Who is eligible?
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 illness, accident, or disability must be more than 10% of the family’s yearly income from all sources up to $100,000, plus 15% of any portion of the family income that is above $100,000, in a given 12-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 is a reimbursement program for:
- Expenses within 2 years of the date the application is received by the Fund
- Expenses for which the family is directly responsible as a result of the child’s medical condition, accident or disability
- Expenses not covered by health insurance or any other source, after the family makes all reasonable attempts to pursue other funding
Eligibility is based on the child’s medically related expenses compared to family income.
Applications cannot be processed without proof of income from all sources for the 12-month eligibility period.
Proof of payment by the family for all expenses is required for reimbursement. In some cases, proof of insurance denials and appeals may be needed.