Samaritan Healthy KidsConnect

Important information for
Samaritan Healthy KidsConnect members

Effective January 1, 2014, Samaritan Health Plan Operations will no longer be administering health benefits through the Oregon Healthy Kids Program. This program is being disbanded in the state of Oregon. Current Healthy KidsConnect members will not lose coverage. Beginning September, 2013, eligible members will be enrolled onto the Oregon Health Plan instead of any Healthy KidsConnect Plan in Oregon. 

Samaritan Health Plan Operations will handle claims payment for dates of service through December 31, 2013. For questions about appeals, benefits or claims for services with dates prior to January 1, 2014, please contact our Customer Services.

For questions regarding enrollment or eligibility, please call Oregon Healthy Kids at 1-877-314-5678. 
 

Your benefits

Your member materials are important documents that describe your health insurance benefits in detail. Your member materials include:
Member handbook - your benefit plan description that includes covered services, exclusions and limitations.
Summary of benefits - this is a summary of your cost sharing for covered services on the 300% and above plan and the subsidized plan.

P R I O R   A U T H O R I Z A T I O N
Coverage of certain medical services and surgical procedures requires written authorization from Samaritan Health Plans before the services are performed.
2012 Prior Authorization List

Privacy Notice

Your network providers

Samaritan Healthy KidsConnect has an extensive provider network for your needs. Please note that provider information may change at any time. We recommend that you confirm your provider's network status and level of coverage PRIOR TO SEEKING SERVICE. Call Samaritan Health Plans Customer Service, Monday through Friday, 8 a.m. to 5 p.m.:

  • 1-800-832-4580
  • Corvallis (541) 768-4550

PCP provider directory - a list of contracted PCP's to choose from to receive treatment and services

Specialist provider directory - a list of contracted specialists to choose from to receive treatment and services


Your pharmacies and covered drugs

P H A R M A C I E S
Samaritan Healthy KidsConnect has a national network of contracted pharmacies.  Most major chain pharmacies and many independently-owned pharmacies are contracted with us and can fill prescriptions for you. To find out about a specific pharmacy please contact Customer Service for help.

F O R M U L A R Y
Your Samaritan Healthy KidsConnect Formulary contains a listing of covered drugs, prior authorization requirements and any drug quantity limits. This formulary does not contain the names of all medications available in the market. If your medication is not listed, please contact Customer Service for assistance.
2011 Formulary


Notifications

Letter from the CEO, Kelley Kaiser 

Notice of Privacy Practices and Member Rights and Responsibilities:  This notification informs you of your Health Insurance Portability and Accountability Act (HIPAA) rights, Appeal Rights and your rights and responsibilities as a member of Samaritan Healthy KidsConnect.

Your member forms

Primary Care Provider (PCP) Change Card: Choose or change a PCP.

Prior Authorization-Referral Form: Request an authorization for Medical services.

Appeals Request Form: Request a medical appeal with SHK.

Medication Exception & Authorization Form: Request medically necessary medications that are not normally covered on SHK’s formulary and for medications that require prior authorization.

Member Reimbursement Form:  Request reimbursement for covered services that you have received and paid for out of your pocket.

Prescription Reimbursement Form:  Request reimbursement for covered medications that you have received and paid for out of your pocket.

Prescription Mail Order Form
Use this form when you have a written prescription that you are mailing to Samaritan Health Services.

Request for Health Plan Records Form: This form is required to be completed when  you are requesting any Health Plan documentation from us.

Send us an email

Call us:
(541) 768-4550
1-800-832-4580
TTY 1-800-735-2900
8 a.m. - 5 p.m., daily

Visit us:
Mon. - Fri.
8:30 a.m. to 5 p.m.
815 NW Ninth Street
CORVALLIS