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Frequently Asked Questions
Hearing Aid Coverage for Children Program
On this page:
- Program Overview
- Covered Benefits
- Eligibility
- Apply for Coverage
- Annual Eligibility Review
- Appeals
- Find a Provider
- Treatment
- For Providers
What is the Hearing Aid Coverage for Children Program?
The Hearing Aid Coverage for Children Program (HACCP) is a state program that offers coverage for hearing aids and related benefits to eligible California children and youth under age 21 who need hearing aids but don't have coverage (or have very limited coverage).
What languages are HACCP materials available in?
Key HACCP materials, including the HACCP Online Application Portal, are available in Arabic, Armenian, Chinese, English, Farsi, Hindi, Hmong, Japanese, Khmer (Cambodian), Korean, Laotian, Mien, Punjabi, Russian, Spanish, Tagalog, Thai, Ukrainian, and Vietnamese.
What services are covered by HACCP?
HACCP covered benefits include:
- Hearing aids, including assistive listening devices (ALDs) and surface-worn bone conduction hearing devices (BCHDs)
- Supplies, including ear molds and hearing aid batteries
- Medically necessary hearing aid accessories
- Hearing aid-related audiology and physician services
Does HACCP send my child’s hearing aids to us directly?
No. HACCP reimburses Medi-Cal enrolled providers, such as audiologists, for dispensing hearing aids to members.
Are there any restrictions on the type of hearing aids that are covered by the program?
HACCP covers a wide range of hearing aids, including digital and programmable devices, assistive listening devices (ALDs), and surface-worn bone conduction hearing devices (BCHDs), where medically necessary for an enrolled child's individual needs. Specific types of hearing aids covered by HACCP are listed by procedure code in the HACCP Provider Manual.
What happens if my child outgrows their hearing aids?
Kids grow fast! When your child outgrows their hearing aids, or if their current hearing aids are no longer meeting their medical needs, please work with your child's HACCP-participating audiologist to identify which new device(s) is medically necessary for your child.
Just like with an initial set of hearing aids, their provider will then send us a Treatment Authorization Request (TAR) letting us know what's going on (usually with clinical reports) and which hearing aid(s) they recommend for your child's medical needs.
Does the program cover hearing aid batteries?
Yes, HACCP covered benefits include conventional hearing aid batteries, as well as zinc air batteries for BCHDs. Specific procedure codes are listed in the HACCP Provider Manual.
My child needs a bone conduction hearing device (BCHD). Are these covered?
Surface-worn BCHDs are covered when medically necessary. BCHDs require Treatment Authorization Request (TAR) approval.
Who is eligible for HACCP?
HACCP is available to children and youth under 21 years of age, who:
- Live in California, regardless of immigration status.
- Have a provider referral for hearing aids/hearing aid evaluation (optional resource: Provider Referral for Patient Enrollment form (DHCS 8482)) OR a hearing aid prescription.
- Have a household income up to and including 600 percent of the Federal Poverty Level (FPL).
- Are not enrolled in, or income-eligible for, Medi-Cal.
- Do not have hearing aid coverage through California Children's Services (CCS).
- Do not have health insurance OR have health insurance that does not cover hearing aids or only covers up to $1,500 toward the cost of hearing aids.
For additional details, please visit HACCP’s Eligibility webpage.
Is there a cost to participate in the program?
There is no cost to participate in HACCP.
Are there any income requirements to be eligible for the program?
Yes, the household income must be higher than the Medi-Cal eligibility cutoff for the applicant's age and county of residence, but may not exceed 600 percent of the Federal Poverty Level (FPL).
- For ages 0-18, income eligibility for Medi-Cal includes household incomes up to and including 266 percent of the FPL, or 322 percent of the FPL for children living in Santa Clara, San Mateo, or San Francisco Counties.
- For ages 19-21, income eligibility for Medi-Cal generally includes household incomes up to 138 percent of the FPL.
- Income limits may be higher in certain circumstances, such as pregnancy.
How long does the program cover the cost of hearing aids?
