Get ready to apply
North Dakota Health and Human Services
Special Health Services Financial Coverage Program
What you get
Help paying for approved specialty services to diagnose or treat chronic conditions, including cancer and leukemia. Open now.
- Who starts it
- You
- How it’s sent
- Online, on their website
- Your time
- About 15 minutes
- Last checked
- Aug 27, 2026
Before you start, check you fit
- Coverage is limited to listed chronic conditions and specialty services accepted through the program.
- The current household-size chart, dollar limits, service details, and leukemia-specific coverage rules are not fully published on reachable pages.
- You need to show financial need.
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What their form asksA preview, so you can gather things first. Fill it in on their site.
Open their application ↗ Checked Aug 27, 2026What the form asks for
SHS three-document application packet questionsRequest for Services factsClient, disclosure parties, information categories and expirationHousehold and income verificationHave ready
- Request for Services SFN 1103.
- Authorization SFN 970.
- Financial Coverage Program Verification.
After you send
Keep a copy and follow up with their staff if receipt is not confirmed.