Preemie SSI Benefits

By Jane Amar
Supplemental Security Income can help parents handle the costs of their premature baby's care.

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Supplemental Security Income (SSI) is a needs-based benefit program that pays monthly benefits to aged, blind and disabled individuals. Although the Social Security Administration manages the program, it is not Social Security. U.S. citizens do not need work under Social Security to receive SSI. Newborn infants can qualify for SSI if the child's disability, and the income and resources of the child and her parents meet eligibility requirements. Over 1.2 million children receive monthly SSI payments.

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.

Medicaid

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.

Presumptive Payments

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.

In-Home Services

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.

About the Author

Jane Amar received a Bachelor of Arts in Spanish language and literature from the University of California in Riverside in 1970. After more than 37 years in government service in management and technical positions, she retired and began her writing career. Since 2007 she has written online content in English and Spanish for profit and nonprofit services and individual entrepreneurs.

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