Many parents of preemies find themselves facing large and unexpected medical bills after delivering their babies. For parents needing help, you can start by visiting Medicaid.gov and your local department of Health and Human Services to find out if your child is eligible for any federally funded assistance programs. The income limits may be different in each state, and even if you have a good job, some states make exceptions for things like premature birth because of the high cost and the frequent need for ongoing care. In some states, medical conditions or the fact that your child was born prematurely will automatically make your preemie eligible for federal assistance. The only way to find out is to check.
The Affordable Care Act (ACA):
Starting on October 1, 2013, everyone who does not have health insurance and who is not eligible for Medicaid can visit Healthcare.gov to find out how to obtain health insurance through the Health Care Exchange. Many preemies have health conditions that used to may make finding insurance expensive if you could not get it through your (a parent’s) employer. The insurance that is now available is intended to be less expensive for people with pre-existing conditions. If you did not have insurance before, and will now have to pay for coverage, there are six things you need to know about getting health insurance:
- There will be no spending limits (This means that there is no maximum amount that insurance companies will pay for your preemie’s medical care. No matter how many medical expenses you have, your insurance company will pay its part).
- Insurance companies can not “drop” your coverage if your baby’s care becomes expensive, and if it DOES become expensive, having insurance could save you from having massive medical bills to pay on your own (please note that you will still have to pay copays and deductibles).
- You can purchase insurance through the ACA starting on Oct. 1, 2013 and can continue through March 31, 2014. You can change your insurance or purchase new insurance after that date if you have a life-changing event like job loss, marriage, divorce, and childbirth.
- Everyone not insured by March 31, 2014 will face a tax penalty when you file your income taxes the following year unless you ask for and get an exemption. If you have a life-changing event after March 31, 2014, you will have the chance to change your insurance or purchase new insurance without a tax penalty.
- Many people will be eligible to receive money to pay for (or help pay for) the monthly insurance cost. The amount you will get depends on your income and family size.
- In many states Medicaid will become available to families that were not eligible before. Medicaid provides full insurance coverage without any cost to preemie parents.
These insurance changes may sound helpful or they may sound scary, but every preemie parent needs to learn what to do if you are not already insured. Preemie care can be very expensive and taking some time to make sure you have help with these costs can help you avoid some financial hardships. Here are some websites and links to articles to help you find out more.
Healthcare.gov – The primary source for information about the ACA and the Health Insurance Marketplace.
Health Reform: Exchanges Will Be Cornerstone for Coverage Choices - An Everyday Health article explaining what healthcare exchanges are and how they work.
IRS.gov – IRS information about ACA tax provisions.
Taxing issues with the Affordable Care Act – A Washington Post article explaining the amount you would pay as a tax penalty for remaining uninsured.
Tax Law Changes in 2013 from the Affordable Care Act (ACA) That Affect Higher Income Earners – A Huffington Post Article explaining what the ACA tax law changes mean for higher income earners.
Medicaid.gov - Detailed information about Medicaid Expansion through the ACA.
Medicaid Expansion Map
The Advisory Board Company - Providers of the medicaid expansion map, an interactive medicaid expansion map and detailed information on state-by-state participation in medicaid expansion.
Financial Help Websites:
The U.S. Department of Health and Human Services can point you toward local resources other than Medicaid that can help with providing low-cost services or with paying health care expenses. Make an appointment with your local Department of Social Services to apply for any of these programs.
The Ronald McDonald House program provides a “home-away-from-home” for families so they can stay close by their hospitalized child at little or no cost.
MiracleBabies aims to become the nation’s premier non-profit resource for neo-natal intensive-care unit (NICU) patients and their families. Their mission is to provide financial assistance and support to families in need with newborns in the neonatal intensive care unit.
INFORMATION FOR PARENTS:
The resources provided here include lists of websites that provide a wide range of information about prematurity and about caring for preterm infants. General Information Resources and Medical Resources are also available.