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Apply for Assistance

How to Apply

General Notes & Guidelines

21 Kids provides financial assistance to children who need specialized dietary foods and supplements to treat inborn errors of metabolism and who do not have the costs of these therapies covered by health insurance or federal/state assistance.

In general, 21 Kids will assist those families who earn less than 350% of the Federal poverty level. The latest information is available by searching for “HHS poverty guidelines” at: https://www.federalregister.gov

As of 2021, the current income limits that 21 Kids will accept for help, based on family size, (including parents or legal guardians), are as follows:

  • 2 people = $60,970
  • 3 people = $76,860
  • 4 people = $92,750
  • 5 people = $108,640
  • 6 people = $124,530
  • 7 people = $140,420
  • 8 people = $156,310
  • 8+ people: add $15,890 for each person.

To Apply Through Secure Online Portal

Click Here

Mail-in Application

21 Kids Assistance Request (PDF) Please save this file to your computer and send the completed file to your child’s physician.

21 Kids does not accept applications directly from applicants. This application must be submitted by the applicant’s physician’s office or health care agency, (hospital, nurse, registered dietician, genetic counselor, etc.), on behalf of the applicant.

Your child’s physician or health care provider may e-mail the completed application to: baglio@ACIEMFoundation.org or be printed and surface-mailed to:

21 Kids
1047 Algonquin Road
Norfolk, Virginia  23505

Disclaimer

The application MUST BE SIGNED BY THE APPLICANT AND REFERRING HEALTH CARE PROFESSIONAL. Typed “signatures” on electronically submitted applications will be considered as original.

Signatories acknowledge that:

21 Kids provides assistance solely on the recommendation of the applicant’s physician or healthcare provider. Assistance provided by 21 Kids is not to be taken as a recommendation of any treatment program or affirmation of the effectiveness of medical regimen so prescribed. 21 Kids’ sole responsibility is to financially assist those in need.