The Children's Special Health Program (CSHP) is a statewide financial assistance program for uninsured children with a qualifying medical condition(s) requiring long-term multi-disciplinary medical treatment and rehabilitative measures to improve ability to function. CSHP works with families, providers, and communities to ensure access to care that is family-centered, community-based, and culturally sensitive.
Program mission
To enable children with special healthcare needs to have improved health outcomes and an enhanced quality of life through care coordination assistance to ensure access to care and financial support for continuity of care to achieve health goals.
Who is eligible for CSHP?
Program eligibility and limitations may depend on:
- Age of child, must be under the age of 18
- Diagnosis of a qualifying medical condition
- Residency status, child must be a legal resident of Idaho (per rule, only child must be legal)
- Family income and size to determine financial eligibility
- Uninsured children
- Insured children with cystic fibrosis or PKU
- Child’s parent/guardian is required to apply for Medicaid before applying for CSHP services
What services are provided?
To ensure access to care, CSHP offers:
- Financial assistance for pre-approved services
- Care coordination support by a care coordinator
- Referrals
Prior authorization of CSHP services are required.
- Any CSHP-funded services provided must be approved in advance
- You, your healthcare provider, or the billing contact can reach out to CSHP staff at 208-334-5962 or IdahoMCH@dhw.idaho.gov to obtain prior authorization
- Failure to obtain prior authorization may result in denied claims and your family may be responsible for the cost of the services provided
Medical conditions that may qualify
- Medical care follow-up visits
- Diagnostic testing and imaging
- Treatment services
- Surgical procedures
- Up to $25,000 annual limit
- Medical care follow-up visits
- Diagnostic testing and treatment services
- Surgical and orthodontic services
- Medical care follow-up visits
- Diagnostic testing and treatment services
- Surgical procedures and therapies
- Bracing and appliances
- Up to $12,000 annual limit
- Medical care follow-up visits
- Inpatient hospital surgical care by qualified plastic surgeons for burns and for various congenital or traumatic defects of the outer surface of the body requiring correction to obtain or restore physical function
- Equipment supplies and physical therapy
- Up to $15,000 annual limit
- Medical care follow-up visits and condition-related referral services
- Up to $15,000
- Medical care follow-up visits and condition-related referral evaluations
- Transportation to out-of-state medical centers based on physician referral
- Diagnostic testing and imaging
- Medicine and supplement treatments
- Medical equipment
- Up to $18,000 annual limit
- Medical care follow-up visits
- Diagnostic testing and imaging
- Casting, Bracing and other instruments
- Wheelchair and other equipment
- Hospitalization for corrective surgical procedures
- Up to $15,000
- PHE Monitoring
- Consults with a Registered Dietician
- Nutritional assessments
- Medically prescribed low protein foods ($250 maximum per month) and formula
View the table of the Idaho Children's Special Health Program conditions.
- Emergency room visits
- Acute inpatient overnight hospital services
- Routine pediatric and dental care
- Respite care
- Prescription medicines (except cystic fibrosis)
The CSHP application is available to download or you may request a copy by emailing IdahoMCH@dhw.idaho.gov
Completed applications with the required supporting documentation (income tax return and Medicaid denial letter) can be faxed to 208-334-4946 or mailed to Children’s Special Health Program, P.O. Box 83720, Boise, ID 83720.
Transitioning to adulthood or the process of becoming an adult, involves new experiences and decisions. Issues like health insurance, finding a doctor who takes care of adults, choosing a work or school setting, transportation, and housing present new and sometimes overwhelming challenges. Visit our Children and Youth with Special Health Care Needs webpage for additional information and resources regarding healthcare transition. The webpage provides information and guidance about a very important part of that process — gaining healthcare independence. Parents can learn how to support youth in taking charge of their health care, and youth, teens, and young adults can learn the skills that will prepare them for success. Youth with special health care needs may need more time and practice to reach that goal. Start early and plan ahead!
Got Transition has great transition resources for youth and families.
You can request transition guides from Idaho Parents Unlimited by calling 208-342-5584 or using the request printed copies button below.