Frequently Asked Questions
How Does It Work?
If you're still suffering psychological symptoms related to the events of 9/11, you may qualify for coverage under the NYC 9/11 Benefit Program. To find out, call (877) 737-1164 (877-SEP11MH). A benefit coordinator will work with you to establish whether you are eligible and explain the process for submitting claims.
If you are found eligible, you will receive reimbursement for out-of-pocket costs, up to the maximum amount allowed under the NYC 9/11 Benefit Program fee schedule for mental health or substance-use treatment.
If you have insurance, you must first apply your insurance benefit toward the cost of treatment. The NYC 9/11 Benefit Program will reimburse for the remaining out-of-pocket costs.
If you don't have insurance, you can receive reimbursement for the fees you pay to providers, up to the maximum amount allowed under the NYC 9/11 Benefit Program's fee schedule .
The Benefit Program will directly reimburse providers if they file claims for services they provide to eligible patients. If a provider's fee exceeds the reimbursable amount for a given service, the patient will be responsible for the balance.
Who Is Eligible?
Two groups of NYC residents are eligible for the program.
Group A includes individuals or family members of those who:
- Lost a family member, were physically injured, or lived below Canal Street
- Worked in the WTC area or at the Pentagon - whether or not they were at work that day or were evacuated from the WTC area or the Pentagon
- Attended a school near the WTC, or are the parent of a child who attended nearby
- Were a rescue, recovery, or reconstruction worker assigned to a "restricted site"
- Were an emergency dispatcher on 9/11 or worked in the morgues serving the attacks sites
- Worked south of Canal Street or at Ronald Reagan Airport, and before January 11, 2002 lost their job or earned less than 70% of their pre-9/11 income
- Have a family member, or shared a home with someone, who meets the criteria above
Group B includes NYC residents who are not in Group A but who have psychological symptoms that are likely related to the attacks. Individuals in this category will be screened, and their treating providers will be asked to submit a letter affirming that their conditions are likely related to the events of 9/11.
What Services Are Covered?
The NYC 9/11 Benefit Program reserves the right to modify covered services at any time. Covered services include:
- Outpatient mental health and substance-use services: The benefit program covers out-of-pocket costs associated with outpatient treatment. There is no dollar cap on reimbursement for members of Group A. For members of Group B, reimbursement is limited to $3,000 over the lifetime of the benefit.
- Medication and laboratory work related to mental health and substance-use treatment: Additionally, the benefit covers reimbursement for medication and/or laboratory work up to $1,500 over the lifetime of the benefit.
- Psychological evaluations and testing: The benefit covers up to eight hours of evaluation and testing for children age 21 and under.
The benefit program does not cover the following:
- Inpatient services
- Emergency-room visits and related services
- Art therapy and other expressive therapies
- Missed appointments
- Medication not related to mental health or substance use
- Services provided outside of New York State
Who Can Provide Treatment?
To receive reimbursement, you must receive services from a provider who is licensed/certified in New York State, or who works under the supervision of a New York State-licensed provider in the same field of practice and practice in New York State.
Services delivered by the following licensed or certified professionals are covered under the NYC 9/11 Benefit Program:
- Social workers
- Nurse practitioners
- Certified alcoholism or substance-use counselors
- Mental health counselors
- Marriage and family counselors
- Licensed psychoanalysts (state license holders only; national certification is not sufficient)
How Do I Enroll?
Please note that enrollment ends July 7, 2010.
To get started online, Group A members click here. A benefit coordinator will call you to complete your enrollment once you have submitted all required information.
To enroll by phone, please call (877) 737-1164 (877-SEP11MH). Your call is confidential. Benefit coordinators are available to help you decide which services are right for you and your family, and to help you find a New York licensed provider.
- April 21, 2008: Enrollment begins
- January 2, 2007: Coverage begins (retroactively)
- July 7, 2010: Enrollment ends
- January 7, 2011: Coverage ends
- March 31, 2011: Last day to submit claims
Note: Terms are subject to modification based on available resources and the success of the program. This program is funded and overseen by the New York City Department of Health and Mental Hygiene, with benefit access coordinated by the Mental Health Association of NYC.
What Other Treatment Options Are Available?
The World Trade Center (WTC) Centers of Excellence offer integrated physical and mental health care at no cost to eligible individuals who were exposed to the collapse of the World Trade Center. The WTC Centers of Excellence have treated thousands of people with 9/11-related health issues.