Catastrophic Illness Fund Summary

Catastrophic Illness in Children Relief Fund

What does the Catastrophic Illness in Children Relief Fund (the Fund) do: Provides reimbursement of expenses not covered by insurance, state or federal programs or other sources to New Jersey families whose children have a catastrophic illness or condition.

What is a Catastrophic Illness or Condition:

• Catastrophic refers to the expenses, not the severity of the illness or condition
• Condition may be acute or chronic

Key Fact: The family must generally pay the expenses first and then the Fund reimburses the expenses.

Eligibility:

• Child must be under 22 at time medical expenses were incurred Eligible expenses must exceed 10% of family’s gross income, plus 15% of any excess income over $100,000 in any prior 12 month consecutive period.
• Eligible expenses must exceed 10% of family’s gross income, plus 15% of any excess income over $100,000 in any prior 12 month consecutive period.
  • Can be a calendar year or any 12 month period
  • No deadline or statute of limitations to submit for past expenses
  • May reapply every 12 months

Examples of types of expenses reimbursed (not inclusive):

• Doctor appointments
• Medicine
• Therapies
• Hospitalizations
• Durable medical equipment
• Home modifications
• Transportation
• Medical Supplies
• Lab Costs
• Hotel for out of state medical visits
• Home health care
• Modified vehicle

Types of not reimbursed (not inclusive)

• Expenses related to education
• Modifications to rentals or vacation homes

Other relevant rules

• May not combine multiple children’s expenses
• Total application each year cannot exceed $100,000
• Insurance premiums may be counted as an expense to help with eligibility but will not be reimbursed
• Some categories have reimbursement limits