Enrollment in HACCP is effective for up to 12 months at a time and is renewable each year during a member’s Annual Eligibility Review (AER). To learn more about AER, visit HACCP’s Apply for Coverage webpage.
Exception: When a member turns 21, that member’s HACCP coverage expires at the end of their birthday month.
Can my child receive hearing aid coverage through the program if they already have insurance?
As long as your child’s other health coverage is limited to $1,500 or less for hearing aids, they will be able to apply for supplemental coverage through HACCP.
HACCP offers coverage for eligible children and youth who have health insurance that does not cover hearing aids, as well as supplemental coverage where their insurance only covers up to $1,500 per year toward the cost of hearing aids. Your provider must bill your insurance first.
My child qualifies for CCS. Should we switch to HACCP?
No. CCS provides a robust set of hearing aid-related benefits, as well as broader coverage for related services. If your child is enrolled in CCS coverage for a hearing-related condition, they do not qualify for HACCP.
How do I apply for coverage?
HACCP offers several ways to apply for coverage:
Printable Application: Download and complete an electronic version of the HACCP Application (fillable PDF), print, sign, and mail or fax your completed form and required documents to HACCP.
If applying in hard copy (either the printable or paper format), families can send in their application to HACCP by:
Uploading to: www.dhcs.ca.gov/haccp (Click “Chat with us..." in the bottom corner of your screen and select “Upload Documents.")
Fax: Toll-free to (833) 774-2227
Hearing Aid Coverage for Children Program
What documentation is required to apply for the program?
Applications must include required medical, financial, and health plan (if applicable) documents:
Hearing aid prescription or provider referral for each child or youth applying for coverage:
Documentation for each person living in the home who has a job:
- A recent pay stub (from less than 45 days ago), or
- A signed, dated statement from your employer showing your gross income and how often you are paid, or
- Last year's federal income tax return.
Documentation for each person living in the home who is self-employed:
- Last year's federal income tax form with Schedules C, C-EZ, or F, or
- A signed, itemized profit and loss statement for the last 3 months.
If you have income from Disability, Pensions, Retirement, Social Security, Veteran's Benefits, Worker's Compensation, or Unemployment, send a copy of:
- The award letter, check, or bank statement showing direct deposit for the most recent payment.
For each applicant who has health insurance, send a copy of:
- A denial of coverage notice for hearing aids from their health insurance plan, or
- The current year's Evidence of Coverage for their health insurance plan (showing the applicant's name as the insured, or accompanied by a health insurance card or similar that identifies the applicant as a member of that plan).
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.
How do I find my insurance plan’s explanation of coverage?
You should have received an explanation of coverage (EOC) 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.
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 of the HACCP Application? 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.
What happens if my child's application for HACCP enrollment is approved?
On the day you are approved for HACCP, we will send you an HACCP ID card that you can show your Medi-Cal enrolled provider to receive HACCP-covered benefits, such as prescribed hearing aids or related services and supplies.
Additionally, HACCP conducts an Annual Eligibility Review (AER) each year, at the anniversary of your program enrollment, to assist you with extending your coverage for another twelve months. We will let you know ahead of time which updated documents are needed to stay enrolled in HACCP.
What happens if my child's application for HACCP enrollment is denied?
If you do not qualify for HACCP, you will receive a letter explaining which eligibility criteria were not met, and how to request reconsideration of your application if you feel there was a misunderstanding or if your circumstances have changed. In some cases, enrollment into HACCP may be denied because your child may qualify for another program, such as Medi-Cal.
Annual Eligibility Review
What is the Annual Eligibility Review (AER)?
The Annual Eligibility Review (AER) is a yearly assessment conducted by HACCP to determine if each member participating in the program can continue to receive coverage for hearing aids and related services for an additional year. To learn more about the AER process, visit HACCP’s Apply for Coverage webpage.
Who needs to turn in an AER?
Each member must complete their AER in order to renew their HACCP coverage.
What are the steps for a successful AER?
To have a successful eligibility review, follow these steps:
Note: Hearing aid prescription/referral is not required during AER.
How do I submit my AER materials?
