Children's Hearing Aid Program

Information for Patients

Apply

Our digital application can be found below and electronically completed. It can also be downloaded and printed, or a copy can be sent to you through email, fax, or post mail.

Choose from our network of audiologists!

Once approved, you will work with our team to find an audiologist in our network.

Attend the appointments.

Your paired audiologist will suggest the best path for your child. If hearing devices are needed, Sertoma will pay the doctor for the device, leaving the patient with little to nothing to pay.

Enjoy sound!

You will work with your child's audiologist to schedule a time to be fit with the new devices. The audiologist will explain the warranties and other information about the new devices.

Meet our audiologists!

Click below to see our current list of providers participating in the program.


Don't see your child's audiologist on our list? Please let chat, call, or email our office to let us know. We are working every day to expand the number of participating audiologists, and would love to work with yours!


Documents to include with the application

  • Picture files can be attached directly to the below digital application

Parent/Guardian must be a Florida Resident

One of the following must be submitted by all parent(s)/guardian(s) listed on the application:

  • Florida Driver's License
  • Florida Photo Identification card obtained at the DMV
  • Florida Vehicle Registration

Child must be between the ages of 0 to 18

To verify the age of the child on the application, one of the following must be submitted:

  • Child's Birth Certificate
  • Child's photo ID issued by a government agency, such as a ID card issued by the DMV or a passport

The application must include the tax return for the most recent tax year.


If the family did not file a tax return, please contact our office for information on what to submit as proof of income.

Click for our digital brochure

Eligibility requirements and application

400% Federal Poverty Rate

  • Total household income must be below the displayed maximums depending on how many are in the household. 
  • Must include all adults and dependents in the household
  • All individuals that contribute to the care of the patient must include their income.

The patient must be ineligible for CHIP(KidCare) / Medicaid

Children eligible for CHIP (KidCare) or Medicaid are not eligible for funding under CHAP. Please contact our office for additional information on eligibilty for KidCare and/or Medicaid.

Insurance Coverage

Sertoma understands dealing with insurance is difficult and confusing. If you have any questions about getting the required documentation, please do not hesitate to contact our office.


If the child is covered by health insurance, a copy of the health insurance card along with the summary of benefits coverage must be supplied by the family from the insurance company. Please call your insurance company to obtain this document, and submit it with your application.


If the insurance covers or partially covers the hearing devices the family is interested in, Sertoma will work with you to obtain the documentation from the insurance company required for this step.


If the insurance pays for a portion of the device, CHAP will pay for the portion the insurance does not cover. Families will never have any cost!

Click here for full screen application. (This will open a new window, any text entered will not move to the new window)

Alternatively, you can download the application by clicking below, and submit through email, fax, or mail to:

Email: CHAP@familyhearinghelp.org

Fax: 727-807-6172

Mail:   Sertoma Speech & Hearing Foundation

Attn: Children's Hearing Aid Program

5211 US Hwy 19, Ste 200

New Port Richey, FL 34652

Click for printable application

Frequently Asked Questions:

  • How do I apply?

    Applications can be accessed at www.familyhearinghelp.org/chap (this page) for a live application that can be completed and signed digitally. You may also download a copy that can be filled out by hand. An application can also be requested by emailing CHAP@familyhearinghelp.org or by calling our office at (727) 312-3881.

  • How can I see if my child is eligible for this program?

    Sertoma has the eligibility prerequisites displayed listed at the top of this page. Still have questions about eligibilty? Live chat with us during normal business hours with the blue chat button on the bottom right of your screen.

  • How do I send in the application?

    Applications online can be turned in automatically by clicking “finish” and “Submit”. Applications can also be downloaded and submitted by emailing to CHAP@familyhearinghelp.org, faxing to (727) 807-6172, or by mailing to:



    Sertoma Speech & Hearing Foundation

    Attn: Children's Hearing Aid Program

    5211 US Hwy 19, Ste 200

    New Port Richey, FL 34652

  • Do you take insurance?

    While Sertoma does not handle insurance through CHAP, insurance coverage will be applied to the devices cost and the CHAP funding will cover the difference. Even if a patient has private insurance with hearing aid coverage, there will be no cost to the family for their child's new devices!


    Patients who have CHIP (KidCare) and/or Medicaid are not eligible to recieve assistance through CHAP.

  • What is proof of income?

    The most recently filed tax return filed by the parent/guardian's who have custody of the child. If the family did not file a tax return, our staff will work with you to determine what documents are needed.

  • What is proof of residency?

    A clear copy of the identification for one of the parent(s)/guardian(s) listed on page 1 of the application is required to verify Florida residency.



    This proof must be one of the below:

    • Florida Driver's License
    • Florida Photo Identification card issued by the DMV
    • Florida Vehicle Registration

  • What is proof of age?

    Sertoma is required to verify the individual receiving assistance under CHAP is younger than 18. Proof can be the child's birth certificate or their photo ID.

  • Does the program cover service costs, such as fees for testing?

    Sertoma now reimburses the cost of services directly to the audiologist. This means that, if a patient is approved through our program, there will be no expenses required by the family to get their child new device(s)!


    If you feel you were charged incorrectly by a provider in this program, please contact our office as soon as possible.

  • What if I have more questions?

    We are here to help! Our contact information is below. Our office is open Monday to Friday from 8am to 4:30pm, and closed on most federal holidays.


    Phone: 727-312-3881


    Email: CHAP@familyhearinghelp.org


    Live Chat: During office hours, click the "Live chat with our team!" button on the bottom right corner of this page.

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