Tip for Local club application

Programs vary significantly by local club — some provide hearing aids, others help with the cost

Tip for Local club application

You must demonstrate financial need and inability to obtain hearing aids through other programs

Tip for Local club application

Some states also have separate state-funded hearing aid programs — check with your state health department

Dental, Vision & Hearingeasy

Lions Club Hearing Aid Program Application

Local club application · Local Lions Clubs

Local program distributing refurbished or low-cost hearing aids to those in need.

Form Details

Total fields: 20
Auto-fillable: 14 (70%)
Time without BeneFill: 15 minutes
Time with BeneFill: 5 minutes
Time saved: 10 minutes
Filled by: patient
Frequency: one time
State-specific: Yes — form may vary by state

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Where to Submit This Form

🏢

Contact your local Lions Club chapter

https://www.lionsclubs.org/en/start-our-approach/club-locator

Hearing aid assistance programs vary by local club. Contact your nearest chapter.

🌐

Call Lions Clubs International

1-630-571-5466 for general information and club locator assistance.

Filing Deadline

Applications are accepted on a rolling basis. Availability depends on the local club's funding and program.

Required Attachments

📎 Completed application (available from the local Lions Club)
📎 Audiogram and hearing evaluation from a licensed audiologist
📎 Proof of income and financial need
📎 Documentation showing inability to obtain hearing aids through insurance, Medicaid, or VA

Processing Time

Varies by local club — typically 2-8 weeks for application review and funding approval.

What Happens Next

If approved, the Lions Club will work with you and a local audiologist to obtain and fit hearing aids. Coverage amounts vary by club.

Tips for This Form

✓ Programs vary significantly by local club — some provide hearing aids, others help with the cost
✓ You must demonstrate financial need and inability to obtain hearing aids through other programs
✓ Some states also have separate state-funded hearing aid programs — check with your state health department
✓ If the local Lions Club cannot help, ask about the Hearing Aid Project from Hear Now (Starkey Hearing Foundation)

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Disclaimer: BeneFill™ provides form-filling assistance and informational guidance only. It is not affiliated with, endorsed by, or sponsored by the Local Lions Clubs or any government agency. The information provided is for general informational purposes and does not constitute legal, medical, financial, or tax advice. Always verify form requirements and submission details directly with the issuing agency.