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.
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 agethey 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 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.
Child Care Resources and Assistance (1-800-424-2246) – Child Care Aware is a program of the National Association of Child Care Resource & Referral Agencies, the Office of Child Care, the Administration for Children and Families, and the U.S. Department of Health and Human Services.
Finding Affordable Private Insurance Coverage
If you need help finding private or public health insurance you can visit www.healthcare.gov . This site offers links to consumer assistance available in each state and a wealth of information about understanding your coverage and health care options. You will also find the latest information about state and national health care initiatives and what they mean for your family.
Get help with insurance problems, find out about consumer protections, your rights, new coverage options, and ways to manage your health care costs at www.healthcare.gov/using-insurance/index.html . There is also information about what to do if you’ve been rejected for insurance or need to appeal an insurer’s decision about a claim. You can also find a link to your state’s Consumer Assistance Program.
Get Personalized Help From a NICU Parent
If you have questions or need help, call Hand to Hold’s Family Support Navigators toll free at (855) 424-6248 xt. 712 or email us at support [at] handtohold [dot] org.
Erika Goyer is the mother of three boys. Her oldest son Carrick Michael was born at 27 weeks gestation and weighed 1 pound, 14 ounces. Carrick died soon after his birth due to complications of prematurity. Erika went on to have two more high-risk pregnancies and two healthy sons.