Additional Questions

Details of You and Your Household


The Details of You and Your Household screen allows you to answer additional questions about members in the household. These questions apply to each individual on the application and may vary based on the information provided.


Click Household Member tabs to answer questions about each person on the application and click Next to continue.



Pregnancy Details (individual applicants applying for financial assistance)


Pregnancy Details identifies pregnant household members and collects details. This screen does not display female applicants of the household under the age of 10.


If a member of the household is pregnant, select Yes for “Is anyone in your household pregnant?” Then, check names of pregnant household members and answer questions about each.


If no member of the household is pregnant, select No and click Next to continue.



Health Care Coverage and Benefits Information (applicants applying for financial assistance)


If anyone in the household has health care coverage that is not Medicaid (Oregon Health Plan (OHP)) or Children’s Health Insurance Program (CHIP), you must provide additional information about the policyholder and coverage on the HealthCare Coverage and Benefits Information screen. You may find the required information on the applicable household member’s insurance card or by contacting the insurance company.


To identify household members with health care coverage, select Yes in answer to the question, “Does anyone in your household currently have health care coverage, including dental coverage that is not OHP or CHIP?” Click the Add Plan link to report any additional coverage.


If there are no household members with current health care coverage, select No and click Next to continue.



Loss of Medical Coverage


In addition to health care coverage currently held by household members, identify any household member who has recently lost medical coverage and provides details. List the information on the Loss of Medical Coverage screen.


To report a household member who has lost coverage in the last 90 days, select Yes to, “Has anyone in your household lost coverage in the last 90 days?” Then, check the appropriate members, and answer questions displayed.


If there are no household members who have lost coverage in the last 90 days, select No and click Next to continue.



Non-Custodial Parent Information


In Household Relationships, there is a Non-Custodial Parent screen to list information about an absent parent.


Enter contact details for each non-custodial parent in fields provided. If contact details about the non-custodial parent are not known, check the box next to the statement, “If unknown, please check here.”


Before you can exit the Non-Custodial Parent Information screen, you must acknowledge the Cooperation with Medical Support statement. This statement requests your consent to assign Division of Child Support (DCS) rights to enforce medical support from the child’s absent parent. It also provides consent to help DCS find the absent parent, unless you specify a good reason not to do so.


You can choose or refuse to cooperate with medical support by selecting Yes or No from the first drop-down menu. If you select No, you can select a reason for not cooperating from the second drop-down menu and provide comments in the text box.


Upon completing the Non-Custodial Parent screen, click Next to continue.



Medical Expenses


The Medical Expenses screen identifies any medical expenses that household members had in the past three months. Expenses may be eligible for retroactive payment, if the household member is OHP (Medicaid) eligible.


To identify household members that have had medical expenses, select Yes to, “Does anyone in your household have any medical bills from the last three months that he/she needs help paying?” Then check the applicable household members and any month a health provider saw them.


If there are no medical expenses to report, select No and click Next to continue.



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