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

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Maine program

Free help with applications and complicated care

Maine care coordinators help families manage a child’s ongoing health needs and insurance paperwork.

What it is

Maine care coordinators help families manage a child’s ongoing health needs and insurance paperwork.

Treatment can bring forms and calls across several agencies. Maine’s Children and Youth with Special Health Care Needs service helps families work through them. Separate complex-care and Medicaid ombudsman services can help with specific problems.

Eligibility rules
  • Care coordination serves Maine children from birth to 21 with a chronic medical, behavioral or emotional condition.
  • The Complex Case Unit’s youth route serves young people age 17 and under.
What you get
  • Free help with insurance applications and appeals.
  • Connections to specialists and community resources.
  • Help with complicated care or discharge needs through the Complex Case Unit.
What the help includes
  • The Maine Medicaid Ombudsman answers coverage questions and helps with problems involving MaineCare.
If you decide to apply
  1. Ask your hospital social worker for a care-coordination referral, or complete the CYSHCN inquiry form.
  2. Have the diagnosis, treating hospital and any denial letters ready.

Care coordination: 207-287-5357. Maine Medicaid Ombudsman: 1-800-965-7476 · Official page ↗

After you ask
  • The care-coordination service promises initial contact within two business days of the referral form.
Good to know

These services help arrange care and resolve paperwork. They do not pay your treatment or travel bills.

Other details
  • Youth Complex Case Unit referrals can go through the hospital team.
Official sources
Ask your social worker

“Would a care coordinator help us with applications or appeals, and what can they take off our hands? Are there any drawbacks, and could you help with a referral?”

Why I’m asking: I want a person who can help connect the paperwork with my child’s care.

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

Send the form or make the call, and say what the problem is.

Your social worker

A care coordinator contacts you within two business days and works the applications and appeals with you.

The care team

Records and letters when the application asks for them.

Who decides
No decision to win: these are services you ask for.
Ask the agency
“My child is in cancer treatment. Can a care coordinator help us with the coverage application and any appeals?”

How to apply

First step: Send the CYSHCN Registry and General Inquiries form, or call 207-287-5357.

  1. Send the CYSHCN form; someone contacts you within two business days.
  2. Call the ombudsman on 1-800-965-7476 before appealing a MaineCare denial.
  3. Ask the hospital to refer to the Complex Case Unit if going home is getting complicated.

Official application / program page ↗

Where it starts: Submit the CYSHCN Registry and General Inquiries form, or call 207-287-5357. For the Complex Case Unit, youth referrals go to cassie.antonelli@maine.gov. For coverage questions, call 1-800-965-7476.

What to gather

  • The diagnosis and the treating hospital
  • Any denial letters

How long: The state promises first contact within two business days of the form.

What a yes looks like

A named care coordinator who rings you back.

What a no looks like, and the next move

There is no eligibility decision here; if nobody rings, call 207-287-5357.

Watch out

  • It is not a payer. Nothing published says it covers treatment, travel or unpaid bills.

Dates that change this

2026-09-11: No diagnosis list, payment schedule or income cutoff for Maine Title V was found. Treat this as help with applications and appeals, not as a payer.

The numbers and the rules

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

What it is worth

Free care coordination birth to 21, plus a complex-care unit and a Medicaid ombudsman line.

  • $2 — Promised first contact after the referral form

Covers: Help with insurance applications and appealing denials · Referrals to providers, specialists and community resources · The Complex Case Unit for complicated care and placement problems, 17 and under · The Maine Medicaid Ombudsman on 1-800-965-7476

What it costs the family: Free.

The eligibility facts, as published

Age
birth to 21 for care coordination; 17 and under for the Complex Case Unit youth route
Residency
Maine
Condition
a long-term chronic medical, behavioural or emotional condition needing ongoing or specialised care

Expect friction on: None of these three pays a bill

The trap: Care coordination is not a payer. There is no published list of diagnoses it pays for, no payment schedule and no income cutoff, because none of those documents exists to read. Ask for help with applications and appeals, which is what the programme says it does.

Where I read this

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