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CSHS Financial Assistance

Children's Special Health Services

  

Financial Assistance Program Information

Children's Special Health Services (CSHS) provides a limited amount of financial assistance for qualified Children and Youth with Special Healthcare Needs (CYSHCN), age birth-21.  If your child is uninsured or under-insured, you might qualify for assistance.  Please review the eligibility information below and contact us if you have questions.

CSHS Financial Assistance Application 
CSHS Financial Assistance Program Information

 

Eligibility Information

In order to be eligible for CSHS Financial Assistance a child or youth must be:

  • Age birth through 21 (up to 22nd birthday)
  • Have one of the following:
    • a disabling physical condition that can be substantially improved or corrected with surgery,
    • a condition or disease that can be cured, improved, or stabilized with medical treatment,
    • a suspected physically disabling condition, medical condition, or disease;
  • A resident of the state of Montana and either a U.S. citizen or a qualified alien as defined under federal statue.
  • Enrolled in Healthy Montana Kids (MT Medicaid or CHIP), if eligible

A family or legal guardian must:

  • Complete and sign the CSHS Financial Assistance Application
  • Include the following documentation with the application:
    • Release of Information Acknowledgement
    • The most recent tax returns for every person in household who earns income (not required if under the age of 19 and attending school).  See the CSHS website for information about income guidelines.
    • A note or signature (see top of application, Page 2) from a medical provider confirming the diagnosis of the applicant.
    • Copy of insurance card (front and back)
    • Documentation of out of pocket insurance premium expense (if applicable)
    • Family income must be verified to determine eligibility.  The department will request documentation of income from the applicant.