Tennessee program
State help with costs insurance leaves (Children's Special Services)
Children’s Special Services can help pay costs left by insurance for a child with an eligible condition.
What it is
Children’s Special Services can help pay costs left by insurance for a child with an eligible condition.
This health department program pays after other coverage. It can help with costs tied to a qualifying condition, including some deductibles, copays and equipment. The county health department checks both the diagnosis and income.
Eligibility rules
- Children must be under 21. Uninsured children and children with TennCare or private insurance may be considered.
- The income line is 225% of poverty on adjusted gross income: about $6,188 a month for four people. The county also has to match your child's exact diagnosis to its approved list.
What you get
- Help with eligible deductibles, copays, coinsurance and equipment tied to the condition.
What the help covers
- Payments come after other available coverage, rather than replacing a health plan.
If you decide to apply
- If you decide to pursue a referral, the social worker can help contact the county health department.
- A diagnosis letter, income records, insurance details and remaining bills help the county assess the request.
Children’s Special Services: 615-741-7353 or your county health department. · Official page ↗
After you ask
- The county health department reviews the referral and the condition-related costs.
Good to know
The county must confirm your child’s exact diagnosis and which related bills qualify. Insurance alone does not settle that review.
Other details
- The statewide contact is 615-741-7353. A local health department can discuss a referral.
- The July 14, 2026 Snader temporary injunction concerns a defined group already enrolled and affected by June 1, 2026 notices. Its restoration, review and confidentiality protections do not establish eligibility for every new applicant. An existing enrollee’s counselor can help check whether the order and any later court action apply.
Official sources
“Does our child’s diagnosis qualify for Children’s Special Services, and which costs could it cover? What limits should we expect, and could you help with a referral if it fits?”
Why I’m asking: I want to know whether there is help for the treatment costs insurance leaves behind.
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 referral form or call, and ask whether your child’s diagnosis is on the approved list.
Your social worker
The oncology social worker sends the referral and the diagnosis letter.
The care team
Records and letters when the application asks for them.
- Who decides
- The Tennessee Department of Health, through the county health department.
- Ask your social worker
- “Can we refer to Children’s Special Services, and ask them straight out whether leukemia is on their approved list and what income figure they use?”
How to apply
First step: Discuss a Children’s Special Services referral with the social worker or county health department at 615-741-7353. The county checks the diagnosis and applicable income rule.
- Call 615-741-7353 or send the state referral form, and ask whether leukemia is on the approved conditions list.
- Ask what the county health department uses as its income figure today.
Official application / program page ↗
Where it starts: Start at the local health department or send the state referral form. Statewide line 615-741-7353.
What to gather
- A letter naming the diagnosis
- Proof of household income
- Insurance cards
How long: No published figure for how long a referral takes was found. Ask when you call.
What a yes looks like
A letter naming the services the program will pay for, and a care coordinator at the county health department.
What a no looks like, and the next move
Ask whether it was income or the conditions list, and ask for the answer in writing.
Watch out
- It pays last. It does not replace insurance and it will not act before your plan has.
- We could not find the line in the approved conditions list that names leukemia. Ask before you count on it.
- The statewide page says 225 percent of the poverty line and Nashville’s says 200. Ask which your county uses.
Dates that change this
2025-01-17: The state page sets the ceiling at 225 percent of the poverty line but still shows a table labeled effective January 17, 2025 with a 2024 heading, and Nashville’s own page says 200 percent. Ask the local health department which figure it is using today. (not yet confirmed against the final rule)
The numbers and the rules
The arcane layer, kept on purpose. Checked September 11, 2026.
What it is worth
Pays what other coverage leaves for a child under 21 with a qualifying condition, at or under 225 percent of the poverty line.
Covers: Medical and surgical treatment · Hospitalization · Medicines and durable medical equipment · Care coordination through the county health department
Legal protection: Copays, deductibles and coinsurance tied to the child’s condition can be paid to a participating provider
What it costs the family: A current family cost-share schedule was not published. Ask the local health department.
The eligibility facts, as published
- Age max exclusive
- 21
- Income
- family adjusted gross income at or below 225 percent of the poverty line
- Diagnosis
- a qualifying condition on the approved list; no line naming leukemia or cancer was located
- Other coverage
- children who are uninsured, have TennCare or have private insurance may all apply
- Role
- payer of last resort
Expect friction on: It pays last, after every other plan · No line naming leukemia in the approved conditions list could be found, so ask before you count on it
The trap: We could not find the line in the approved conditions list that names leukemia or cancer, so nobody should promise this will pay. Ask the local health department whether your child’s diagnosis is on the list before you count on it.
Where I read this
- Children's Special Services — Tennessee Department of Health, read September 10, 2026
- Nashville Children's Special Services Health Program — Metro Public Health Department, Davidson County, read September 10, 2026
- Children's Special Services vendor enrolment manual — Tennessee Department of Health, read September 10, 2026
- Community Health Access and Navigation in Tennessee — Tennessee Department of Health, read September 10, 2026
- Tennessee local health departments — Tennessee Department of Health, read September 10, 2026
- Snader v. Tennessee Department of Health, agreed temporary injunction — Tennessee Department of Health, read September 10, 2026