CCHS Durable Medical Equipment Grant Application

Who can apply?

Any individual with a diagnosis of CCHS in need of durable medical equipment not covered by insurance whose income is below a certain level.

Grant Guidelines:

Applications are competitive and need-based. Applicants must provide proof of CCHS diagnosis, a letter of denial from insurance company, as well as a letter of medical necessity from the attending physician. When applicable a prescription will also be required. Please include a detailed description of medical equipment requested. Proof of income will be required (IRS Tax documentation). Please note that to meet our mission of helping as many families as possible, we have a $50,000 maximum annual income threshold for a family of 2 or fewer, $85,000 for a family of 3, $115,000 for a family of 4, and $145,000 for a family of 5 or more.

Exclusions: medical co-pays, therapy costs, respite assistance, educational, home and vehicle, prescription drugs, hospital procedures and treatments, travel costs.

When funds are depleted for the year, the program will be closed until the next application cycle and notification will be placed on our website. Applications will be reviewed and approved on a first-come, first-served basis. An applicant may apply once per year with a yearly maximum up to $5,000 and a life-time award maximum of $15,000. If your durable medical equipment request exceeds these thresholds a special consideration may be requested, however it is not guaranteed.

Applications that are incomplete or missing requested information will not be placed in queue for review until complete. All applicants will receive an email stating approval or denial of their application. Denied applicants wishing to re-apply must provide additional documentation of a change of status or circumstances or that other alternatives have failed. We request up to 45 days to review your application.

Awards are paid directly to the durable medical equipment company or provider.

By awarding these grants, CCHS Foundation is making no recommendation as to the appropriateness or safety of a particular piece of equipment or therapy in treating CCHS and associated conditions. CCHS Foundation and its Board of Directors are not responsible for the safety and use of awarded equipment or therapies. Applicants are strongly urged to consult with their medical professionals and therapists regarding equipment and therapies that would be most beneficial for their situation. We will not divulge application information without written consent from the applicant or their legal guardian. We do ask that award recipients submit a photo showing patient using their equipment or therapy that we may use to help advertise this grant program. Patient will only be identified by first name and only with written consent.

Please complete the form below.

If you have questions, please email us @ mycchsnetwork@gmail.com or call us @ (619) 913-7037.

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