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Healthy Steps - North Dakota's Children's Health Insurance Program
2010

Healthy Steps is a health insurance program for North Dakota children who do not have health insurance coverage, are 18 years of age or younger, do not qualify or are not fully covered by the North Dakota Medicaid Program, and live in low-income families. 


  1. What is Healthy Steps and who is eligible?
  2. Do I have to go in person to apply?
  3. Does a stepparent’s income count?
  4. Are there any rules about pre-existing conditions in Healthy Steps?
  5. Does it matter how long my child has lived in North Dakota?
  6. Does my child have to be a U.S. citizen to get Healthy Steps?
  7. How do I get an application for Healthy Steps?
  8. How does Healthy Steps work?
  9. How often do I need to renew coverage for Healthy Steps?
  10. How soon will my child be able to get on the program?
  11. Is there a list of doctors to go to?
  12. What are assets and why are they asked about on the application?
  13. What do I have to do to have my child stay on the program?
  14. What does Healthy Steps cost? Are there co-payments?
  15. What is the application like?
  16. What kinds of things are counted as income?
  17. What services does Healthy Steps cover?
  18. Where do I send my Healthy Steps application?
  19. Will Healthy Steps pay medical bills for services before my child got on Healthy Steps?

1. What is Healthy Steps and who is eligible?
Healthy Steps is a health insurance program for North Dakota children who do not have health insurance coverage, are 18 years of age or younger, do not qualify or are not fully covered by the North Dakota Medicaid Program, and live in low-income families.  Indian Health Services is NOT health insurance.  If you have a medical insurance policy that only covers a specific service, like dental, vision, or cancer-only policies, you should apply.

2. Do I have to go in person to apply?
No. Completed applications can be mailed to the North Dakota Department of Human Services in Bismarck or your county social service office for processing. Face to face interviews are not necessary to apply for the children's health insurance plan. You will have to provide copies of “documents of proof” that show your income (such as pay stubs or tax returns). You can complete the application yourself or you can get help filling it out from a county social services worker. Be sure to send COPIES of your proof of income documents.

3. Does a stepparent’s income count?
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.

4. Are there any rules about pre-existing conditions in Healthy Steps?
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.

5. Does it matter how long my child has lived in North Dakota?
It doesn’t matter how long your child has lived in this state.

6. Does my child have to be a U.S. citizen to get Healthy Steps?
No, but you need a Social Security Number for each child for whom you are applying to get Healthy Steps.  A child must be a US citizen or an alien who is lawfully admitted for permanent residence.  Non US citizens need proof of the lawful status of each child for whom you are requesting assistance (such as a resident alien card or a temporary resident card).

7. How do I get an application for Healthy Steps?
You can get one at your county social services office or by calling 1-877-KIDS-NOW (1-877-543-7669). Healthy Steps brochures include a postage-paid reply postcard which can be used to send for an application. Applications are also available at county social service offices  and on the North Dakota State website.
You may complete an online application which will be electronically sent to your county social service office, who will determine your qualification for programs. 

8. How does Healthy Steps work?
You will get three (3) Health Care cards for each child who is eligible for the program.  One card will be used for physical health care, one card will apply to dental care, and the third card is for vision care. You should bring all cards with you when you go to the doctor, pharmacy or get any health service.

9. How often do I need to renew coverage for Healthy Steps?
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.

10. How soon will my child be able to get on the program?
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.  Under state law, Healthy Steps coverage begins on the first day of the next month after eligibility is determined. Please read the letter you receive carefully.

11. Is there a list of doctors to go to?
Yes. Once your child is determined eligible for Healthy Steps, Blue Cross/Blue Shield of North Dakota will mail you a Benefits Book that contains a list of participating providers (which includes 99 percent of the physicians in North Dakota) and a list of services available through Healthy Steps.

12. What are assets and why are they asked about on the application?
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.

13. What do I have to do to have my child stay on the program?
You must tell the Healthy Steps office about any changes in your household within 30 days of them happening. Things you must report include births, deaths, moving out of state, people moving in or out of your household, and receipt of any other health insurance coverage.

14. What does Healthy Steps cost? Are there co-payments?
There are no monthly premium costs to participating families. Families may be responsible for modest co-payments for some services.  The only out-of-pocket costs are for, emergency room visits ($5 per visit), hospitalizations ($50 per hospitalization), and prescriptions ($2 per prescription).  Due to the unique relationship that exists between the federal government and tribal governments, the co-payment requirement has been waived for American Indian children.

15. What is the application like?
There are two application forms. You can use either form to apply for Healthy Steps.  One form is the “Application for Health Care Coverage.” It is 8 pages long and will ask you about everyone who lives with you, how much money they make, and your household expenses.

The second application is the “Application for Assistance” and is about 17 pages long. It will enable you also to be screened for eligibility for Child Care Assistance and the Supplemental Nutrition Assistance Program (SNAP – formerly Food Stamps). It also will ask you about everyone who lives with you, how much money they make, and your household expenses. If you want, you can use this same application to apply for cash assistance (TANF). 

You may submit an Application for Assistance to your county social services office or complete an online application which will be electronically sent to your county social service office, who will determine your qualification for programs.

16. What kinds of things are counted as income?
 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.

17. What services does Healthy Steps cover?
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.

18. Where do I send my Healthy Steps application?
If you are mailing your completed Healthy Steps application, you can send it to the Healthy Steps Office at:

Healthy Steps Program
North Dakota Department of Human Services
600 East Boulevard Avenue Dept 325
Bismarck, ND 58505-0250
FAX: 701-328-2085

The Healthy Steps Office is open Monday through Friday from 8:30 to 4:30.  You may also call this office with questions: 1-877-KIDS-NOW (1-877-543-7669).

You also have the option to mail your application to your county social service office or you may complete an online application which will be electronically sent to your county social service office, who will determine your qualification for programs.


19. Will Healthy Steps pay medical bills for services before my child got on Healthy Steps?
No. It will not pay for any past medical bills.