Preemie Cash Benefits
SSI pays benefits to infants under one year whose birth weight was below certain thresholds ranging from 1,200 but not more than 1,325 grams (2 lbs., 5 oz.) for a child born at 33 weeks to 2,000 grams or less (4 lbs., 6 oz.) for a child born at 37 to 40 weeks gestational age. An infant weighing less than 1,200 grams is potentially eligible regardless of gestational age at birth. While in the hospital, the SSI benefit amount is $30 plus any state supplement, reduced by any income the child may have such as Social Security or public assistance. When discharged to the parents, the SSI basic benefit changes to $674 monthly, reduced by the child's and the parents' countable income.
Eligibility for SSI automatically entitles the child to Medicaid coverage in 32 states and the District of Columbia. Medicaid will generally pay the hospital bill. If the parents have private health insurance, Medicaid will usually cover the co-pays and deductibles.
If the premature child meets the low birth-weight criteria and there are no income or resource limitations, Social Security offices pay "presumptive payments." The child's birth weight creates a presumption of eligibility that allows payments for up to 6 months while waiting for the official disability determination by the local State Disability Determination Service (DDS).
Parental Deeming Waiver
Parents' income and resources deemed available for a child's support may make a premature infant ineligible for SSI upon leaving the hospital. However, the individual state of residence can waive the parent's income and allow the child to continue to receive the SSI payment of $30 and Medicaid if the child needs a high level of care that could require institutionalization. If the child can receive the same care at home at the same or less cost than the state would pay a facility, the state may waive deeming of the parents' income. The child's own income could affect the payment amount.
If the SSI eligible child's parent cannot work because they must stay at home to care for their disabled premature infant, some states may pay the parent In-Home Support Service wages. The program pays the parent a monthly income for caring for the child. The cost to the state is less than what it would pay to place the child in a nursing home so the parent could work.
- Social Security: Benefits for Premature Children
- Social Security: Program Operations Manual: $30 payment limit
- Social Security: Deeming Eligibility Chart for Children
- Social Security: Programs Operations Manual: Presumptive Payment Criteria
- California Department of Social Services: In=Home Support Services
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