16 Del. Admin. Code § 4108-3.0

Current through Register Vol. 28, No. 7, January 1, 2025

Section 4108-3.0 - Eligibility

3.1 A child under three (3) years of age is eligible if confirmed through:

3.1.1 A prescription from a licensed audiologist;

3.1.2 Birth certificate or other documentation for proof of age;

3.1.3 Address of residence to document Delaware residency;

3.1.4 No immediate access to another hearing aid under Medicaid, the State children's health program or private insurance, as per insurance denial letters; and

3.1.5 Proof of the parent or legal guardian's inability to pay for the hearing aid based on:

3.1.5.1 Proof of family income by review of three of the most recent consecutive pay stubs for each parent or legal guardian, using the Federal Poverty Guidelines as the reference. If such pay stubs are not available, documents as approved by program manager must be submitted.

3.1.5.2 Documentation of insurance coverage, and/or medical assistance status.

3.2 A parent or legal guardian who borrows a hearing aid for an eligible child shall:

3.2.1 be the custodian of the hearing aid;

3.2.2 return the hearing aid immediately to the loan bank upon the expiration of the loan period or receipt of a suitable permanent hearing aid, whichever occurs first;

3.2.3 be responsible for the proper care and use of the hearing aid;

3.2.4 be responsible for any damage to or loss of the hearing aid apart from normal wear and tear, due to the intentional or gross negligence of the parent or guardian; and

3.2.5 sign a written agreement provided by the program manager that states the term and conditions of the loan.

3.3 For a child to be eligible for one or more extensions of the initial six month loan period, a parent or the guardian of the child must show:

3.3.1 That there is no immediate access to another hearing aid under Medicaid, the State children's health program or private insurance;

3.3.2 The child's parent or legal guardian currently does not have the financial means to obtain immediate access to another hearing aid; and

3.3.3 Proof of making reasonable efforts to obtain immediate access to another hearing aid, such as pursuing insurance coverage for hearing aids or pursuing alternate financial assistance to cover the hearing aid; and

3.3.4 Has met initial eligibility criteria prior to age three; not to exceed two extensions during the third year of life.

16 Del. Admin. Code § 4108-3.0