Children's Special Health Services

Financial Assistance Program Information 

The Children Special Health Services (CSHS) Financial Assistance Program is open beginning January 1, 2022 and will be open until the funds have been exhausted.

Children’s Special Health Services (CSHS) can provide up to $2,000 per year of financial assistance for treatment and enabling services and/or items 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.

This program may not be a fit for everyone. However, we will work with all families to connect them to resources and supports. As the funding is limited for this program, all other potential funding sources (Ex. Medicaid, EPSDT, HMK, any other insurance, MonTECH, Jadyn Fred Foundation, Brondum Foundation, etc.) must have been tried prior to applying for this program.

Per the set of administrative rules, financial assistance for treatment and enabling services requested by medical providers may be funded by CSHS as long as there is sufficient federal funding.

If you sent in an application that was put on the waitlist, you will need to reapply as the application has been updated and has significant changes.

Eligibility Information

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

  • age birth through 21 (up to 22nd birthday)
  • Has or is at increased risk for a chronic physical, developmental, behavioral, or emotional condition and also,
  • Requires health and related services of a type or amount beyond that required by children generally
  • Is a resident of the state of Montana and either a U.S. citizen or a qualified alien as defined under federal statute
  • Must be enrolled in Healthy Montana Kids (MT Medicaid or CHIP), if eligible
  • Must be at or below 300% Federal Poverty Level, check below to determine if your family is eligible.

2022 Poverty Guidelines

Persons in Household 300% FPL
1 $40,770
2 $54,930
3 $69,090
4 $83,250
5 $97,410
6 $111,570
7 $125,730
8 $139,890
For each person over 8 add: $14,160
Source:  2022 Federal Poverty Guidelines

 

A family or legal guardian must:

  • Complete and sign the CSHS Financial Assistance Application
  • Have a medical provider complete Section 2 of the application, sign and initial
  • Include the following documentation with the completed application:
  1. Release of Information Acknowledgement
  2. The most recent tax returns for every person in household who earns income (not required if under the age of 19 and attending school).
  3. Copy of insurance card (front and back), or Medicaid or HMK information
  4. Documentation of other financial resources requested and/or used
  5. Extra pages for descriptions of condition, services, or items if needed

Children’s Special Health Services Financial Assistance Policy

Financial Assistance Application Checklist

Financial Assistance Application