Frequently Asked Questions
What is the CSHCN Services Program?
The CSHCN Services Program helps children with special health-care needs and people of any age with cystic fibrosis secure health care and support services.
Under Title V of the Social Security Act, the state receives block grant funding for services to women and children. Title V pays for health care benefits and case management for children, and some types of public health services for all.
Title V and the CSHCN Services Program provides family-centered, community-based, culturally competent, coordinated health care, and family support services. The Program believes in family choice, and the power of collaboration between parents and professionals.
Who is eligible for the CSHCN Services Program?
CSHCN clients must have a physical medical condition that is expected to last at least a year and require more health care than what children usually need. To be eligible; you must live in Texas, have a limited income, and be under 21 years old—or any age if you have cystic fibrosis.
How do I apply for CSHCN?
You can print a CSHCN Services Program Client Application under Forms and Publications at http://www.dshs.state.tx.us/cshcn/pdf/appengli.pdf. You can also apply at your local state health services office.
Because the CSHCN Services Program is the payer of last resort, all applicants must also apply for the Children’s Health Insurance Program (CHIP) and Medicaid. You can apply to both programs online at http://www.chipmedicaid.org/ or by phone at 1-800-543-7669. CSHCN Service Program applicants must also apply to the Medicaid Buy-In Program for Children (MBIC).
Does the CSHCN Services Program provide drug coverage?
Yes, the CSHCN Services Program does cover medicines and some medical supplies when they are necessary and prescribed by a doctor. For a full list of CSHCN Services Program benefits, see http://www.dshs.state.tx.us/cshcn/benefits.shtm.
Does the CSHCN Services Program help with travel?
Clients of the CSHCN Services Program can access the Medical Transportation Program for help with transportation to medical appointments or the drug store. You should request a ride as soon as you can, and no less than three working days before your appointment.
To request a ride, call
- 1-855-687-4786 if you live in the Houston or Beaumont area
- 1-855-687-3255 if you live in the Dallas area
- 1-877-633-8747 (1-877-MED-TRIP) if you live anywhere else
How do I find a particular specialist in my area?
Providers must be on the CSHCN Services Program in order to be reimbursed by the program. To find a specific type of provider, use the on-line Provider search. Make sure to select “CSHCN Services Program” for the health plan.
Which pharmacies are CSHCN Services Program providers?
To find a CSHCN Services Program pharmacy, use the on-line CSHCN Pharmacy Search.
What do I do if I get a medical bill?
Don’t ignore it! Call your provider’s office right away. Make sure they know you are on the CSHCN Services Program and that they have your client ID number. If the provider is not enrolled in the Program you will be responsible for the bill. If the provider is enrolled, follow these steps:
Make a copy of the bill. The bill should include the client’s:
Name and ID number or social security number
Date of Service
Date and any amount of any payments you made on the account
the provider’s name and address
Write a letter addressed to Client Correspondence telling the date you told the provider you/your child are/is a client of the CSHCN Services Program. If possible, include the name of person you spoke with at the provider’s office. If you do not have a copy of the bill with this information, ask the provider for a copy of the bill which contains the requested information.
Send the copy of the bill and your letter to
PO Box 202018
Austin, TX 78720-2018
Keep a copy of the information you send in for your records.
You will receive a letter from our claims administrator, the Texas Medicaid & Healthcare Partnership (TMHP), within thirty days of receipt of your letter. If the provider is enrolled and you still need help, call the TMHP/CSHCN Services Program client line at 1-877-888-2350.
Send comments or report broken links by e-mail to CSHCN Services Program.