Live Better Foundation

No Cost to Screen

Find Out If You May Qualify

Tell us a little about the applicant's hearing needs and financial situation. There is no charge to submit this form. Our team will review the information and follow up with the most appropriate next step.

How We Can Help

Hearing aids normally cost $2,000–$8,000 or more at retail. The Live Better Foundation provides them to approved applicants without that retail cost. Depending on your situation, we offer three forms of assistance: help accessing benefits you may already have, our standard program with a small processing fee, or full sponsorship for those with exceptional financial hardship.

Free — No Charge to Submit

Eligibility Screening Form

All fields marked with an asterisk are required. Everything else is optional but helps us give you the most accurate guidance.

About the applicant

Who is completing this form?

A parent, caregiver, or authorized representative may complete this form on behalf of the applicant.

Does the applicant currently have hearing aids?

Has the applicant had a hearing test?

Does the applicant have any of the following?

Select all that apply.

Does the applicant know whether their plan includes a hearing-aid benefit?

Some insurance plans include partial or full hearing-aid coverage. We can help determine whether a benefit exists.

Household information

We use income ranges rather than requiring documents during the preliminary screening. Financial documentation may be requested later in the process.

Could the applicant afford the processing fee?

Our standard program requires a processing fee — $150 for one hearing aid or $300 for two. This is not the cost of the hearing aids themselves (which normally retail for $2,000–$7,000+). The fee is refundable if the application is denied or cancelled.

How is the hearing loss affecting the applicant?

Select all that apply.

Please note: Submitting this form does not guarantee approval or hearing aids. Final eligibility depends on financial documentation, hearing needs, available devices, and program resources at the time of review.

There is no charge to submit this screening form.

What Happens After You Submit

Foundation staff will review your information and contact you with one of the following next steps.

Assistance accessing an existing benefit

If you have insurance, Medicare, Medicaid, VA eligibility, or another program that may cover hearing aids, we will help you navigate those benefits.

Invitation to complete the full application

Applicants who appear to qualify for our standard program will be invited to submit the full Foundation application. A processing fee of $150 (one hearing aid) or $300 (two hearing aids) is required at that stage — not here. This fee is refundable if your application is denied or cancelled.

Consideration for full sponsorship

Applicants with exceptional financial hardship may be considered for full sponsorship — the processing fee is waived entirely. No payment is requested at any stage for sponsored applicants.

Referral to another resource

If our program is not the right fit, we will do our best to connect you with another organization or resource that may be able to help.

Have questions before submitting? We're happy to help.

Contact Us