WTC Health Program Coverage: Free Care for 9/11 Illnesses
What does the WTC Health Program cover?
The World Trade Center (WTC) Health Program (also called the WTCHP) covers medically necessary treatment for certified 9/11-related conditions, with no premiums, deductibles, or copays. Coverage includes diagnostic testing, physician visits, hospitalization, surgery, prescription drugs, cancer treatment, and mental health care. Over 70 cancers and dozens of respiratory, aerodigestive, musculoskeletal, and mental health conditions are covered. Care is delivered through Clinical Centers of Excellence in the NYC area and the Nationwide Provider Network elsewhere in the U.S.
Key Takeaways
- 100% Covered: No premiums, deductibles, or copays for certified conditions.
- 70+ Cancers: Plus dozens of lung, respiratory, aerodigestive, musculoskeletal, and mental health conditions, such as sleep apnea, GERD, and COPD. See the full list of WTC Health Program covered conditions.
- Nationwide Access: NYC members use Clinical Centers of Excellence; members elsewhere within the U.S. use the Nationwide Provider Network.
- Free Monitoring: Annual exams available even before a condition is certified.
- Certification Required: Each condition must be individually certified as 9/11-related.
- No Enrollment Deadline: The program runs through 2090; enrollment is possible any time.
The program was created by the Zadroga Act, the 2010 federal law that also reopened the September 11th Victim Compensation Fund (VCF).
What the WTC Health Program Covers
The WTC Health Program covers a wide range of medically necessary services for certified conditions, but not every service is available to every member. Eligibility can depend on your responder or survivor status, prior authorization, and other requirements specific to that service. Tap any item for details.
All responders receive an initial health evaluation upon enrollment and annual monitoring exams thereafter, whether or not they have a certified condition. Survivors receive a one-time initial health evaluation. Annual monitoring begins for survivors once a condition is certified. Monitoring exams include a physical exam, breathing tests, mental health assessment, 9/11 exposure assessment, and routine blood and urine tests.
All medically necessary treatment for certified conditions, including doctor visits, specialist consultations, surgery, hospital services, lab work, imaging, and procedures following WTC Health Program and NCCN guidelines where applicable.
Cancer treatment is covered under NCCN treatment guidelines for each specific cancer type. Treatment must be provided by a WTC Health Program participating provider approved for cancer care. Free cancer screening is also available before any diagnosis; see below.
Chimeric Antigen Receptor T-cell (CAR-T) therapy, an advanced immunotherapy for cancers that have relapsed or not responded to standard treatment, is covered when medically necessary for a certified cancer or an associated condition, subject to prior authorization.
Covered when a certified condition has caused chronic, end-stage damage to the organ and standard treatments have been exhausted. Coverage requires prior authorization and applies only to non-experimental transplant procedures.
Covered for cancer-related pain, fatigue, and nausea in members with a certified cancer, and for chronic pain from certified musculoskeletal or traumatic injury conditions. Up to 12 visits are available in the first 90 days, extendable to 20 visits over 12 months with documented improvement.
Available to members with at least one certified condition, and separately to any eligible member who currently smokes and is referred after lung cancer screening, even without a certified condition. Covers non-nicotine medications and nicotine replacement products such as patches, gum, and lozenges.
Roughly ten certified mental health conditions are covered, including therapy, counseling, and medication through psychiatrists and other mental health providers. Residential mental health treatment is not covered. Mental health conditions are not compensable through the VCF, but are fully covered for treatment.
In certain circumstances, therapy for a member's family, or marital counseling for a member and spouse, may be covered as part of treating the member's own certified condition. Ask your Program provider or case manager whether your situation qualifies.
In certain circumstances, covered for certified WTC-related mental health and substance use disorders, including acute hospitalization and specialty outpatient treatment. Residential substance use treatment is not covered.
Medications prescribed for certified conditions are covered with no copay for responders. Survivors are required to maintain primary health insurance for pharmacy coverage; the WTC Health Program coordinates with primary insurance and covers the remainder.
Limited dental coverage is available for members before cancer treatment or organ transplant: a once-per-lifetime dental checkup including cleaning and x-rays, and based on findings, medically necessary dental care. Members with certified head and neck cancer may receive additional dental treatment to address new dental issues caused by cancer treatment.
Equipment used in the home, such as hospital beds, wheelchairs, nebulizers, and CPAP machines, is covered for certified conditions with a provider prescription and prior authorization, supplied by a preferred Program provider whenever possible.
Certain vaccines recommended by the CDC's Advisory Committee on Immunization Practices are covered for eligible enrolled members, based on age, timing, and other requirements. Not available to FDNY family members.
Limited COVID-19 testing and treatment is covered when medically necessary to address a certified condition or a condition medically associated with it, subject to Program authorization and eligibility criteria.
Medically necessary home health care is covered for a limited period for homebound members who require it to treat a certified condition, with authorization from your CCE, the NPN Clinical Director, or the WTC Health Program.
Covered when treatment for a certified condition is no longer controlling the illness and the member has a life expectancy of six months or less, with support in the member's home or a hospice facility. Care can continue beyond six months if your CCE or the NPN Clinical Director confirms it is still needed.
Hospital stays, including semi-private rooms, meals, nursing, prescription drugs, and other hospital services and supplies, are covered when medically necessary for a certified condition. Your CCE or the NPN Clinical Director must authorize the stay before admission.
Covered for members whose certified condition requires intensive physical rehabilitation with a coordinated care team that cannot be provided on an outpatient basis. Requires Program authorization.
