Families of September 11 is now operating as the For Action Initiative. The
web pages on this site are available for informational purposes only.
Please visit us at www.foractioninitiative.org
June 7, 2006
Health Care Support Program - Sign up extended to June 30, 2006
What does the program cover? - Eligible individuals or families can choose from one of the following alternatives
• OPTION 1 - receive reimbursement for 50% of health and/or dental insurance premiums for a maximum of two years.
• OPTION 2 - receive reimbursement for up to $2,500 per year for each of two years for out-of pocket deductibles, co-payments, or payments for professional health care services where your benefits have been exhausted. Costs submitted for reimbursement are not eligible for submittal to any other reimbursement program including LifeNet and all other 9/11-related funds and grants. If in doubt, contact Diane Nealon for any questions about eligibility for other health care support programs.
Program Length - Two Years
• The program will run for 24 consecutive months and can be started any time from 1/1/2006 through and including 5/31/2006. You may select the start date when you request consideration for eligibility.
• Each year you will select an option which will stay in force for twelve months once it is selected. You may change options only once thereafter - to affect the second year. Near the conclusion of month twelve, you can request a different option, which will go into effect on the first day of month 13 of the 24 month program.
Who is eligible? The program's current requirement is that you satisfy all of the following criteria. These criteria are subject to change given appropriate federal and state regulation and legislation:
• Relationship - You were impacted by the attacks of 9/11/01. "Impacted" is defined by one of the two following definitions:
1. You are related to an individual killed or injured in the September 11th terrorist attacks (relationship must be either as parent, spouse, child, sibling or domestic partner. This relationship does not had to have been one in which you were financially dependent upon the loved one who was killed or injured) or
2. You suffered personal injury or trauma as a direct result of being at the World Trade Center area (whether as a victim or a rescue worker)
• Residency - your legal primary residence for the past twelve months
1. You can provide documentation that your primary residence has been Massachusetts, New Hampshire or Rhode Island, and you have lived there for at least the past twelve months
1. The annual taxable income for an individual (documented by a copy of your federal tax return) can not exceed $94,200. For families, the annual taxable income cannot exceed $188,400. Please note - this is a change from the original program design, necessary to comply with appropriate Internal Revenue Service advisories and regulations.
How do I request an eligibility determination? - Families requesting eligibility need to send the following documents. These can be provided by mail, or by email using scanned documents in PDF format.
• a cover letter indicating
o for persons related to a lost loved one(s)
• the name(s) of the individual(s) requesting eligibility, their relationship to the loved one(s), and the name of the loved one(s).
o for people who were directly injured or traumatized as a result of being at the World Trade Center site on 9/11/01
• your name
o a statement choosing which option you would like
• Option 1 - insurance premium reimbursement or
• Option 2 - out-of-pocket reimbursement
o the start date you choose for your eligibility
• any date from 1/1/2006 through and including 5/31/2006) to begin.
• a completed copy of your 2005 tax return (covering 1/1/05-12/31/05). Please only send the 1040, 1040A or 1040EZ. We do not need any attachments or supplementary schedules. This will also serve as documentation of your current residency.
• a copy of documentation establishing the state of your residency for the past twelve months.
• for those persons related to a lost loved one, a copy of documentation supporting your relationship to your deceased loved one(s)
If you believe any of the above documentation is already on file at the Fund, please let us know. Duplicates are NOT necessary. We will respond promptly to all families requesting a decision on their eligibility for this program.
Please direct your email correspondence to firstname.lastname@example.org
The mailing address is:
The Massachusetts 9/11 Fund, Inc.
Health Care Support Program
75 Kneeland Street - Sixth Floor
Boston, MA 02111-1901
What is the process for submitting paid bills for reimbursement once I am told I am eligible for this program?
Eligible families submit copies of paid bills (no more frequently than once per month, please) for reimbursement consideration. The mailing address to use is the same as immediately above.