Written by a parent, not a doctor. Nothing here is medical advice.

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Indiana program

Help with specialist bills (Children's Special Health Care Services)

Indiana's program for children with serious health conditions can pay approved bills insurance leaves behind.

What it is

Indiana's program for children with serious health conditions can pay approved bills insurance leaves behind.

Children's Special Health Care Services can fill approved gaps after private insurance and Medicaid pay. Cancer is on the diagnosis list, but the program reviews each child's case. The application includes proof of a Medicaid application.

Eligibility rules
  • Eligibility runs from birth through the day before the 21st birthday.
  • Family income before tax must be at or below 250% of poverty. The 2026 three-person monthly line is $5,692.
  • The line is $5,692 a month for three people and about $6,875 for four (2026).
  • Oncologic disorders appear on the diagnosis list. The Department of Health decides the individual case.
What you get
  • No program copay for approved specialist care and medicines.
  • A care coordinator can help with the application and referrals.
  • Travel help may be available when other coverage does not cover the trip and CSHCS approves it.
What the help includes
  • Private insurance and Medicaid pay before CSHCS.
  • The care coordinator can identify which specialist bills and medicines meet the program's service limits.
  • Travel help is for round trips of 50 miles or more, paid at half the state mileage rate for the miles beyond the first 49, and only when Medicaid does not already cover the trip.
If you decide to apply
  1. Ask a CSHCS care coordinator to help with State Form 49006.
  2. Have income records and proof of the Medicaid application ready.
  3. Ask the oncology team to supply the diagnosis and requested services.

Indiana CSHCS, 800-475-1355; travel questions, option 4 · Official page ↗

After you ask
  • Financial and social information is due within 30 days of signing the application.
  • Coverage ends before the 21st birthday, rather than at the end of that year.
  • The CSHCS office confirms the approval period and annual renewal requirements. A denied Medicaid bill is not automatically a covered CSHCS bill.
Good to know

Full Medicaid transport coverage generally comes first. The CSHCS travel office checks limited-coverage exceptions; other specialist help remains limited to approved gaps.

Other details
  • A Medicaid application is required even when family income appears too high for Medicaid.
  • Having Medicaid does not by itself rule out CSHCS. The programs can work together, with CSHCS paying last for a qualifying condition and approved service, including some Medicaid does not provide. The office and hospital check the bill and advance-approval requirements. Travel has separate restrictions.
Official sources
Ask your social worker

“Could CSHCS help with any specialist bills our insurance leaves? What limits or drawbacks should we understand, and could you help us apply if there are useful gaps it can cover?”

Why I’m asking: I want to understand which treatment costs could still receive help after other coverage pays.

More background and detailed requirements
Additional program information and published rules

Who does what

The three parts, side by side. The agency decides; nobody on this page does.

You

File State Form 49006 and attach proof that you applied for Medicaid. Send financial and social information within 30 days of signing.

Your social worker

A care coordinator can help you fill in the form and can refer you on.

The care team

The oncology team supplies the diagnosis and the list of approved services.

Who decides
The Indiana Department of Health.
Ask your social worker
“Can you help us apply to Children's Special Health Care Services, attach the Medicaid application proof, and ask which of our bills it would pick up?”

How to apply

First step: Ask a care coordinator to help you file State Form 49006, with proof that you applied for Medicaid, on 800-475-1355.

  1. File State Form 49006 with proof that you applied for Medicaid.
  2. Ask a care coordinator to help with the form.
  3. If you have no Medicaid, ask about travel reimbursement on option 4.

Official application / program page ↗

Where it starts: File State Form 49006 with proof of a Medicaid application. Call 800-475-1355; press option 4 for travel reimbursement.

What to gather

  • Proof that you applied for Medicaid
  • Household income before tax
  • The diagnosis letter from the oncology team
  • A completed W-9 and direct-deposit form, if you want travel money

How long: The website says an application must be processed 30 days from the date it was signed, and bases the effective date on when it was received. Neither is a promised decision date.

What a yes looks like

An approval letter naming the covered services and the effective date. Check that date against the first bills.

What a no looks like, and the next move

If information was missing, the form says the application is denied for failure to cooperate. Ask what was missing and re-file.

Watch out

  • Insurance and Medicaid pay first; this programme fills approved gaps up to its own limits.
  • Full Medicaid transport generally comes first; the travel policy has limited-coverage exceptions that CSHCS must confirm for the child's exact category.
  • Eligibility ends the day before the 21st birthday, not at the end of that year.

Dates that change this

2026-01-01: The travel rate is not settled: the current page says "$0.245 cents per mile" for trips over 49 miles one way, while the 2010 policy says half the state rate for round trips of 50 miles or more. Ask for the written rate before you drive.

The numbers and the rules

The arcane layer, kept on purpose. Checked September 11, 2026.

What it is worth

Pays approved specialist bills and medicines that insurance leaves, with no copay, at or under $6,857 a month for four people.

  • $6,857/month — Income ceiling, household of 4 (250 per cent)
  • $5,692/month — Income ceiling, household of 3 (250 per cent)
  • $0 — Programme copay

Covers: Specialty care related to the eligible condition · Prescription medicines · Care coordination · Travel reimbursement for families without Medicaid

Legal protection: No programme copay

What it costs the family: No copay. The programme pays after other coverage.

The eligibility facts, as published

Age
birth to the day before the 21st birthday
Income
family income before tax at or under 250 per cent of the poverty line; the 2026 table prints $6,857 a month for four people
Condition
the diagnosis list names oncologic disorders, for example cancer, rather than leukaemia specifically; eligibility is decided individually
Other coverage
Private insurance and Medicaid pay first. CSHCS permits co-enrollment and can cover some separately approved services Medicaid does not provide. Travel restrictions differ from other service eligibility.

Decisions this site cannot make: Indiana Department of Health eligibility decision on State Form 49006

Expect friction on: Proof of a Medicaid application is required with the form

The trap: Insurance and Medicaid have to pay first. The programme then pays the lesser of the Medicaid allowed rate, the balance after the primary payer, or the copay.

Where I read this

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