Catastrophic Illness in Children Relief Fund
About Catastrophic Illness in Children Relief Fund (CICRF)
The Catastrophic Illness in Children Relief Fund (CICRF) helps families bear the excessive financial burdens associated with the care of children with special health care needs and disabilities. CICRF is a payor of last resort. It provides financial assistance for Massachusetts families with children experiencing a medical condition requiring services that are not covered by a private insurer, federal or state assistance, or any other financial source.
The Fund is designed to act as a safety net for families who have excessive expenses related to a child’s medical needs. The family may be responsible for these expenses due to:A lack of insurance or dependent coverageExpenses that are greater than the maximum benefit allowed by their insurance company Pre-existing conditions, co-payments, and other expenses that are not covered by insurance
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.
Who is Eligible to Apply?
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.
What Expenses are Covered?
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.
Who Oversees the Fund?
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
- 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
Executive Office of Health & Human Services
- Lauren A. Smith, MD, MPH
Department of Public Health
- Joseph G. Murphy
Division of Insurance
- Marcia Huttner, MLS
How Does a Family Apply for the Fund?
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
CICRF – Resources
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.
- Community Support Line 1-800-882-1435Family Ties
- Directions: Resources for Your Child’s Care
- Financial Assistance – Resources to help you manage your financial needs.
- Food & Nutrition – Programs that offer access to free or low cost food to help eligible people meet their basic needs.
- Health Care & Insurance – Programs offering free or low-cost health care and insurance coverage.
- Catalog of Health and Human Services
For assistance call 1-800-882-1435 (within Massachusetts), 617-624-6060, or TTY 617-624-5992