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
- 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.
For assistance call 1-800-882-1435 (within Massachusetts), 617-624-6060, or TTY 617-624-5992.
This information is provided by the Division for Children & Youth with Special Health Needs within the Department of Public Health.
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