CICRF
is a reimbursement program. The expense must have already been incurred
in order to be eligible for the Fund and to receive reimbursement. In
cases of extreme medical emergency, the CICRF Commission may grant
approval before the expense is incurred.
NOTE: Because the amount
in the Fund varies from year to year, and the number of requests varies
as well, CICRF cannot guarantee funding in all cases. Families are
advised not to assume or make financial decisions based on the
expectation that the Fund will pay, even if they have received payment
for a similar expense in the past.
In order to be eligible for the Catastrophic Illness in Children Relief Fund:
- The
family's out-of-pocket expenses related to their child’s medical
condition must be more than 10% of the family's gross annual income up
to $100,000 and 15% of any portion of the annual family income that is
above $100,000, in a given twelve month period.
- The applicant must be a resident of Massachusetts.
- The applicant must be 21 years old or younger at the time the expenses were incurred.
- The
applicant must be under the care of a licensed health care provider
with staff privileges at a hospital licensed or accredited to provide
pediatric or neonatal care.
- The Fund will consider expenses incurred within the last 24 months prior to the application date.
The following
expenses may be eligible for payment/reimbursement if found to be
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
- Medically related home and vehicle modifications
- Medical transportation
- Home health care
- Related travel expenses for out of state treatment
- 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 treatment.
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.
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 cannot be included in the calculation of total eligible
expenses.
In all cases, CICRF should be considered the payor of
last resort after the family makes all reasonable attempts to pursue
other funding.
CICRF receives
monies through an annual allotment of $1 for each employee whose wages
are counted as part of employer contributions for unemployment health
insurance. The State Treasury manages the Fund.
The Fund is
administered by the Catastrophic Illness in Children Relief Fund
Commission, an independent, multidisciplinary Commission. Members from
the public and private sectors are recommended by the Office of the
Attorney General and the Governor's Office. Final appointments are made
by the Governor. The Massachusetts Department of Public Health provides
staff support to the Commission. The Commission is the final authority
on decisions regarding expenditures from the Fund.
The Catastrophic Illness in Children Relief Fund Commission
Public Members
- Patricia Roche, MEd, JD, co-chair
- Bonnie Thompson, BS, co-chair
- Deborah Cotter, BS, AFL-CIO Representative
- Laurie Glader, MD
- Linda Landry, JD
- Donna Nimec, MD
State Agency Ex-Officio Members
- Steven Grossman
Treasurer and Receiver General
Office of the State Treasurer
- John W. Polanowicz
Secretary
Executive Office of Health & Human Services
- Lauren A. Smith, MD, MPH
Interim Commissioner
Department of Public Health
- Joseph G. Murphy
Commissioner
Division of Insurance
Commissioner Emerita
The
application can be
downloaded from the link below. You may print the blank
application form and fill it out by hand and mail it. To maintain
confidentiality, the application form cannot be transmitted
electronically.
If you need help in translating or completing the
application, please call the 800 number located at the bottom the blog and CICRF staff will assist you.
To request that an application be mailed to you, please call or write:
Catastrophic Illness in Children Relief Fund
Massachusetts Department of Public Health
250 Washington St., 5th Floor
Boston, MA 02108-4619
phone: 1-800-882-1435 or 617-624-6060
TTY 617-624-5992
Your child and
family may be eligible for additional support services in your home or
community. The following websites provide information about resources
available to families who have a child with special health care needs.
For assistance call 1-800-882-1435 (within Massachusetts), 617-624-6060, or TTY 617-624-5992
_____________________________________________________________________________
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