To qualify for this program, your child must be between the ages of 2 and 21, have coverage through a state-approved program, and have a documented diagnosis that meets the program’s requirements. Use the form below if all applies.
Eligibility for this program is limited to children with a qualifying diagnosis. Families who do not meet these requirements will not be able to participate.
⚠️ You acknowledge: to qualify, your child must: be on Medicaid, have a special needs diagnosis, and be age 2–21.
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