Social Security benefits (SSI) for preemies

alphaphi98 · July 2013

Anyone know about SSI benefits for preemies? I heard about it from a friend. I'm thinking about it for DD.

jacque_z · July 2013

Is your LO currently in the NICU or out of the NICU but considered disabled? Otherwise, benefits are based on your income and the income limit is incredibly low. I know we didn't bother with the paperwork because the benefit was going to be $30/m while my LO was in the NICU.

jbranden12 · July 2013

Anna was eligible for SSI and Medicaid while she was in the NICU because she was born under a certain weight, but like pp said, she became ineligible as soon as she got home. She only got $30 a month, but it was worth all the paperwork to have Medicaid cover what our insurance didn't.

Cst2CstBride · July 2013

Babies qualify based on birthweight or medical condition. When they are in the NICU income is not considered, but will be when baby goes home. As PP said, the payment is often very low while admitted, as you aren't "paying" to care for baby, the hospital is. But, if you financially qualify, the payment increases when baby comes home.

Medicaid comes with SSI, so it might still make sense for people who have high out of pocket expenses. Medicaid would cover what your primary insurance does not.

DrRx · July 2013

We did while our DD was in the NICU since applying for SSI is what allowed you to automatically pick up Medicaid coverage. Medicaid helped cover the copays and coinsurance after our insurance paid. We didn't qualify after we got out due to income, but it was incredibly helpful while she was in. Whatever our insurance didn't pay for, Medicaid picked up. I don't even want to think about what it would be like if we didn't have this. My daughter qualified because she was VLBW (less than 1kg) at birth. However, I do believe that different states have different rules.

jess_and_paul · July 2013

DS qualified due to low birth weight. It was worth the visit to the SS office as well as all the paperwork as Medicaid ended up covering over $68,000 worth of medical bills that my insurance did not cover!

flerlgirl · July 2013

BostonKisses2 said:
jacque_z:
Is your LO currently in the NICU or out of the NICU but considered disabled? Otherwise, benefits are based on your income and the income limit is incredibly low. I know we didn't bother with the paperwork because the benefit was going to be $30/m while my LO was in the NICU.

All of this. And when they're in the NICU, they have to qualify for the low birthweight portion to get coverage. Certain conditions/disabilities may, in theory, qualify you for benefits post-NICU, but if your income doesn't meet the requirements they'll deny you.

We didn't apply in the NICU because it wasn't worth it to us even though she qualified. We had to apply post-NICU after she got her CF dx and we were filling out the medicaid application, but were denied because we exceeded the income limit. Because you would apply for your child and LO is under age 18, household income is factored into the equation. At age 18 and above, it's based on the individual's income and household income isn't a factor.

What they said. J qualified on his birthweight but we wouldn't qualify otherwise.

ashleymarie512 · August 2013

Here in Iowa we were just told that the eligibility criteria was being born prior to 30 weeks gestation and also being under 2lb 10oz, which LO was both. We filled it out to allow for supplemental insurance coverage while she's in NICU in the event that Wellmark denies anything.

Social Security benefits (SSI) for preemies

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