Uninsured Medical Catastrophe Fund

Overview

Virginia taxpayers can designate a portion of their Virginia tax refund to the Uninsured Medical Catastrophe Fund beginning with the 1999 tax return, and anyone can make a contribution to the fund at any time. It is anticipated that funding will be limited relative to the potential need.

The Fund should have a positive impact on Virginia families by providing access to treatment for uninsured medical catastrophes. Because the UMCF regulations are designed to help uninsured Virginians receive treatment that they otherwise would not have received, the UMCF will not pay for services already rendered, including emergency services. Hospitals are already required to provide emergency services.

There will be four criteria that must be met prior to disbursement of funds. The first criterion is that the individual meets the eligibility rules. The second criterion is that there is an approved treatment plan. The third criterion is that funds are available. The fourth criterion is that a provider can be found who is willing to accept the UMCF contract.

In addition to being a citizen or legally resident alien and a resident of Virginia, an eligible individual must have income under 300% of poverty, have a life-threatening illness or injury and be uninsured for the needed treatment. The UMCF in general will pay for services needed to treat an acute illness or injury or the acute phase of a chronic illness. The services must be part of an approved treatment plan. The proposed treatment plan must be for a course of treatment to remediate, cure, or ameliorate the life threatening illness or injury. The treatment plan must not be open-ended.

The UMCF is not responsible for maintenance medications or additional treatments beyond the course of treatment approved by DMAS. The UMCF will not pay for custodial care, transportation, or mental health services. Even if an applicant is determined eligible and the treatment plan is approved, expenditures are limited to available funding. The UMCF is not an entitlement. Funds will be disbursed on a first-come, first-served basis based on the date the original application is received by DMAS or its agent. The agency will also develop a waiting list, if necessary.