hospital and clinic services
  • Prescriptions
  • Mental health services
  • Preventive well-child exams
  • Vaccines
  • Dental and vision services

For questions about health and vision coverage, refer to the Blue Cross Blue Shield of North Dakota benefits handbook or call the number on the back of your card.

For dental services, refer to the Delta Dental of Minnesota benefits handbook or call the number on the back of your card.

Q. What does Healthy Steps cost?

A. There are no monthly premium costs to participating families. The only out-of-pocket costs are:

  • $2 co-payment for each generic prescription
  • $4 for a preferred-brand prescription
  • $8 for a non-preferred-brand prescription
  • $5 co-payment for each emergency room visit
  • $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 health insurance policy that only covers medical. Can I still apply for coverage?

A. No. You are not eligible for Healthy Steps if you already have a health insurance policy. If you only have a policy that covers specific services like dental, vision, or cancer-only policies, you should apply.

Q. How soon after applying will I know if my child qualifies for Healthy Steps?

A. Applications are processed as quickly as possible, however, it may take up to 45 days to process. To speed up the processing time, parents should be sure to send in a completed application and to include copies of all household verification.

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

A. No. 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. 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. Staff will return originals if needed.

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

A. Yes. However, you must have a referral from a Healthy Steps participating provider (Exception: emergency situation). Contact the number on the back of your card 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, a list of participating providers will be mailed, or you can call the number on the back of your card.

Q. Do I need to name a primary doctor?

A. No. You do not need to select a primary doctor. However, you must seek services from a Blue Cross Blue Shield of North Dakota participating provider.

Q. What kinds of things are counted as income?

A. Healthy Steps looks at taxable income minus a few deductions. 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 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 person 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 step-parent’s income count?

A. If a step-parent lives with a child, the step-parent’s income will count for the child. So, the 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.

 

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