When a baby requires care after birth, they will be transferred to the Neonatal Intensive Care Unit, or the NICU. Babies may require a NICU stay if they were born prematurely, had problems during delivery, or experienced complications after birth.
The cost of a NICU stay depends on a number of factors including duration, treatments, location, and more. Premature babies commonly see the highest cost since their stays tend to be longer. And with roughly 517,400 babies being born prematurely in the United States, it’s a cost with which many families are familiar (1).
According to a 2007 study, the average NICU stay for babies born between 32 and 34 weeks was 17.6 days, and the average cost for NICU stays for these babies was $31,000 (2). These costs varied with the type of treatments required for these preemie babies. For example, 56% of these preemies required intravenous nutrition and 54% of them required some type of respiratory assistance, whether it was continuous positive airway pressure, oxygen, or ventilation.
Many families begin financial planning to prepare for the costs associated with pregnancy and childbirth ahead of time. Being aware of financial options and supports available to you ahead of time can help ease your mind, even if your child doesn’t require a NICU stay after birth.
Paying for a NICU stay with private medical insurance
You will need to talk to your private medical insurance carrier to find out which NICU costs are covered by your plan (3). You will also need to add your baby to your insurance plan right after birth (most plans have a 30 day waiting period for you to add the baby). Many plans cover a mother and a baby’s hospitalization, but many will not cover care given by specialists or specialized services (4). It’s a good idea to talk to your insurance carrier as early as possible regarding your baby’s medical bills, copays, deductibles, services that won’t be covered, and any coverage limits (5).
In one recent story, a woman named Amy Jay gave birth to premature Evelyn, who was in need of a two week stay in the NICU to save her life (6). Amy’s private insurance did not cover any of the hospital costs, which totaled $178,389.47. Thanks to payment plans and helpful family and friends they are able to pay it off slowly, but the family was considering filing bankruptcy to cover their child’s NICU stay.
Paying for a NICU stay on Medicaid
If you have Medicaid, ask the hospital’s financial staff or a NICU social worker which costs will be covered by your state health insurance and which will not (3). If you are uninsured and do not have Medicaid, apply as early as possible (5)! Eligibility for Medicaid varies from state to state. Pregnant women and children under age six are considered at-risk populations, so even if you didn’t qualify for Medicaid before pregnancy, you may qualify during.
Using Supplemental Security Income (SSI) for your child’s NICU stay
Parents of preemie babies might be eligible for SSI income through the Social Security Administration (SSA) for the length of the baby’s hospital stay (7). These benefits are dependant on the baby’s birth weight and their gestational age at birth. They are allotted based on a number of factors, including the parent’s income.
Checking Your NICU Bill
If you’re concerned about the costs of your hospital stay or your baby’s NICU stay, ask for an itemized bill (3). This bill will include the cost of each individual service or product. You will be able to see exactly what you are paying for and speak with the hospital about any charges that seem incorrect.
Insurance Claims Appeals
It’s a great idea to call your insurance provider regarding any charges you’re not sure about (3). You can appeal in situations where coverage was denied and make a case for why that service should have been covered under your plan.
Additional Financial Help for a NICU stay
It’s a great idea to ask a hospital social worker what your options are for covering NICU costs (3). They can point you in the direction of the types of aid that are available and how to apply for other benefits. The hospital’s financial department is a great place to go as well. Many hospitals will lower the bill for individuals making less than a certain amount per year, will offer payment plans to those in need, or will offer uninsured people some sort of discount.
Your baby’s health is the most important thing to consider when they are in need of medical care and treatments. But it’s also a good idea to do what you can to be prepared for the costs that are associated with this care ahead of time.
Using funds from a lawsuit for NICU bills
Medical malpractice occurs when a healthcare provider fails to follow the standard of care in treating a patient, resulting in harm. If you think you or your baby experienced medical malpractice, you will be able to use the money from your possible settlement to pay for NICU bills. During the process of your case, the insurance company will be contacted and asked if they have a lien on the case. If they confirm a lien, they will be reimbursed as part of the possible settlement. In this way, your past damages and medical expenses during your NICU stay can be covered by a lawsuit retroactively.
- Frazier, A. (2018, November 13). NICU Costs Could Skyrocket Under The AHCA. Retrieved December 13, 2018, from https://www.romper.com/p/how-much-would-a-nicu-stay-cost-under-the-american-health-care-act-things-may-change-57765
- Kirkby, S., Greenspan, J. S., Kornhauser, M., & Schneiderman, R. (2007, April). Clinical outcomes and cost of the moderately preterm infant. Retrieved December 13, 2018, from https://www.ncbi.nlm.nih.gov/pubmed/17605448
- Paying for NICU care. (n.d.). Retrieved December 13, 2018, from https://www.marchofdimes.org/complications/paying-for-nicu-care.aspx
- March of Dimes Last updated: February 2016. (n.d.). How to pay for your premature baby’s care in the NICU. Retrieved December 14, 2018, from https://www.babycenter.com/0_how-to-pay-for-your-premature-babys-care-in-the-nicu_10300016.bc
- Bird, C., & Forman, J. (n.d.). Parents Have Different Options for Paying a Preemie’s Hospital Bills. Retrieved December 14, 2018, from https://www.verywellfamily.com/help-paying-your-premature-babys-medical-bills-2748682
- Wisner, W. (2017, May 22). Insurance Company Refuses to Cover Preemie, Leaving Parents with $200K in Medical Bills. Retrieved December 14, 2018, from https://www.babble.com/parenting/jay-family-nicu-stay-not-covered-by-insurance/
- Disability Benefits Center. (n.d.). Retrieved December 14, 2018, from https://www.disabilitybenefitscenter.org/faq/SSI-benefits-premature-children