You can submit your AER materials through any of the following methods:
Hearing Aid Coverage for Children Program
Alternately, members may sign into HACCP’s Online Application Portal at haccp.dhcs.ca.gov to complete and submit an updated application.
Is there a deadline for submitting the AER application materials?
Yes, it is essential to ensure that HACCP receives your application materials by the AER renewal date. Please make sure to submit all required documents on time to avoid any interruptions in your coverage.
Is a hearing aid prescription/referral necessary for the AER?
No, a hearing aid prescription or referral is not required for the AER.
What happens if I don't complete the AER process?
Failure to complete the AER process may result in the discontinuation of coverage for hearing aids and related services through HACCP. It is crucial to comply with the AER requirements to maintain continuous coverage.
Can I appeal if my eligibility is not approved during an AER?
If your eligibility is not approved during your AER, you may have the option to appeal the decision. For further details about the appeal process, visit HACCP’s Apply for Coverage webpage, call HACCP at (833) 956-2878, or chat with us online (Click “Chat with us...” in the bottom corner of your screen.).
How often do I need to go through an AER?
The AER is conducted annually. Therefore, you will need to provide current documents each year to renew your HACCP coverage for the following twelve months.
Where can I find more information or assistance regarding the AER process?
For additional information or assistance with the AER process, call HACCP at (833) 956-2878 or chat with us online (Click “Chat with us...” in the bottom corner of your screen.). You may also look for the information you need in the form instructions.
What are my appeal rights and where can I find more information on how to appeal?
If your eligibility is denied when you apply to enroll in HACCP or during your AER, you have the option to appeal the decision. Additional details about the appeal process are available on HACCP’s Apply for Coverage webpage. For further assistance, call HACCP at (833) 956-2878 or chat with us online (Click “Chat with us...” in the bottom corner of your screen.).
Can I file for an appeal if my eligibility, enrollment, or disenrollment was made in violation of the program rules?
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, 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?
Appeals received will be reviewed within 4 business days. Once a determination is made that the dispute from you is an appeal, the administrative vendor must 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.
- 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).
- 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?
Appeals can be submitted to in two ways:
Department of Health Care Services
Attn: HACCP
P.O. Box 138000
Sacramento, CA 95813
Can I choose where to receive services through the program?
Participants may select from Fee-For-Service (FFS) Medi-Cal enrolled audiologists, otolaryngologists (head and neck surgeons, including ENTs), and other hearing-related medical providers throughout the state, who are eligible to provide HACCP-covered services within their scope of practice.
I looked in the HACCP Provider Locator, but didn’t see any provider listings near me. What do you suggest?
For HACCP members who are already established with a pediatric hearing aid provider, we recommend checking whether the current provider is already enrolled as a Medi-Cal provider.
For HACCP members who are interested in becoming established with a new provider, please keep in mind that specialty health care providers, including otolaryngologists and audiologists who prescribe and dispense hearing aids, are often found in “hubs” where they can readily collaborate with other specialists. This is especially the case for children’s health care and pediatric specialists. In California, these provider offices are often located in and around the San Francisco Bay area, the central valley, Los Angeles, and San Diego. As such, it is recommended that members residing outside of these hubs consider choosing a more flexible distance (such as 50 miles) from the “Search radius” dropdown box when searching for providers in the HACCP Provider Locator. For further assistance finding a participating provider near you, call HACCP at (833) 956-2878 or chat with us online (Click “Chat with us...” in the bottom corner of your screen.).
My child is enrolled in a Kaiser Permanente health plan. Once they are approved for HACCP, can they get their hearing aids through their Kaiser provider?
Southern California: HearUSA is an in-network provider for Kaiser Permanente Southern California health plans. Several HearUSA locations participate in HACCP and are listed in the HACCP Provider Locator.
Northern California: Efforts are underway that will allow HACCP members who are enrolled in Kaiser Permanente Northern California health plans to similarly access HACCP covered benefits through in-network providers, such as Kaiser Permanente Hearing Centers. In the interim, these members may bring any existing documentation (e.g., hearing aid prescription, otolaryngologist exam report, etc.) from their Kaiser physician and/or audiologist to an HACCP-participating dispensing audiologist to submit the TAR, fit the child's hearing aids, and bill HACCP. For assistance finding an HACCP-participating audiologist near you, please visit the HACCP Provider Locator, call HACCP at (833) 956-2878, or chat with us online (Click “Chat with us...” in the bottom corner of your screen.).
