Children’s Special Health Care Services
Children’s Special Health Care Services (CSHCS) is a program within the Michigan Department of Health and Human Services (MDHHS). It is for children and some adults with health care needs and their families. CSHCS members do not have any copayments.
Upper Peninsula Health Plan (UPHP) Medicaid and Healthy Michigan Plan CSHCS members can learn more about their core benefits here.
Four things decide whether someone is eligible for CSHCS:
- Residency – You must be a Michigan resident.
- Citizenship – You must be a United States citizen or a documented noncitizen.
- Age – Children must have a health condition that qualifies them and be 20 years old or younger. Persons 21 years and older with cystic fibrosis or certain hereditary blood-coagulation disorders commonly known as hemophilia may also qualify.
- Qualifying Medical Condition – MDHHS medical consultants review each case to decide if someone is eligible. More than 2,500 diagnoses may be eligible. For a list of covered conditions, view the CSHCS Services Diagnosis Code List.
To apply, first ask your health specialist to submit a medical record less than one year old to CSHCS. It can be a letter or report that fully describes the condition and treatment plan. Your specialist will need permission to send the record to CSHCS.
If the person with special needs has not seen a specialist or if you have questions, please do one of the following:
Please call UPHP Customer Service at 1-800-835-2556 (TTY: 711) with the name of your primary care provider (PCP) or your child’s PCP.
If you do not (or your child does not) have a PCP, the document linked below will provide a list of PCPs who have agreed to accept any UPHP Medicaid member enrolled in CSHCS. The list is meant to help you, not limit your choice. If the doctor you want is not on the list, call UPHP Customer Service for help.
As children get older they must prepare for the transition to adult life. Transitioning to adult life means planning for future needs including:
- Health care
- Independent living
Children with special health care needs will need to make the transition from pediatric care to adult care. Health care planning should also include:
- Learning independent health care skills
- Finding adult health care providers
- Getting proper health care coverage
Below is a link to resources to assist with this process:
If you need help or a list of providers, please contact UPHP Customer Service at 1-800-835-2556 (TTY: 711) and ask to speak with a CSHCS care coordinator.
The CSHCS Family Forum brings together UPHP staff, health department staff, and CSHCS members and their families from all across the Upper Peninsula. Participants have the opportunity to learn more and provide input on the program in order for UPHP to serve them better.
- Family Connections of Michigan connects families of children and youth with special health care needs, and the professionals who help them, with information and news they can use.
- The Michigan Family-to-Family Health Information and Education Center aims to improve access to high-quality care and supports for children with special needs by empowering families.
- MDHHS CSHCS Website
Contact UPHP Customer Service at 1-800-835-2556 (TTY: 711) and ask to speak with a CSHCS care coordinator for help with the following:
- Complex care management including:
- Health assessment
- Care plan
- Assistance achieving goals
- Finding a health care provider
- Transitioning to adult providers
- CSHCS attested providers
- Care coordination
- Assistance with prior authorizations
- Assistance with durable medical equipment
- Assistance navigating your benefits
- Questions or concerns
Page Last Updated: 04/8/2021