To qualify for equipment, applicants must have a hearing or speech challenge and receive assistance from a public assistance program administered by a state agency, or an income of 200% or less of the 2023 federal poverty guidelines.
Examples of Public Assistance Programs in Utah:
- Medicaid
- Children’s Health Insurance Program (CHIP)
- Utah Telephone Assistance Program (UTAP/Lifeline)
- Supplemental Nutrition Assistance Program (SNAP)
- Home Energy Assistance Target Program (HEAT)
RELAY UTAH INCOME GUIDELINES based on 200% of the
2023 Federal Poverty Guidelines
For families/households with more than 6 persons, add $10,280 for each additional person.
| Maximum Household Income Allowed to Qualify | ||
| Household Size | Gross Monthly Income | Gross Annual Income |
| 1 | $2,430 | $29,160 |
| 2 | $3,287 | $39,440 |
| 3 | $4,143 | $49,720 |
| 4 | $5,000 | $60,000 |
| 5 | $5,857 | $70,280 |
| 6 | $6,713 | $80,560 |
The Application Process
Click the RED “Home Equipment Application” Button to download the PDF Relay Utah Application.
- In order to have your application reviewed by Relay Utah, you will need to download and complete the application (see applications above).
- Include documentation you are receiving assistance from a public assistance program administered by a state agency, or have an income of 200% or less than the federal poverty guidelines.
Income documentation can include:- Tax returns
- Social Security benefits letter
- Social Security Disability benefits letter (SSDI, SSD)
- Payroll stubs
When submitting documentation, please redact (black out) any sensitive information including account and social security numbers.
- Have one of the following certify the application:
- Licensed Physician
- Licensed Physician Assistant
- Otolaryngologist
- Audiologist (AuD)
- Speech-Language Pathologist
- Qualified State Agency Employee
- Mail, fax, or email the application to:
Public Service Commission of Utah
c/o Relay Utah
Box 4558
160 East 300 South, 4th floor
Salt Lake City, UT 84111
FAX: 801-530-6796
EMAIL: relay@utah.gov
The applicant will be notified when the application is approved. The recipient’s legal guardian may sign the application if the recipient is a minor or unable to sign the application.