How long does it take to receive services through the program?
New members generally receive their enrollment confirmation within ten days of completing their HACCP application (including all required documentation). The time to receive covered services varies depending on the provider selected. HACCP provides health coverage for specified benefits, but the reimbursement goes to the Medi-Cal enrolled provider – often audiologists or otolaryngologists (head and neck surgeons, including ENTs) – for providing the service to the HACCP member.
Do parents need to pay out of pocket for HACCP-covered services?
No, providers bill HACCP directly for covered benefits, just like they do for Medi-Cal/CCS. Please note: If you have partial coverage through a health insurance plan, your provider must bill your insurance first.
Is there a list of codes that require a TAR?
For a comprehensive list of covered procedure codes and applicable TAR requirements, please see the HACCP Provider Manual.
Is authorization needed to see my HACCP-participating audiologist?
While certain audiology services may require a TAR, providers may submit the TAR either before or after the appointment. As a result, the answer to this question depends on a particular audiologist's billing policies.
My kids’ HACCP-participating provider is having a hard time getting Treatment Authorization Requests approved.
We can provide case-specific support to your provider. Please let them know help is available. They can email us directly at haccp@dhcs.ca.gov.
What is the process for providers not yet accepting Medi-Cal/HACCP?
Can an educational audiologist who is not a Medi-Cal provider still refer a child (e.g., a student they support) to HACCP?
Yes. The referring medical provider/hearing professional does not need to be Medi-Cal enrolled. Only the provider(s) submitting TARs and/or claims for HACCP reimbursement need to be enrolled in Fee-For-Service (FFS) Medi-Cal.
How can providers help our patients enroll in HACCP coverage?
There are two key roles providers play in assisting a patient under 21 in applying for HACCP coverage:
- Let your patient know about HACCP, and that we're here to help them!
- You can share an HACCP brochure, flyer, or application with your patient, or refer them to our webpage at www.dhcs.ca.gov, where they can find lots more information about what HACCP covers and even apply online.
If your patient doesn't have a current hearing aid prescription to include with their application, you can provide a referral for them to include when they apply for HACCP – by filling out a Provider Referral for Patient Enrollment form or writing a referral letter that includes:
- Name of the person applying for HACCP coverage
- Statement that the referral is for hearing aid(s), hearing services, hearing aid evaluation, or other hearing aid-related services
- Your name and area of expertise
- Referrals may be issued by an audiologist, otolaryngologist, physician, audiometrist, or other trained/licensed hearing or medical professional.
Can providers complete the application for our patients? Your patient (or their parent/guardian, for unemancipated minors) will need to establish their own secure log-in.
Does enrollment in HACCP and receipt of the HACCP ID Card give implied authorization for hearing aids and services?
No, enrollment and ID card reflect program acceptance; TAR approval is still required.
Is the authorization tied to a particular center for all services or can a patient/family seek different services at different centers? If so, can families change providers?
The provider who submits the TAR and receives the TAR authorization must also be the provider to submit the claim. If the client changes providers, the new provider must submit a new TAR for any further hearing aid(s) and supplies.
What is the timeframe for TAR review?
DHCS anticipates responding to most TARs within 30 days of receipt.
How should providers confirm benefits are active or that hearing aids have not been provided by another vendor rendering the patient ineligible for new hearing aids until current hearing aids reach their useful lifetime?
Providers may check AEVS to confirm a patient’s HACCP eligibility. Duplicate hearing aid requests will be eliminated by the TAR process. If a patient has an HACCP ID card but is not yet showing up in AEVS, please call the HACCP Help Center to confirm current enrollment.
Will authorizations be issued as a group (similar to CCS’ SCG 04)?
No. However, multiple requests for the same patient and billing provider may be included as separate line items within the same eTAR submittal.
