Apply for Coverage
Hearing Aid Coverage for Children Program
How to apply:
Include all required documentation:
-
Household income,
-
Existing health coverage (if any),
-
Hearing aid prescription (signed by your child’s otolaryngologist or physician) or referral
Mail or fax your application to HACCP:
Hearing Aid Coverage for Children Program
PO Box 138000
Sacramento, CA 95813
Fax: (833) 774-2227
- Eligibility will be determined within 10 days from receipt of complete application. HACCP will confirm the applicant’s enrollment status to them by mail.
Annual Eligibility Review (AER)
Each year, all family members participating in the Hearing Aid Coverage for Children Program (HACCP) have an Annual Eligibility Review to see if they can continue to receive coverage of hearing aids and related services through HACCP.
Steps for a successful eligibility review:
- Fill out the streamlined HACCP AER Application
- Send proof of income
- Provide current year health insurance plan documents*
*Hearing Aid prescription/referral is not required
You can provide your application materials to us by:
- Online Portal: Sign in and complete your application at haccp.dhcs.ca.gov
- Fax: Toll-free to 1 (833) 774-2227
Mail:
Hearing Aid Coverage for Children Program
P.O. Box 138000
Sacramento, CA 95813
We must receive this information by the AER renewal date.
Appeal
Applicants may file an appeal if they believe eligibility effective date of coverage, enrollment decision, or disenrollment decision was made in violation of the program rules.
Applicants must file a written appeal within 60 calendar days of the action, failure to act, or receipt of notice of decision being appealed. An appeal must include a copy of the letter regarding a decision being appealed or a written statement of the action or failure to act, a statement from applicants as to what is being disputed and the requested resolution and any other relevant information applicants wish to include.
If an appeal is incomplete or does not concern at least one of the three issues listed above or is received beyond the specific timeframe, (i.e., 60 days), applicants are not entitled to a full appeal and the administrative vendor will review the request and process as a Program Review.
Appeals received will be reviewed within four (4) business days. Once a determination is made that the dispute from the applicant is an appeal, the administrative vendor shall forward the appeal to DHCS within 5 business days.
Exceptions: The following will be forwarded to DHCS if:
- The issue includes an outstanding medical bill(s) incurred due to a dispute on the effective date of coverage; or
- The issue is of a sensitive nature and the referral has been approved (i.e., request from legislative member or request pertains to a policy issue currently under review or pending revision); or
- The applicant sends a dispute that does not meet one of the three appealable reasons listed above for the second time.
DHCS will adjudicate the appeal. Once DHCS makes a determination to enroll, disenroll, or other actions, the administrative vendor will be notified. Upon receipt of the notification, the administrative vendor must process the request within 2 business days and provide confirmation to DHCS that the action is complete.
Appeals can be submitted to Maximus in two ways:
Department of Health Care Services
Attn: HACCP
P.O. Box 138000
Sacramento, CA 95813
FAQs
Where on the application should I list myself as the parent/caregiver?
If you are the primary contact for the application, please list yourself in Section 1.
Who do I list in Section 2? How many of my kids should I list if only one needs hearing aid coverage?
For Section 2, please list only the child(ren) needing hearing aid coverage.
Who do I list in Section 3 (Household)?
Please list all
family members who live in the home, including all children under age 21, parent/stepparent, or the spouse of any teenager or pregnant individual who lives in the home. Do not list aunts, uncles, nieces, nephews, or grandparents.
Do I list myself?
If you live in the home with the child(ren) applying for HACCP and you are one of the family members listed, yes.
How many of my kids should I list if only one needs coverage?
For Section 3, please list all children under age 21 who reside in your household. (This is different than Section 2.)
Where do I list additional family members?
If your household includes more than four of the family members described for Section 3, please add their names and details on a separate sheet of paper. If you’d like, you can even type and print a second copy of pages 5-6 of the application form for your additional family members.
How do I find my insurance plan’s explanation of coverage?
You should have received an explanation of coverage document when you first enrolled in your plan. You can also call your health plan’s member services to request they send you a copy.
How can my child get coverage to get a hearing aid prescription?
If your child doesn’t have a hearing aid prescription yet, but has a provider referral to be evaluated for hearing aids (for example, from their pediatrician or a school audiologist), you can attach the provider referral for hearing aids to the application instead of a hearing aid prescription. Once enrolled, HACCP does cover physician services such as otolaryngologist exams for a hearing aid prescription.
HACCP Appeals FAQ
What are my appeal rights and where can I find more information on how to appeal?
A: If your eligibility is not approved during the Annual Eligibility Review (AER), you have the option to appeal the decision. Please reach out to the HACCP program for specific information on the appeal process here: https://www.dhcs.ca.gov/services/HACCP/Pages/Families/Application-Process.aspx
Can I file for an appeal if my eligibility, enrollment, or disenrollment was made in violation of the program rules?
A: You can file a written appeal within 60 days of the action, failure to act, or receipt of notice of decision being appealed. An appeal must include:
A copy of the letter regarding a decision being appealed or a written statement of the action or failure to act;
A statement from you as to what is being disputed, and;
The requested resolution and any other relevant information.
If an appeal is incomplete or does not address at least one of the three issues listed above or is received beyond the specific timeframe, (i.e., 60 days), you are not entitled to a full appeal and the administrative vendor will review the request and process as a Program Review.
How long does it take for an appeal to be processed?
A: Appeals received will be reviewed within four (4) business days. Once a determination is made that the dispute from you is an appeal, the administrative vendor shall forward the appeal to DHCS within 5 business days.
Exceptions: The following will be forwarded to DHCS if:
- The issue includes an outstanding medical bill(s) incurred due to a dispute on the effective date of coverage; or
- The issue is of a sensitive nature and the referral has been approved (i.e., request from legislative member or request pertains to a policy issue currently under review or pending revision); or
- The applicant sends a dispute that does not meet one of the three appealable reasons listed above for the second time.
Once DHCS makes a determination to enroll, disenroll , or other actions, the administrative vendor will be notified. The administrative vendor must process the request within 2 business days and provide confirmation to DHCS.
Where can I submit my appeals to?
A: Appeals can be submitted to in two ways:
Submit an email to HACCP@maximus.com; or
Mail a letter to:
Department of Health Care Services
Attn: HACCP
P.O. Box 138000
Sacramento, CA 95813
