Grant Application - Criteria

Please carefully read the criteria. Applications submitted that do not meet the criteria will not be considered. The Foundation may also request additional information from you after the application is submitted.

In evaluating applications, the Regional Board will consider applications based on the following criteria:

1. The following items are excluded from grant consideration: dental or orthodontic treatment unrelated to a serious medical condition, biomedical consultations, chelation therapy (this exclusion does not apply for a primary medical diagnosis of lead toxicity confirmed by blood lead levels), educational tutoring, heavy metal toxicity testing, herbal testing, home improvement/modifications, hyperbaric oxygen treatment, service dogs and other pets (does not apply to animals who support the visually impaired), camps, therapies of feeding, listening, vision, cognitive, neuro-feedback and social skills.

2. The applicant must be 16 years old or younger and live in the United States and receive and pay for care/items in the United States.

3. The applicant must be covered by a commercial health benefit plan and limits for the requested service are either exceeded, or no coverage is available and/or the copayments are a serious financial burden on the family. The UnitedHealthcare Children's Foundation requires a commercial health benefit plan. A commercial health benefit plan is defined below:

Included		Excluded
Your commercial health benefit plan is offered through: Your commercial (private) employer. Example: most grant applicants whose parent works for a commercial entity will have this type of health insurance. Your health benefit plan is offered through a commercial health plan that you individually purchased. Example: small business owners, sole-proprietors, etc. Your health benefit plan is offered through your employment with a town, city, state or federal government. Example: teachers, police officers, active duty or civilian military duty, etc.		Medicaid, Medicare, SCHIP (which may be called various names by each state), HIS or other state or federally subsidized health insurance programs given to those without insurance or with low incomes.

4. The potential of the intervention to significantly enhance either the clinical condition or the quality of life for the child, the financial status of the family and the severity of the child's illness. If a grant is approved, services must be provided by a trained, and if appropriate, licensed professional.

5. Financial need of the child's family will be evaluated and documented through information provided on the application and by submission of a photocopy of the most recently filed Federal tax return (Internal Revenue Service 1040, 1040-A, or 1040-EZ). The following scale will be used to determine financial eligibility:

   Your Family Size As reported on your IRS 1040	Adjusted Gross Income As reported on your IRS 1040
   2	$40,000 or less
   3	$50,000 or less
   4	$60,000 or less
   5	$70,000 or less
   6	$80,000 or less
   7 or more	$90,000 or less

   Awards will NOT be granted to individuals in families whose Adjusted Gross Income (AGI) exceeds the scale.

6. Other financial resources to meet the health care need are not available.

7. The amount awarded to an individual within a 12-month period is limited to either $5,000 or 85% of the fund balance, whichever amount is less. Awards to any one individual are limited to a lifetime maximum of $7,500.

8. An application must be submitted prior to the child's 17th birthday.

9. The health care professional is to be paid directly; exceptions can be made to reimburse the family if adequate documentation is submitted showing the health care professional has been paid.

10. Applications are to be reviewed by a health care professional appointed by the Foundation to determine the medical appropriateness of the treatment.

11. An application must be submitted to the Foundation prior to the receipt of services. The Foundation does not pay for past medical expenses.

12. Applicants who are not approved by the Regional Board must wait a period of twelve months before re-applying, unless the medical condition and requested items have significantly changed from the original request.

13. In order to apply for your child, the child must live with you 51% or more and be listed as a dependent on your most recently filed IRS 1040. If the child is not listed on your most recently filed IRS 1040, then we need a copy of both your most recently filed IRS 1040 and the most recently filed IRS 1040 on which the child is listed as a dependent.

14. If a grant is approved, you can not re-apply for another grant until 30 days before your current grant expires. Yearly and lifetime maximum grant limits apply.