This program is available to all MO HealthNet (formerly Medicaid) eligible children (birth to age 21) residing in Missouri who are in need of medically necessary services from MO HealthNet providers.

The participant must:

  • Be a Missouri resident
  • Be birth to age 21
  • Need medically necessary services
  • Be enrolled in MO HealthNet

How to Apply

Contact any of the Regional Offices to make a referral for enrollment.

Enrollment form, CC-1, can be printed by selecting the link below:

Be sure to print both pages. The second page provides instructions on filling out the application. You can take the form to your local SHCN office. They can help you fill out the form or send the form to SHCN.