- This page, Apply for financial eligibility from the Hearing Aid Program, is offered by
- Division for Children & Youth with Special Health Needs
- Bureau of Family Health and Nutrition
- Department of Public Health
Apply for financial eligibility from the Hearing Aid Program
Contacts
Universal Newborn Hearing Screening Program
The Details of Apply for financial eligibility from the Hearing Aid Program
What you need for Apply for financial eligibility from the Hearing Aid Program
- Written documentation of household income.
The preferred form is the most recent federal tax form (including W-2s). This includes all those whose income is counted in determining family income. Income not included on federal tax forms must be submitted with written verification. - The applicant family should supply all medical bills (including dental) paid or incurred during the past twelve months.
This should be in the form of receipts or copies of billing statements
How to apply Apply for financial eligibility from the Hearing Aid Program
- Download and complete the Department of Public Health Hearing Aid Program for Children Application (PDF) | (RTF)
- Mail completed application, information about income and description of insurance benefits for hearing aids to:
Division for Children & Youth with Special Health Needs
Attn: John M. Stewart
250 Washington Street, 5th Floor
Boston, MA 02108-4619
Next steps for Apply for financial eligibility from the Hearing Aid Program
Letter of financial eligibility
Once the completed forms and appropriate documentation are reviewed, we will send a letter indicating your financial eligibility determination. The letter will serve only as your notice of eligibility for the program – it is not a hearing aid purchase authorization.
Final approvals can be made only after the program has received complete reports and recommendations directly from an audiologist licensed by the Commonwealth of Massachusetts and a price quote from a participating hearing aid dispenser.