Expenses
For CICRF, "catastrophic illness" is based on the amount of uncovered and eligible medically related expenses for the care of a child/youth that are greater than a certain percent of the family's annual income. CICRF is the payor of last resort, meaning expenses covered by other sources (such as insurance and fundraising) or the responsibility of other state or federal programs (such as the Department of Education), are not considered.
The date of the expense and payments must occur within 24 months before the date this application is submitted and before the child/youth's 22nd birthday. Fund policy limits the amounts counted toward eligibility, and reimbursement is on a sliding scale for some expenses such as vehicle purchases, home modifications and whole-house generators.
CICRF requires proof of payment by the parent/guardian, invoices, medical information and other documentation to be considered. CICRF will use this information to compare your income from all sources to money spent on eligible medical related expense during the last 24 months up to the date of your application. CICRF will determine one or two 12-month periods of eligibility. CICRF will contact you with questions and any additional documentation that may be required.
Commonly Reimbursed Expenses
Family Support: The Fund can provide a daily rate depending on distance traveled for expenses associated with visiting the hospital for inpatient or outpatient care.
Accessible Vehicles: The Fund can consider expenses related to purchasing and/or modifying a vehicle if your child uses a wheelchair or travels with mobility or other durable medical equipment requiring additional storage space.
Home Modifications: The Fund can consider modifications such as an accessible bedroom or bathroom, wheelchair ramp or widened doorways.
Medical Equipment & Supplies: The Fund can consider expenses for uncovered medical equipment (such as stairlifts, generators and ceiling lifts), uncovered medical supplies, and medication (self-pay, copays/coinsurance/deductibles).
Medical Expenses: The Fund can consider expenses such as uncovered hospital, physician, laboratory, ambulance and therapy expenses (self-pay, copays/coinsurance/deductibles) .
Funeral Expenses: The Fund can consider in-state expenses to cover services, burial plots, memorials for families, up to $10,000 only for families earning less than 400% Federal Poverty Income Guidelines (FPIG).
CommonHealth and MassHealth premiums: The Fund can consider expenses for CommonHealth and MassHealth premiums for families not receiving Premium Assistance; private health insurance premiums are not covered.
Lodging expenses: The Fund can consider lodging if you live more than 50 miles one way from the provider CICRF may consider other reasonable expenses related to the treatment and rehabilitation of the child’s illness or medical condition.