Insurance, Part 2

Did you know that while your child is in the hospital, he/she may be eligible for Supplemental Security Income (SSI) payments and Medicaid?

SSI makes monthly payments to eligible people who have disabilities. SSI eligibility is based on income so many people don’t qualify however when your child is in the hospital they are considered separately because they aren’t living with your family (so your income is not factored).

Here are some of the conditions that can warrant immediate payment of benefits:

• Birth weight below two pounds, 10 ounces
• Cerebral palsy
• Down syndrome
• HIV infection
• Total blindness
• Total deafness
• Muscular dystrophy
• Severe mental retardation (child age 7 or older)

Please Note: Even if your child has one of the conditions listed above, the state agency may finally decide that your child’s disability is not severe enough for SSI. If that happens, you will not have to pay back the SSI payments that your child got.

Here is the website with information and details about payment and eligibility. You can also contact your local Social Security office for information and instructions for applying.

In addition to SSI, your child can also be eligible for Medicaid. If your child is expected to be hospitalized for over 30 days, your child should qualify for Medicaid during the hospitalization regardless of your family income.

When is this most useful? Obviously if your family doesn’t have any insurance than Medicaid will cover the NICU stay. However Medicaid can also act as a secondary health insurance for babies already covered by your insurance. Take advantage of this if your health insurance doesn’t cover 100% of all expenses and/or if your insurance has a lifetime cap.

Here is a link with details and information about Medicaid.

Talk to your NICU social worker about these issues – they should have all of this information and details as they pertain to your state.