When Roxy was just a couple days old, we were met by a hospital social worker at her bedside. We were asked for a variety of information including insurance coverage. At this point, Russ and I had not discussed whose insurance would be used for Roxy. The social worker quickly took information for both so that Roxy would have coverage from both. (Did you know that the decision of which insurance is primary is settled by whose birthday comes first in the year? My insurance was primary because my birthday is in January whereas Russ’ birthday is in June.)
Through our discussions with the social worker, we were also told to apply for Social Security Disability benefits for Roxy. I was a bit surprised to learn that a child born weighing under two pounds, ten ounces, is automatically entitled to SSI benefits as well as Medicaid coverage. This handy chart from the Social Security Administration shows the weight and gestational age for qualification. The social worker urged us to visit our local Social Security office to start the application process. I opted to call our local Social Security office since I was recovering from a Cesarean section.
We were told that Roxy qualified for benefits as we expected she would due to her birth weight (1 pound, 9 ounces at 29 weeks gestation). We were a bit surprised to find out that she would receive a check for $30 per month while in the hospital and would receive Medicaid benefits.
Needless to say, the Medicaid benefits were extremely helpful for the $250,000 hospital bill our preemie incurred during her NICU stay as well as the $20,000 doctors’ bill.
Following the advice of the social worker was a lifesaver for us. I have read other horror stories about preemie parents and their trials with the Social Security office as well as being denied benefits, but we were fortunate to work with friendly and helpful staff at the Social Security Administration.
One thing to remember if you find your preemie receiving these benefits: Contact your SSA office immediately after your child is discharged. We mistakenly thought that the hospital would alert the SSA of Roxy’s discharge from the NICU. When we called a couple months later, we were told we would have to reimburse the $30 per month Roxy had received since discharge. However, we also found out that Roxy was entitled to receive one month of full SSI benefits (approximately $600 or $700) for the month of her discharge. They simply subtracted the amount we owed to them from the amount owed to us for Roxy’s discharge month.
For more information on applying for Social Security benefits for your preemie, the Social Security Administration has a great website with lots of information and tools as well as an office locator.
Did you apply for SSI benefits for your preemie? What advice would you give parents applying for assistance?