Can You Use the WTC Health Program If You Don't Live in the NYC Metro Area?

Yes. You can receive World Trade Center (WTC) Health Program benefits even if you do not live in the New York metropolitan area. Members who live outside the area receive care through the Nationwide Provider Network (NPN), which serves members throughout all 50 states and U.S. territories. Many 9/11 responders and survivors have moved away from New York or never lived nearby. Through the NPN, they can receive the same Program benefits available through the Clinical Centers of Excellence (CCEs) in the New York metropolitan area, including centers affiliated with Mount Sinai, NYU, Northwell, Stony Brook, and Rutgers.

The NPN is a network of healthcare providers across the country who provide WTC-related services. Members should not receive a bill for approved WTC-related services received through the Program. However, it is important to use a participating provider who has agreed to the Program's requirements. Seeing an out-of-network provider can leave you responsible for the cost.

How the Nationwide Provider Network (NPN) Works

The NPN connects individual providers and provider groups with WTC Health Program members for initial health evaluations, annual monitoring, diagnostic testing, and treatment. It also helps submit certification requests for conditions that may be 9/11-related. Managed Care Advisors (MCA)-Sedgwick administers the NPN.

MCA-Sedgwick coordinates appointments, case management, medical records, certification requests, and an NPN call center and member portal.

What Is the Nationwide Provider Network?

The NPN is the WTC Health Program's system for members who live outside the New York metropolitan area and want to receive WTC-related healthcare close to home. It connects responders and survivors with participating providers and specialists throughout the country and U.S. territories.

How the NPN Differs From a Clinical Center of Excellence (CCE)

The Program delivers care through two systems: CCEs in the New York metropolitan area and the NPN outside that area. CCEs are specialized clinics whose teams regularly treat members of the 9/11 community. The NPN works differently. It has no central clinic; MCA-Sedgwick coordinates care through participating hospitals, clinics, and medical practices near the member.

Both systems provide access to the same WTC Health Program benefits. The setting and the way care is coordinated are different.

What Medical Care Can You Receive Through the NPN?

The NPN provides access to the same Program services available through the New York CCEs, including:

• Annual monitoring exams

• Diagnostic testing

• Treatment for certified physical health conditions

• Mental health evaluations and treatment

• Prescription medications related to certified conditions

• Specialist referrals

• Ongoing follow-up care

Covered care depends on your membership status and whether a condition is certified. WTC-related conditions may include aerodigestive disorders, cancers, acute traumatic injuries, mental health conditions such as post-traumatic stress disorder, depression, and anxiety, and certain musculoskeletal disorders for responders.

Finding an NPN Provider Near You

After enrollment, MCA-Sedgwick helps you find participating providers in your area. Depending on your condition, your care team may include:

• Primary care physicians

• Pulmonologists

• Oncologists

• Mental health counselors

• Gastroenterologists

• Ear, nose, and throat specialists

• Other medical professionals

The Program covers approved care for certified 9/11-related conditions when the provider:

• Is part of a health network contracted with the Program or one of its vendors

• Has agreed to provide care to WTC Health Program members

To help ensure that a provider participates and the care is authorized, NPN members should contact MCA-Sedgwick before scheduling with a new provider. MCA-Sedgwick can identify a provider and help schedule covered care.

NPN vs. Choosing a New York Clinic: Which Makes Sense for You?

Some Program members continue receiving care at a New York CCE even after moving away because they prefer to stay with doctors who have treated them for years and who have extensive experience with the unique health issues affecting the 9/11 community. They travel to New York for their Program appointments. Other members transfer to the NPN to receive Program care closer to home.

The right choice depends on your health needs, ability to travel, and whether you already have an established relationship with a New York clinic. The Program generally requires you to receive your health benefits through one CCE or the NPN at a time, but both provide access to the same benefits.

How to Enroll in the WTC Health Program From Out of State

Living outside New York does not affect your eligibility for the WTC Health Program. If you lived, worked, attended school, participated in rescue, recovery, or cleanup efforts, or were otherwise present in a covered disaster area after September 11, 2001, you may qualify if you meet the eligibility rules for your group, regardless of where you live now.

To apply, you must submit an application and the required supporting documentation. The application asks for identification and contact information. Your supporting documents should show:

• The activity you performed or how you were present

• The location of your 9/11-related activity or presence

• The relevant dates or time period

• The hours or duration required for your eligibility group

Once your application is approved, members who live outside the New York metropolitan area are automatically assigned to the NPN. From there, you can schedule an initial health evaluation and begin receiving monitoring or treatment for covered conditions based on your membership status.

Enrollment can sometimes be complicated, particularly when employment or other records are difficult to locate, or you have moved since 2001. An experienced VCF attorney can help you gather the necessary documentation and ensure that your application is complete.

Already Enrolled at a New York Clinic but Moved Away? How to Transfer Into the NPN

If you originally enrolled through a New York CCE and later relocated for work, retirement, or family reasons, you can request a transfer to the Nationwide Provider Network. In most cases, members may change their clinic once a year. Start by speaking with your current CCE or the NPN. You will also need to authorize the release of your medical records so your history, certifications, and treatment information can move with your care.

To prepare for the transfer, ask your current clinic and the NPN about:

• Which specialists are available near your new home

• How prescriptions, follow-up care, and other parts of the transition will be handled

• Whether any upcoming appointments should be completed before the transfer

Some members transfer to the NPN, while others remain with a New York CCE and continue traveling for their Program care. Confirm your plan with your current clinic or the NPN before scheduling care.

How Your NPN Records Connect to Your VCF Claim
and Documentation

Whether you receive care through the NPN or a New York CCE, your WTC Health Program certification information is important to a September 11th Victim Compensation Fund (VCF) claim. The World Trade Center Health Program and the VCF are separate programs. The World Trade Center Health Program provides medical monitoring and treatment, while the VCF provides financial compensation for eligible 9/11-related losses.

With your authorization, the VCF asks the WTC Health Program to confirm that you have a certified 9/11-related physical health condition. The Program does not send the VCF your full medical records through its routine information-sharing process. It provides the name and category of the certified condition and the associated diagnosis code. Depending on your claim, additional medical records may still help show the severity of your condition and the losses it caused.

Let Hansen & Rosasco 9/11 Attorneys Help You Enroll in the WTC Health Program

Whether you are enrolling in the Health Program for the first time, transferring into the Nationwide Provider Network, or pursuing compensation through the VCF, an experienced 9/11 attorney can make the process easier and help ensure that your applications and documentation are complete.

The dedicated attorneys at Hansen & Rosasco, LLP help members of the 9/11 community across the country navigate enrollment, gather proof of presence, coordinate documentation, and pursue available compensation and medical benefits. Contact our team today to learn more about your options.