“Can My Preemie Qualify for Monthly Disability Benefits?”

Despite recent medical advances, premature babies often suffer from low birth weight and underdeveloped organs. Any baby that’s born before the 37th week is considered to be premature, or a “preemie.” Some preemie babies may develop long-term or permanent disabilities, and the treatment costs are often astronomical. Fortunately, preemie babies that meet the Social Security Administration’s low birth weight requirements may qualify for financial assistance.

How to Get Your Preemie Baby’s Benefits Claim Expedited

Typically, you must wait at least 3-5 months after submitting your claim to start getting disability assistance from the SSA. There are, however, a few exceptions to help you get around this mandatory waiting period. Luckily, the SSA expedites applications from parents of preemie babies, which then makes the approval process much faster. Your preemie may qualify for Supplemental Security Income (SSI) right away if your child’s less than one-year-old and:

  1. The birth certificate or other medical evidence shows a birth weight below 1,200 grams (2 pounds, 10 ounces), or
  2. Available medical evidence shows one of the below following gestational ages (GA) and corresponding weights at birth:
    • 37-40 weeks GA and birth weight below 2,000 grams (4 lbs., 6 oz)
    • 36 weeks GA and birth weight at or below 1,875 grams (4 lbs., 2 oz.)
    • 35 weeks GA and birth weight at or below 1,700 grams (3 lbs., 12 oz.)
    • 34 weeks GA and birth weight at or below 1,500 grams (3 lbs., 5 oz.)
    • 33 weeks GA and minimum birth weight of 1,200 grams (2 lbs., 10 oz.), maximum of 1,325 grams (2 lbs., 15 oz.)

Your child typically won’t qualify for Social Security disability insurance (SSDI), because the SSA doesn’t provide low birth-weight SSDI benefits.

What if Your Preemie Doesn’t Meet These Expedited Claim Requirements?

If your baby doesn’t meet the birth weight or gestational age requirements for expediting your claim, don’t worry! Your preemie may still be eligible for monthly SSI payments. The first step is filing your child’s disability claim and medical evidence proving your preemie meets the SSA’s eligibility requirements.

To see the agency’s list of eligible disabling conditions and evaluation guidelines, click the link for each category listed below:

Once you’ve submitted your child’s application, you’ll wait 3-5 months to hear whether the SSA approved or denied your claim. The SSA always sends notifications by mail, but you can call your local office to request current claim status updates.

Other Assistance Programs That Help Parents of Preemie Babies

If your child doesn’t qualify for SSI, several government programs might be able to help you through this difficult time. These additional programs include:

  • Medicaid. This federal and state program helps cover healthcare costs for eligible low-income families. Your household income and family size typically determines if you’re eligible for Medicaid coverage. If you already had Medicaid coverage when your baby was born, then your preemie automatically qualifies as well. Visit Medicaid.gov to see if either you or your preemie meets the program’s current eligibility requirements.
  • Children’s Health Insurance Program (CHIP). If you aren’t eligible for Medicaid, you might still qualify for CHIP. CHIP provides healthcare coverage for children whose parents earn too much to qualify for Medicaid. The CHIP program also covers children whose parents don’t have access to or cannot afford a private health insurance plan.
  • Women, Infants and Children (WIC). In addition to supplemental nutrition assistance for women, infants and children, WIC offers healthcare referrals, nutrition education and breastfeeding support. Visit the WIC website to find your nearest state or regional office location.

Many hospitals also offer other perks to parents whose preemie babies are staying in the NICU, such as:

  • An overnight family room or access to a Ronald McDonald House
  • Free parking
  • Food vouchers
  • Hospital-grade breast pumps

Ask your NICU case manager if any other local or regional assistance programs are available for you and your preemie.

If you’re unsure whether your preemie can meet the SSA’s disability requirements, we recommend talking to a Social Security lawyer. Ready to speak with an experienced disability advocate or attorney about getting monthly benefit payments for your preemie? Having a lawyer file your claim makes you 3x more likely to get benefits.

Click the button below to start your free, no-obligation disability benefits evaluation now:

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Mandy Voisin is a freelance writer, blogger, and author of Girls of the Ocean and Star of Deliverance. As an accomplished content marketing consultant, mom of four and doctor's wife, Mandy has written hundreds of articles about dangerous drugs and medical devices, medical issues that impact disabled Americans, veterans' healthcare and workers' compensation issues since 2016.