Physical therapy, physician services, and related rehabilitative care at a comprehensive outpatient rehabilitation facility are covered for a certified condition. Your CCE or the NPN Clinical Director must review and authorize the care plan.
Around-the-clock nursing or rehabilitation care following a hospital stay for a certified condition may be covered at a skilled nursing facility, subject to specific criteria and authorization from your CCE or the NPN Clinical Director.
Covered for members with medically complex conditions requiring an extended hospital stay, when the WTC Health Program confirms the stay is medically necessary for a certified condition and authorizes it in advance.
Covered when necessary to prevent death or serious impairment from a certified condition. Notify your CCE or the NPN within 24 hours of emergency care. Non-emergency visits to an emergency department are not covered; use urgent or routine care instead.
Covered for a certified condition when treatment is needed within about 12 hours to avoid an emergency, but does not itself require an emergency room. The urgent care facility should notify your CCE or the NPN of the visit as soon as possible.
Non-emergency medical transportation, such as an ambulance, is covered when necessary for a certified condition. Non-emergency general transportation to appointments is available only to Nationwide Provider Network members who live far from a provider with no other options. Both require prior authorization.
Free Cancer Screening, Even Without a Diagnosis
The WTC Health Program covers cancer screening based on U.S. Preventive Services Task Force guidelines, available to eligible members regardless of certification status. Screening is currently limited to four cancers, and is not available to FDNY family members.
Breast Cancer
Ages 40 to 74, mammography once every 2 years.
Cervical Cancer
Ages 21 to 65, a Pap smear every 3 years, or ages 30 to 65, HPV testing alone or combined with a Pap smear every 5 years.
Colorectal Cancer
Ages 45 to 75, using stool-based testing, CT colonography, flexible sigmoidoscopy, or colonoscopy, with frequency depending on the method.
Lung Cancer
Ages 50 to 80 with a 20 pack-year or greater smoking history, currently smoking or quit within the last 15 years, a low-dose CT scan every year.
Screening is for members without symptoms suggestive of that cancer. Anyone with symptoms needs diagnostic testing, not screening, and can request it at any time.
How Care Is Delivered
Clinical Centers of Excellence (CCEs)
Members in the New York metropolitan area receive care through CCEs: specialized clinics with expertise in 9/11-related conditions. FDNY members are assigned to the FDNY CCE. Other NYC-area responders and survivors are assigned to a responder or survivor CCE upon enrollment.
Nationwide Provider Network (NPN), Administered by Sedgwick
Members outside the New York metropolitan area receive care through the NPN, administered by MCA-Sedgwick. NPN members receive the same program benefits as CCE members. Members can nominate a provider to join the NPN if their preferred provider is not yet participating. The program will attempt to find care within 30 miles for urban members and 75 miles for rural members.
The WTC Health Program does not cover treatment received outside the United States or its territories, regardless of where the member lives. Members outside the US must receive care through the NPN or a CCE during visits to the US.
Primary Insurance and Coordination of Benefits
Responders
Not required to have primary health insurance to enroll or receive care. The WTC Health Program covers all costs for certified conditions.
Survivors
Required to obtain and maintain primary health insurance for both medical and pharmacy coverage before receiving treatment. The WTC Health Program coordinates with primary insurance and covers remaining costs. Members who cannot obtain primary insurance may qualify for an exception.
Medicare and Medicaid
Medicare and Medicaid are billed before the WTC Health Program for qualifying treatment for certified medical conditions. This differs from typical multi-payor situations where Medicaid is typically the payor of last resort.
The benefits described here are available at no cost to enrolled members with certified conditions. If you are not yet enrolled, that is usually where to begin. A case review can assess your eligibility and walk you through the enrollment process.
Get a Free Case Review →Common Questions
For certified conditions, there are no copayments, deductibles, or out-of-pocket costs, provided care is received from a WTC Health Program participating provider. Responders' claims go directly to the WTC Health Program. If a certified condition is also covered by workers' compensation, the program pays but seeks reimbursement from your workers' comp carrier. Survivors bill primary insurance first; the WTC Health Program covers the remainder.
The Nationwide Provider Network serves members across the United States and its territories. You receive the same program benefits as New York-based members. The WTC Health Program does not cover treatment received outside the United States or its territories.
The WTC Health Program treats Medicare or Medicaid like any other primary or secondary insurance that gets billed before the program covers the remainder. The WTC Health Program is the payor of last resort.
Yes. Certain cancer screenings are available to all enrolled members by age and risk regardless of certification status. Responders also receive annual monitoring exams regardless of certification. Survivors without a certified condition retain their membership but have limited covered services until a condition is certified.
Yes. The Consolidated Appropriations Act of 2026, signed by President Trump in February 2026, secured WTC Health Program funding through 2040 after the program faced a projected shortfall that would have caused service cuts starting in 2027. The program is authorized through 2090. Congressional action will be needed before 2040 to maintain services beyond that date.
No. The WTC Health Program does not cover the cost of medical marijuana. It is not FDA-approved and remains a Schedule I controlled substance under federal law, even in states where it is legal to purchase.
The WTC Health Program is administered by the National Institute for Occupational Safety and Health (NIOSH), part of the Centers for Disease Control and Prevention (CDC) in the U.S. Department of Health and Human Services. It provides medical monitoring and treatment for certified WTC-related health conditions.
It is separate from the VCF, which provides financial compensation and is administered by the Department of Justice. The two programs have different eligibility rules.
September 25, 2026 · Based on WTC Health Program Member Handbook 2025, WTC Health Program Administrative Manual, and CDC, "About the WTC Health Program." Figures and deadlines may change — confirm the details that apply to your claim.
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