There are numerous government-sponsored financial assistance programs that can help preemie parents with the medical expenses associated with a premature birth.
MedicaidInstitutional Medicaid pays for medical expenses for a child who has a hospitalization longer than 30 days regardless of birth weight or family income. You must apply for Institutional Medicaid prior to discharge. Speak to your NICU social worker or your hospital’s financial assistance office. If you have private insurance, your insurance will be billed first and then Medicaid will be billed for any charges that your insurance does not cover. Even members with good insurance have had thousands of dollars of medical expenses covered by Institutional Medicaid. We highly recommend that you apply for this while your child is in the NICU.
Supplemental Security Income (SSI)Supplemental Security Income (SSI), Premature infants (37 weeks or less) who are low birth weight (less than 1200 grams or 2.8 lbs.), are considered temporarily disabled for the length of their hospitalization. The child (or parents) can receive up to $30.00 per month while the child is hospitalized. Speak to your NICU nurse or social worker for more information. You will need to submit an application at your local Social Security office.
Medicaid WaiversMedicaid Waivers provide some services in the community to people who would otherwise be eligible for institutions, such as nursing facilities or Intermediate Care Facilities. These community services require an additional screening to be eligible. There are different types of waivers. Here are a couple of examples from Virginia:
- A Technology (Tech) Waiver may provide private duty nursing, respite care, environmental modifications, and assistive technology. To be eligible your child must rely on technology in replace of a vital bodily function. For example, a gastric tube (g-tube), ventilator, or oxygen support.
- An Elderly Disabled Consumer Directed (EDCD) Waiver offers personal aide care, medication monitoring, consumer-directed care, and respite. To be eligible for this waiver your child must meet a level of functioning criteria or have a medical need. Go to http://www.dmas.virginia.gov/downloads/pdfs/ab-ltc_medicaid_waiver.pdf to learn more.
Health Insurance Premium Payment Program (HIPP)The Health Insurance Premium Payment Program (HIPP) is a program that may be available to families with Medicaid. It may reimburse all or part of your employer’s sponsored health insurance premiums. To qualify at least one family member must have full Medicaid coverage and it must be cost-effective for Medicaid to pay your health insurance premiums and co-pays rather than pay for the medical services.
Other AssistanceThere are also a number of non-profit organizations that provide financial assistance to families in need to cover some medical expenses:
- Disabled Children's Relief Fund (DCRF), a non-profit 501(c)(3) organization, provides disabled children with assistance to obtain wheelchairs, orthopedic braces, walkers, lifts, hearing aids, eyeglasses, medical equipment, physical therapy, and surgery.
- Needy Meds is a 501(c)(3) non-profit with the mission of helping people who can't afford to pay for their medications
- United Healthcare Children's Foundation is a 501(c)(3) non-profit charity dedicated to facilitating access to medical-related services that have the potential to significantly enhance either the clinical condition or the quality of life of the child and that are not fully covered by the available commercial health benefit plan.
- The Aubrey Rose Foundation helps families caring for children with life threatening illnesses with a focus on the family unity. It strive to lift families from life's complexities during this difficult time by providing emotional and financial support.
- The Kaitlin Marie Bell Foundation is a non-profit organization which supports the needs of medically and physically challenged children. It exists to increase lifestyle opportunities and quality of life for recipients by providing equipment and/or services that would not otherwise be affordable.
- RSV Prevention and Synagis Payment Assistance: The MedImmune Assistance Program is administered as part of the Synagis Reimbursement Hotline and can be reached by calling 1-877-778-9010. More information about additional help available for RSV prevention and treatment can be found by visiting the Patient Access Network. You may also call 1-866-316-7263. For more information about RSV, go to http://www.synagis.com/what-is-rsv.aspx.
- The Abbott Patient Assistance Foundation provides free Abbott medicines, medical nutritionals, and diabetes care products to qualified patients who are experiencing financial difficulties and who generally do not have coverage available for these products through private insurance or government funded programs.