Complete Your Grant Application Here

Home_Picture

Eligibility Criteria:

  1. Is your child 16 years of age or younger at the time of application?

  2. Does your child have a Social Security Number issued by the Social Security Administration? (I-TIN numbers are NOT accepted.)

  3. Is your Adjusted Gross Income (AGI) - as documented on Line 11 of the current year's Tax Return (Line 11 of IRS Federal Tax Form 1040) - at or under the following limits based on your family size? NO EXCEPTIONS will be made to these limits:

    • Family Size of 2 -- $65,000 or less

    • Family Size of 3 -- $100,000 or less

    • Family Size of 4 -- $135,000 or less

    • Family Size of 5 or more -- $170,000 or less

  4. Is your child covered by commercial/private health insurance? (Plans purchased from the Healthcare Exchange are accepted, but the primary coverage CANNOT be Medicaid, CHIP, or any publicly state funded medical insurance.)

  5. Are the medical services/items eligible for award and being received/purchased in the United States? (Please see our exclusion list that details items which would NOT be eligible.)

  I acknowledge that I am able to answer YES to all the questions above.




If you have already created a HealthSafeID on any other UHG owned site/application,please use those same credentials to login to access the UHCCF grant application portal.