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Catastrphic Illness In Children Relief Fund Commission
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In the Catastrophic Illness in Children Relief Fund Program, any illness can be "catastrophic" based on uncovered eligible medical expenses and the family's income in a prior 12-month time period.

A catastrophic illness is any illness or condition, acute or chronic, for which expenses are incurred that are not covered by insurance, state, federal programs, or any other sources* and exceed the program’s eligibility threshold.

There are no specific exclusions by diagnosis. 


*N.J.A.C. 10:155-1.2 defines “other sources” as “including, but not limited to, other State or Federal agency programs, insurance contracts, trusts, proceeds from fundraising, or settlements relative to the medical condition of a child…”

 Comprehensive health coverage is considered a source of coverage for most ambulatory services (medical services performed on an outpatient basis, without admission to a hospital or other facility) provided to a child that are not inadvertent, urgent, or due to an emergency.

 If a child’s source of health coverage includes needed ambulatory services in their provider network, uncovered out-of-network expenses may not be reimbursable.

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