Written by a parent, not a doctor. Nothing here is medical advice.

Childhood Cancer Lantern
Search Saved

New Jersey program

The Catastrophic Fund

The Catastrophic Illness in Children Relief Fund can help with eligible medical expenses insurance does not cover.

What it is

The Catastrophic Illness in Children Relief Fund can help with eligible medical expenses insurance does not cover.

Large medical bills can strain a family at any income. This fund compares eligible costs over a 12-month period with income during that period. It reviews costs after insurance has finished processing them.

Eligibility rules
  • Eligible expenses must concern one child and a chosen 12-month period. The child must have been under 22 when the expenses arose.
  • Eligible costs in the 12 months must add up to more than 10% of your income (15% of any income over $100,000). A family earning $60,000 needs more than $6,000 of eligible costs. Once over that line, the fund can look at the whole amount, not only the part above it.
  • The family must be legally domiciled in New Jersey for at least three months before applying. Eligible children include citizens, green-card holders and children with legal immigration status.
What you get
  • Help with eligible expenses already incurred, including unpaid medical balances.
  • A review of a 12-month period within the previous seven years.
What the help covers
  • Out-of-state medical costs can be considered. Costs incurred outside the United States cannot.
  • The hospital screens for Charity Care before referring remaining costs to this fund.
If you decide to apply
  1. You can ask the hospital counselor to screen for Charity Care and help assemble a Catastrophic Fund application.
  2. For that discussion, it helps to have dated bills, receipts, insurance explanations and income records ready. You can ask which 12-month period best describes the costs.

Department of Human Services, Catastrophic Illness in Children Relief Fund · Official page ↗

After you ask
  • The fund board reviews the application after the services and insurance processing.
  • The chosen expense period can cover any 12 months within the previous seven years.
Good to know

This fund does not replace lost pay or cover rent, a mortgage or utility bills.

Other details
  • Bills and insurance explanations need dates so the income and costs can be matched to the same period.
Official sources
Ask your social worker

“Could the Catastrophic Fund repay some of our child's costs? What qualifies, what paperwork is involved, and could you help us apply after insurance finishes?”

Why I’m asking: I want to know whether expenses we have already faced can be reimbursed.

More background and detailed requirements
Additional program information and published rules

Who does what

The three parts, side by side. The agency decides; nobody on this page does.

You

Keep every explanation of benefits and receipt with its date, and apply after insurance has finished.

Your social worker

The hospital financial counsellor screens you for Charity Care first and can help assemble the file.

The care team

Records and letters when the application asks for them.

Who decides
The Catastrophic Illness in Children Relief Fund board at the Department of Human Services.
Ask your social worker
“Can you help us start a Catastrophic Fund file? Please screen us for Charity Care first, and tell us which 12 months to claim.”

How to apply

First step: Start a folder of every bill and explanation of benefits today, and ask the hospital financial counsellor to screen you for Charity Care first.

  1. Start a folder now: every explanation of benefits, every receipt, every bill with a date.
  2. Ask the hospital financial counsellor to screen you for Charity Care first; the Fund takes what is left.
  3. Pick the 12-month stretch with the heaviest costs when you apply.
  4. If the child is having major surgery and the situation is dire, ask whether the application can be expedited.

Official application / program page ↗

Where it starts: Apply after the services and after insurance has processed them. The hospital screens the family for Charity Care first and refers the uncovered part here.

What to gather

  • Every explanation of benefits from the insurer
  • Every receipt for what you paid yourself
  • Bills with outstanding balances
  • Proof of New Jersey address going back three months

How long: unknown: no ordinary decision time was published. Dire circumstances can be expedited.

What a yes looks like

A decision reimbursing what you paid, or paying providers directly for outstanding balances.

What a no looks like, and the next move

Costs in the period you chose did not reach the line. Ask which 12 months would, and apply again for a later stretch.

Watch out

  • It looks backwards. Apply after insurance has finished, not before.
  • It does not pay rent, utilities or lost wages.
  • Keep every explanation of benefits from the first week; the file is only as good as the paperwork.

Dates that change this

2026-09-11: How long an ordinary decision takes was not published; only expediting in dire circumstances is described. Ask when you file. (not yet confirmed against the final rule)

2020-10-07: A 2020 policy covers medical travel and lodging when treatment is more than 30 miles from home. No current mileage rate was published; ask whether the policy still stands. (not yet confirmed against the final rule)

The numbers and the rules

The arcane layer, kept on purpose. Checked September 11, 2026.

What it is worth

Eligible incurred medical expenses, including unpaid balances, must meet or exceed 10% of the first $100,000 of family income plus 15% above that. This is an eligibility threshold, not a deductible limiting an award to the excess. The Commission decides eligible costs and the award.

  • $10 — Share of the first $100,000 of income that eligible incurred costs must meet or exceed
  • $15 — Share of income above $100,000 that eligible incurred costs must meet or exceed
  • $100,000/year — Income breakpoint where the share changes
  • $12 — Length of the period the costs are measured over
  • $7 — How far back an application can reach
  • $22 — Age before which the costs must have been incurred
  • $3 — Months of New Jersey residence needed before applying

Covers: Reimbursement of costs already paid out of pocket · Direct payment to providers for outstanding balances

What it costs the family: Nothing to apply.

The eligibility facts, as published

Age
costs must have been incurred before the child's 22nd birthday
Age max exclusive
22
Income
no ceiling: eligible medical costs are compared with income
Residency
legally domiciled in New Jersey for at least three months before applying
Immigration
US citizens, green-card holders, or children who have obtained legal immigration status
Geography
out-of-state medical costs can be considered; costs incurred outside the country cannot
Exclusions
rent, mortgage, utilities and lost income are not covered

The trap: It is a reimbursement programme. Apply after the services and after insurance has finished processing, and keep every explanation of benefits and receipt. It does not pay rent, utilities or lost wages.

Where I read this

← Back to your options