The Catastrophic Illness in Children Relief Fund (CICRF) provides financial reimbursement to eligible Massachusetts families caring for children and youth with special health care needs and disabilities under age 22 with medically related expenses not covered by a private insurer, federal or state assistance, or any other financial source.
Created by legislation passed in 2000, the Fund is designed to act as a safety net for families who have significant expenses related to a child's medical needs. By definition, the family has “catastrophic expenses” related to their income; eligibility is defined by law as expenses exceeding 10% of income from all sources in a 12 month period (plus 15% of any amount over $100,000).
The family may be responsible for these expenses due to:
- A lack of insurance or dependent coverage
- Expenses 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
CICRF is a payor of last resort. 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.