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 2026, 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 = $75,740
- 3 people = $95,620
- 4 people = $115,500
- 5 people = $135,380
- 6 people = $155,260
- 7 people = $175,140
- 8 people = $195,020
- 8+ people: add $19,880 for each person.
In order to verify income, make sure to include a copy of the first page of the family’s most recent IRS Form 1040 with the application. No application can be considered without proof of income.
To Apply Through Secure Online Portal
Mail-in Application
If you would prefer to print and fill out the application by hand, please print:
21 Kids Assistance Request (PDF)
and bring the completed application, along with a copy of the first page of the family’s most recent IRS Form 1040, (or other form of income verification), to the child’s physician’s office. They will reach out to us on your behalf.
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.
In order to verify income, make sure to include a copy of the first page of the family’s most recent IRS Form 1040 with the application. No application can be considered without proof of income.
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.