Grant Eligibility Requirements
Is My Child Eligible?
Applicants must meet the following criteria to be considered for a grant:
1. Child must be 16 years of age or younger at the time of application.
2. Child must have a Social Security Number issued by the Social Security Administration. TIN numbers are not
accepted
3. Family must not exceed maximum eligible family income as documented on IRS Tax Form 1040.
$50,000 or less for a family of 2
$75,000 or less for a family of 3
$100,000 or less for a family of 4
$125,000 or less for a family of 5 or more
Primary coverage for the child must be by a commercial health plan, either through an employer or individually
purchased. Secondary insurance through Medicaid or CHIP is permissible. Child is under the care of a licensed
medical professional and family is applying for treatments/equipment/services prescribed by a Medical Doctor (M.D.), Doctor of Osteopathic Medicine (D.O.) or Doctor of Audiology (Au.D.) for hearing conditions.

Are My Child’s Medical Expenses Eligible?
1. Medical Services, Treatments and/or Therapies MUST be administered by a licensed medical professional.
2. Services or Treatments MUST be provided no more than 60 days prior to the date of your complete application.
3. Medical Services and/or Purchased Equipment MUST be administered or purchased in the United States (excludes U.S. Virgin Islands, Puerto Rico, and other United States Territories)