Catastrophic Illness in Children Relief Fund

September 17, 2018

A resource for families of children with developmental disabilities

Meeting the needs of a child with developmental disabilities can get expensive…..really expensive.  Parents, of course, will do everything that they can to make sure that their child has what they need.  But the costs involved often put additional strain on the family.  Even one uncovered medical expense can leave a family in debt. In New Jersey, these families can turn to the Catastrophic Illness in Children Relief Fund (CICRF).

Eligible expenses may have been incurred in any twelve-month period, as far back as 1988, for any child who was twenty-one or younger in those twelve months.  The expenses must be greater than ten percent of a family’s income under $100,000 (plus fifteen percent of income over $100,000).  Expenses may have arisen as the result of non-coverage or partial coverage by insurance. And, they must not be covered by any other state, federal, or community resource.

The CICRF website lists the following “included but not limited to” expenses:

  • Specialized pediatric ambulatory care
  • Addictions/mental health services
  • Acute or specialized hospital care, both in and outpatient
  • Physician care in all settings
  • Medical equipment or disposable medical supplies
  • Pharmaceuticals
  • Medically related home modifications and medical transportation
  • Home health care
  • Experimental medical treatment or pharmaceuticals following special review

Families have used the CICRF to help with a wide variety of expenses such as purchasing an adapted van, covering the cost of hearing aids, or making home adaptations.  They may have had to travel out of state to obtain a specific treatment or surgery or need help covering the costs of medications.  They may be overwhelmed by the costs of in-home care following a hospital stay.  Families must keep in mind that CICRF will pay a provider’s bill or reimburse a family for an expense.  It will not cover an expense before it has been incurred.

To apply for the CICRF, families can call 1-800-335-3863 for an application or they can apply or print an application online.  The application will ask for:

  • Basic child and parent information
  • Health information about the child – diagnosis, surgeries, treatments, etc.
  • Information on all sources of income for the family
  • Employment information for the parents
  • Health insurance information

Most importantly, the application will ask for detailed expense information.  You will need to provide the type of expense by choosing one of the forty-eight specific expenses provided.  The expenses are wide ranging from specific medical costs to music therapy, from transportation costs to dental and chiropractic care.  You can submit expenses for an unlimited number of types of expenses as long as they have occurred in a twelve-month period.  You must provide the amount of the bill, how much was paid by insurance or other resource, how much was paid by the family, and what is currently still due.  You must also provide the date of service.

In order to support this information, you must provide copies of all bills, receipts, copies of cancelled checks and/or credit card bills, as well as collection notices.  Insurance statements and/or explanation of benefit forms must also be submitted.  Transportation expenses must be supported by receipts for things such as fuel, parking, tolls, transit, or taxi fares.

Once the application and supporting documentation is completed, the packet must be forwarded to the state office of the CICRF at Catastrophic Illness in Children Relief Fund Commission, New Jersey Department of Human Services, P.O. Box 728, Trenton, NJ 08625- 0728.  The paperwork will be reviewed by the Commission and a final determination made on the amount of assistance that may be provided.  Approved funding will be paid directly to providers or may reimburse families for expenses they’ve already paid.

For more information, visit the CICRF website.  In Sussex County, you can also learn more by contacting Sussex County Special Child Health Services at 973-948-5239.