The NICU stay can be a stressful time emotionally, and possibly financially! Here's some info to read on the financial aspect of a NICU stay: http://handtohold.org/resources/helpful-articles/how-to-pay-for-your-nicu-stay-national-edition/ and http://ssa-custhelp.ssa.gov/app/answers/detail/a_id/368/~/ssi-benefits-for-premature-children

from http://handtohold.org/resources/helpful-articles/how-to-pay-for-your-nicu-stay-national-edition/:

How to Pay for Your NICU Stay – National Edition

by Erika Goyer, Hand to Hold’s Family Support Navigator and preemie mom

Call Your Employer

Let them know what is going on. If you are a working parent you should ask to speak to someone in Human Resources or Personnel about the following:

Your insurance coverage.
What time off you have available or accumulated through flex-time, sick time, and vacation time.
Whether or not you have temporary disability insurance through your employer.
Whether or not your place of business offers time off through the Family Medical Leave Act.

If you have recently been laid off or fired you may still be able to access health insurance from your former employer. To find out more about COBRA (Continuation of Health Coverage Act) and whether or not it is a good option for your family call 1-866-444-3272.

Ask about Perinatal Coverage

Maternity Leave Resources

To find out more about your rights in the workplace, visit the U.S. Department of Labor’s resource: “What to Expect When You’re Expecting (and after the birth of your child)… at Work”
Baby Center’s (Johnson & Johnson’s) web resource: “Maternity Leave: The Basics” (Also available in Spanish)

Whether you are in the hospital waiting to deliver or already in the NICU, you should be thinking about your perinatal care as well. Many states offer free or low-cost programs for mothers. They will help you cover your patient care as well as your postpartum follow-up appointments. Call your State Department of Health Services or the WIC Perinatal Program to ask questions.

For a list of free or low-cost prenatal and perinatal insurance programs contact your State Department of Health Services or call 1-800-311-BABY.
Find Your State’s toll free WIC Perinatal Program number online or call the Federal Office at 1-703-305-2286.

Find Out if You or Your Child Qualify for Medicaid

Even if you have private health insurance, it’s good to have Medicaid as your secondary coverage. It will help cover expenses after you have met your annual limits on treatments and therapies. The Children’s Health Insurance Program (CHIP) provides health coverage to children in families with incomes too high to qualify for Medicaid, but can’t afford private coverage. Visit www.insurekidsnow.gov to learn more.

Medicaid 1-877-543-7669
CHIP – Children’s Medicaid 1-877-543-7669

If your child qualifies for Medicaid or receives CHIP they also qualify for free routine check-ups, immunizations, hospital care, dental care, and lab and x-ray services.

Look at Alternative Routes to Qualifying for Medicaid

Your state may have Medicaid programs which will allow you to receive Medicaid for your child without meeting the strict income limits and financial guidelines. Some benefits are offered only to children who are born at a very low birth weight or who have extended hospital stays. Others will help you pay your private insurance premiums, deductibles and co-pays.

SSI Disability – If your child is in the NICU and was born at or below a certain birth weight or were small for their gestational age they may automatically be eligible for Medicaid through SSI Disability. Remember, if your child qualifies for even $1 of Social Security Disability Income they will receive full Medicaid. Visit www.ssa.gov and click on the SSI tab to find out more or call 1-800-772-1213.
Institutional Medicaid – Institutional Medicaid pays for medical expenses for a child who has a hospitalization longer than 30 days regardless of birth weight or family income. Programs vary from state to state and may not be offered where you live. You must apply for Institutional Medicaid prior to discharge. Speak to your NICU social worker or your hospital financial assistance office.
Medicaid Buy-In for Children – This program is for families who have a child with a disability, but earn too much money to get traditional Medicaid. Through this program, families can “buy-in” into Medicaid coverage by making monthly payments. Visit your State Department of Health Services website to see if your state offers this program.
Health Insurance Premium Payment Programs – HIPP is a Medicaid program that pays for the private health insurance premiums for certain individuals with high medical costs. HIPP programs are not offered in every state and eligibility requirements vary. Generally, to participate in a state’s HIPP program, you must qualify for Medicaid and have an existing medical condition that has been determined to be a cost-effective condition for the HIPP program. For more information contact your State’s HIPP program.
Medicaid Waiver Programs – Even if your family does not meet the strict financial requirements for Medicaid your child may still be able to get coverage. Federally-mandated, state-run Medicaid Waiver programs exist to help families of children with special health care needs access comprehensive care for their children. Visit www.medicaid.gov and click on your state for a list of waiver programs and direct link to your state’s health agency for more information.

Research Other State Programs

WIC – Women, Infants and Children Program (1-703-305-2286) – The USDA’s Food & Nutrition Service underwrites the Women Infant Children nutrition and breastfeeding program within each state. Their website lists toll-free numbers and contact information for each state’s nutrition and breastfeeding coordinators. This program will help you pay for any specially-prescribed formulas, may be able to lend you a hospital grade breast pump and can help you get healthy food for you and your baby. Benefits are usually extended if you are breastfeeding. Peer breastfeeding counselors are available to help. Fathers can apply for their children to receive benefits too.

from http://ssa-custhelp.ssa.gov/app/answers/detail/a_id/368/~/ssi-benefits-for-premature-children:

SSI benefits for premature children

Email this page

Is it true Social Security will give Supplemental Security Income (SSI) benefits to children born prematurely?

