Catastrophic Illness in Children Relief Fund

Catastrophic Illness In Children Relief Fund
http://www.mass.gov/cicrf/

The Massachusetts Catastrophic Illness in Children Relief Fund (CICRF) provides financial assistance to families with children experiencing a medical condition requiring services that are not otherwise covered by a private insurer, federal or state health care assistance, or any other financial resource. The Fund is administered by the Catastrophic Illness in Children Relief Fund Commission, an independent Commission appointed by the Governor, with staff support from the Massachusetts Department of Public Health. The Fund receives monies through an annual allotment of $1 for each employee whose wages are counted as part of employer contributions for unemployment health insurance.

Who is eligible to apply?
CICRF accepts applications for expenses related to the medical needs of children 18 years old or younger who are residents of Massachusetts. Applicants may be eligible for financial assistance until the day before the child's 19th birthday. Parents or guardians must submit applications for children under the age of 18. Applicants who are 18 years of age, and 'emancipated minors' must submit their own applications.

In order to be eligible, a family must have expenses related to a child's medical condition that exceed 10% of the family's gross annual income up to $100,000 and 15% of any portion of the annual family income that exceeds $100,000. Only expenses for which the family is directly responsible as a result of the child's medical condition may be considered for payment or reimbursement. For example, expenses covered by health or other insurance coverage or "Free Care" are not eligible in the calculation of total eligible expenses.

What expenses are covered?
The following expenses will be considered and may be eligible for payment/reimbursement if found reasonable. The categories include, but are not limited to:

Payments to health care providers
Specialized pediatric ambulatory care
Addiction/mental health services
Acute or specialized hospital care, both in and outpatient
Medical equipment or disposable medical supplies
Medications
Medical transportation
Home health care
Related travel expenses, such as mileage, food and lodging
Following special review, experimental treatment or medications

The Commission will consider other reasonable expenses related to the treatment, palliation, habilitation, or rehabilitation of a child's illness or medical condition. Applicants can request consideration of home and vehicle modifications, but there is not yet a final policy on this type of request.

CICRF may pay for expenses related to experimental treatment in certain circumstances. In general, however, the Fund will not pay for treatment in Phase I clinical trials.

Applications may be submitted for:

Services the child has already received, whether or not the family has already paid for them. In these cases, the Commission can either directly pay the bills owed to medical providers or other vendors, or CICRF can reimburse the family directly for bills already paid. (Expenses for services before July 1, 2000 are not eligible for consideration).
Expenses for proposed services. In these cases, the Commission may agree to assume responsibility for paying bills up to a reasonable limit.

In all cases, CICRF should be considered the payer of last resort after the family makes all reasonable attempts to pursue other funding sources.

How does a family apply for the Fund?
Applications are available from the Community Resource Center (and from Staff Access>Forms) or:

http://www.mass.gov/cicrf/apply.htm

Catastrophic Illness in Children Relief Fund
Massachusetts Department of Public Health
Division for Special Health Needs
250 Washington St., 4th floor
Boston, MA 02108-4619

Phone: 800-882-1435
FAX 617-624-5990
TTY 617-624-5992

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