NICU Family Assistance Application

To avoid delays in processing, please complete ALL requested information

Noah’s Miracles Qualifications

Please read the following information to see if you qualify for assistance

Noah’s Miracles provides support services and assistance to new moms and dads with a baby in the Neonatal Intensive Care Unit (NICU) in Orange County, California. Our Programs include:

  • Travel Assistance Program (TAP)
  • NICU Care Package
  • Breast Pump Rental Program 
  • Referrals to outside resources

Based upon available resources, Noah’s Miracles is pleased to be able to provide assistance for qualified individuals and families for travel assistance, NICU Care Packages, breast pump rentals, and referrals to outside resources. Travel Assistance is based on the applicant’s household income, and extenuating circumstances on transportation to and from the hospital only. The breast pump rentals are based on need, availability, and a deposit is required at the time of rental. There is a 2-week maximum pump rental per household and all local rental programs are exhausted. We DO NOT provide breast pump accessories. 

To evaluate your needs, Noah’s Miracles requires a variety of information about your circumstances and financial situation. It can take up to 15 days for applications to be processed and assistance to be received. Applications are reviewed in the order they are received.

You must meet the following guidelines to qualify for our services:

    1.  Have a baby in the Neonatal Intensive Care Unit (NICU) in Orange County, CA.
    2. Your baby is expected to be admitted to the NICU for at least 14 days.
    3. The parent(s) must be facing financial hardship directly related to their baby’s stay in the NICU (ex. unable to afford transportation to and from the hospital)
    4. The baby must be in the custody of the parent(s). We are not accepting applications if Child Protective Services is involved.
    5. The parent(s) must be actively trying to visit their baby in the NICU as much as possible.

***Exceptions can be made on a case to case basis***

Families with a child in other units of a hospital (such as the Pediatric Intensive Care Unit) do not qualify for assistance through our program.
***An application does not guarantee you will qualify and receive services from Noah’s Miracles. Applications are evaluated in chronological order and assessed by need.***

Income-Based Eligibility Qualification

To qualify for assistance, with Noah’s Miracles your household yearly income for your household size must meet the guidelines listed below: 

Household SizeAnnual Gross Income
2$0 – $29,999
3$30,000 – $39,999
4$40,000 – $49,999
5$50,000 – $59,999

* To calculate yearly income with households of more than 5 members, add $9,999 for each additional person. 

Noah’s Miracles may request proof of income prior to providing assistance which may include any of the following:

    • Prior year’s state or federal Income tax return
    • Current paystub from employer
    • Federal notice letter of participation in General Assistance
    • Divorce decree or child support document containing Income
    • Social Security benefits statement
    • Veterans Administration benefits statement
    • Retirement or pension benefits statement
    • Current paycheck stub
    • Unemployment or Workers’ Compensation benefits statement
    • SNAP (Cal Fresh) Benefits Letter
    • WIC Enrollment

*Noah’s Miracles may also request proof of identification. For example, a driver’s license, government photo ID, passport, or matriculation card.

By completing this  application for assistance you agree to the Terms and Conditions.  

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