Social Security provides SSI disability benefits to certain infants born with a low birth weight whether or not they are premature. A child weighing less than 1200 grams (about 2 pounds, 10 ounces) at birth can qualify for SSI based on low birth weight. A child weighing between 1200 and 2000 grams (about 4 pounds, 6 ounces) at birth and considered small for his or her gestational age also may qualify.

To satisfy our criteria, the following chart shows the gestational age at birth and corresponding birth weight.

Gestational Age                   Weight at Birth
(in weeks)
37-40                             Less than 2000 grams
                                   (4 pounds, 6 ounces)

36                                1875 grams or less
                                   (4 pounds, 2 ounces)

35                                1700 grams or less
                                   (3 pounds, 12 ounces)

34                                1500 grams or less
                                   (3 pounds, 5 ounces)

33                                1325 grams or less
                                   (2 pounds, 15 ounces)

If the child was not born prematurely or with a low birth weight, he or she may still qualify.http://ssa-custhelp.ssa.gov/app/answers/detail/a_id/368/~/ssi-benefits-for-premature-children

And, finally, from an email a friend received from the March of Dimes:

The March of Dimes has other resources that your family may find helpful. Our NICU Family Support Program (https://www.marchofdimes.com/baby/inthenicu.html) exists to help families cope with the experiences of parenting a preemie in the NICU and afterward. We suggest that you contact the local chapter of the March of Dimes where your baby’s hospital is located and ask if they have a NICU Specialist who can assist you. You can find your local chapter here:

http://www.marchofdimes.com/contactus/contactus.html .

Many times parent-to-parent support groups can be of enormous help in sharing their experiences and their resources list. The March of Dimes has created a website for parents of preemies and children with medical conditions called Share Your Story (http://www.shareyourstory.org/) where parents help each other with all kinds of information. We also have a section of our website dedicated to prematurity with lots of good information: https://www.marchofdimes.com/mission/prematurity_indepth.html .

NICUs usually have a social worker or patient advocate who can recommend resources to help families with financial and other stressors. We suggest that you meet with that person to discuss your concerns.

The Ronald McDonald House provides low cost housing to families when their children are in the hospital. We suggest you see if there is a house near the hospital where the baby is hospitalized. Their website is: http://rmhc.org/ .

This is a link to the Patient Advocate Foundation to help you maneuver through the health insurance assistance maze: http://www.patientadvocate.org/index.php.

This is a link to the Patient Access Network Foundation: https://www.panfoundation.org/

Here is a link to the Disabled Children's Relief Fund that provides some information on different types of assistance available: http://www.dcrf.com/ordereze/default.aspx.

This link will give you information on possible assistance with certain hospital bills: http://www.hrsa.gov/osp/dfcr/obtain/CONSFAQ.HTM .

Here is another link to a vast number of resources from The Morgan Project: http://www.themorganproject.org/wp-content/uploads/2011/07/2012-New-Resources-updated28Feb12.pdf. Perhaps you will find a resource here.

This website lists many organizations that help families with children with special needs: http://www.especialneeds.com/funding-resources-special-needs-adaptive-equipment.html

Easter Seals caters to early intervention programs for babies and toddlers, so they may be able to advise you as to where you can go for help. Please visit their website: http://www.easterseals.com/site/PageServer?pagename=ntl_early_intervention. You can download their manual on caring for a special needs child, including the financial aspects of care, at: http://www.easterseals.com/site/DocServer/WithOpenArms.pdf?docID=69583.

I suggest that you read more about what health care reform means for you and your family here: http://www.marchofdimes.com/advocacy/healthcoverage.html . You can go to http://www.healthcare.gov/foryou/individuals/index.html to explore the different options available in your state. The U.S. Department of Health and Human Services also has a Web site to help parents determine if their children are eligible for free or low-cost health coverage under the reauthorized Children's Health Insurance Program. Visit http://www.insurekidsnow.gov/ for more information.

Here is a link to an excellent list of agencies, organizations and support groups that address disability-related issues in children: http://www.nichcy.org (just click on your state).

The SSI Children’s Project: Another option is for you is to contact the American Bar Association (an organization of lawyers). They have a Children’s Project which has compiled a list of hotline numbers for families to obtain free legal help in obtaining Social Security benefits. Families can call a number specific to their state for a referral to free legal assistance, including legal services offices and private attorneys who are working for free on these cases. Call the Social Security Administration at 1-800-772-1213 to obtain the number for your state.

Health insurance benefits by state: http://www.benefits.gov/?_nfpb=true&_nfpb=true&_nfls=false&_pageLabel=gbcc_page_locate_state

Premature Baby - Premature Child is a parent support organization that may also be of assistance. Here is a link to their web site: http://www.prematurity.org . And here is a link to another similar site: http://www.preemie-l.org/ .

The Lindsay Foundation is a non-profit organization whose primary goal is to assist families with resources necessary to provide medical treatment, therapies and rehabilitative equipment in order to improve the quality of life for their special needs children. http://www.lindsayfoundation.org/

Pediatric Angel Network: http://www.pediatricangelnetwork.com/aboutus.html

Livestrong.com: http://www.livestrong.com/article/287615-financial-help-for-children/

Miracle Flight – Financial aid for travel for children to get lifesaving care and also for second opinions: http://www.miracleflights.org/about-us/mission-vision-values/

You might also consider doing a Google search for financial assistance for health care expenses in your town. Often, small non-profits are dedicated to providing help to individuals.

Friday, November 25, 2011

NICU Stay Financial Information