CICRF provides reimbursement for medical expenses associated with all medical diagnoses, including but not limited to acute and chronic illnesses, accidental injuries, physical disabilities, mental health and substance use disorders, etc. The “catastrophic” term in our program name refers to the amount of expenses in relation to your family’s household income, and not to the type of medical condition.

Yes – Since CICRF is a retrospective/reimbursement program, you can only apply for reimbursement of medical expenses that you have already incurred in any previous 12-month time period, as far back as 7 years. Your total amount of expenses must meet the eligibility criteria, which is determined by the total amount of expenses incurred and your total household income during that time period.

No – CICRF is a retrospective/reimbursement program so we cannot provide approval for a future purchase or medical treatment, and can never guarantee that your application will be approved for any type of assistance before your application is presented to the Commission for approval.

Yes - The only requirement is that the expenses must have already been incurred (product purchased or a service was provided).  CICRF can reimburse you for any costs that you have paid out of pocket, or pay providers or venders directly for any outstanding balances.

No - CICRF serves all income levels. However, the total amount of eligible medical expenses that you have incurred in any 12-month time period must meet or exceed 10% of the first $100,000 of your income, plus 15% of any additional income over $100,000.

For example:

No – You essentially can apply for as many consecutive 12-month time periods as you meet the eligibility criteria for, as long as the expenses were incurred before the child’s 22^nd birthday.

No – You cannot combine medical expenses for multiple children in one application. Each application can only pertain to one child applicant.

Yes – You are welcome to submit applications for each child that has incurred enough expenses in a 12-month time period to meet the eligibility criteria.

All application time periods must cover 12-months. They may cover a calendar year, or a split year (i.e 7/22 – 6/23).  Please choose the 12-month time period which captures the majority of the expenses in which you are seeking reimbursement for, and in which you have enough expenses to meet the eligibility criteria.  The State Office may work with you to adjust the 12-month period if it will help you meet eligibility.  If you have submitted an application to CICRF previously, please make sure that the time period you select does not overlap with a previous time period.

At this time, CICRF can only provide assistance for children who are legally domiciled in New Jersey AND  are US citizens, green card holders, or who have obtained legal immigration status (i.e hold visas that allow a family to establish residency).

CICRF may consider reimbursement of out-of-state medical expenses.  Medical expenses that were incurred out of the country are not eligible for reimbursement.

When it comes to home modifications, CICRF pays attention to the date in which the project was completed and usable/accessible to your child.  For example, if your accessible bathroom modification was completed in April 2023, your 12-month application time period should include the month of April in your selection (i.e 1/23 - 12/23, 5/22 - 4/23, etc).

Yes – Despite the $25,000 cap on home modifications, the total award cap on each application is $100,000, so you may combine all of your child’s medical expenses that were incurred during a 12-month time period in the same application.

No, not necessarily.  If the expenses were incurred prior to your child turning 22 years old, and within the last 7 years, then you may submit an application for reimbursement of those expenses. However, if the expenses were incurred after your child turned 22 years old, then you would not be eligible to apply.

For divorced parents, CICRF will consider reimbursement based on the percentage of medical expenses that your divorce decree indicates that you are responsible for.  If your divorce decree states that you are responsible for 50% of the medical costs, then 50% of the total costs will be considered for reimbursement.  This also means that your 50% portion of the total medical costs must meet or exceed 10% or more of your total household income (up to $100,000, and 15% of any additional income over $100,000).  In addition, your ex-spouse may also submit an application for the same time period to seek reimbursement for their share of the other 50% of the medical expenses.

Yes – If you have incurred medical expenses and the medical bills are in your name, and you live independently and financially support yourself, then you may apply for assistance. We would only request documentation to verify your income when processing your application. However, if you still live with your parents and they support you financially, then we would also need documentation of their income when verifying total household income.

Yes – You must be legally domiciled in New Jersey and have lived in the State for at least 3 months prior to submitting an application for reimbursement of medical expenses that you incurred previously.

No – You must be a current legally domiciled New Jersey resident for 3 months or more in order to be eligible for assistance.

No - Since CICRF is a retrospective program, all medical treatments and services must have taken place prior to applying.  In addition, since you will be required to submit copies of your Explanation of Benefits (EOBs) from your health insurance carrier when you apply, it is best to apply after the services have been rendered and all claims have been fully processed through your insurance.

No – We are a program that strictly serves to relieve the financial burden of medical expenses, therefore we cannot provide assistance with mortgage or rent payments, utilities, lost income, etc.

We do not reimburse for the cost of your health insurance premiums, but we can add a portion of it toward your total amount of verified expenses to help you meet eligibility, if needed.

If you underwent a medical procedure, and you are listed as the patient, then CICRF cannot consider reimbursement of your medical expenses. CICRF covers medical expenses for children from birth through age 21. However, all cases are reviewed on an individual basis, so if a life-sustaining procedure was performed for the well-being of the fetus, then your case may be considered.

You will need to submit detailed and itemized invoices for all medical bills (should include dates of service, a description of services rendered, and associated charges), all corresponding Explanation of Benefits (EOBs) for those dates of service, and proofs of payment if applicable. For other purchases, you will need to submit detailed receipts and proofs of payment.

These additional expenses can be presented to the Commission for approval at an upcoming meeting.  You would need to submit a written request to present the additional expense for consideration, a copy of the detailed invoice, corresponding Explanation of Benefits (EOBs), and proofs of payment.  You do not need to submit a new application as your previous application will be reopened and any additional expenses will be processed as what is referred to as a Reconsideration.

Yes – Engaging in fundraising efforts does not automatically disqualify you from applying for assistance. Any funds raised must have been spent prior to applying to CICRF as we operate as the payor of last resort. If you only raised a portion of the total amount needed to cover your child’s total medical expenses, then you can seek reimbursement for the remaining amount of the expenses that fundraising did not cover.  You will be required to submit all of your fundraising account details to CICRF upon submission of your application for analysis.  Failure to disclose any fundraising efforts organized on behalf of your child can lead to ineligibility and disqualify you from receiving reimbursement from CICRF.

We understand that most of the families we serve are experiencing some form of financial burden. However, we can only consider expediting applications ahead of others if a family is in dire circumstances such as risk of home foreclosure or a child has passed.

A reimbursement for medical care is generally not taxable (see https://www.irs.gov/pub525 ). However, it may reduce your medical expense deduction. Please consult with your accountant for further information and guidance.