When a baby requires care after birth, they will be transferred to the Neonatal Intensive Care Unit, or the NICU. A baby 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 (aka preemies) 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).
How much does a NICU stay cost on average?
According to a recent Michigan Medicine-led study, the average NICU stay costs about $4,969. For 1 in 11 families with NICU babies, the cost will exceed $10,000 (2). The cost varies depending on the type of treatments required and the length of the NICU stay.
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. 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 (3). 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 (4).
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. If you are uninsured and do not have Medicaid, apply as early as possible (4)! 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.
Tell us your story.
Dealing with a birth injury diagnosis can be difficult, but our attorneys can help. The ABC Law Centers: Birth Injury Lawyers team focuses exclusively on birth injury and are dedicated to earning justice for families like yours.
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 (5). 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. 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. 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. 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 bills for individuals who are making less than a certain amount per year
- Offer payment plans to those in need or
- 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.
About ABC Law Centers: Birth Injury Lawyers
ABC Law Centers: Birth Injury Lawyers was established to focus exclusively on birth injury cases. A “birth injury” is any type of harm to a baby that occurs just before, during, or after birth. While some children with birth injuries make a complete recovery, others develop lifelong disabilities such as cerebral palsy and hypoxic-ischemic encephalopathy.
If a birth injury/subsequent disability could have been prevented with proper care, then it constitutes medical malpractice. Settlements from birth injury cases can cover the costs of lifelong treatment, care, and other crucial resources.
If you believe you may have a birth injury case for your child, please contact us today to learn more. We are happy to talk to you free of any obligation or charge. In fact, clients pay nothing throughout the entire legal process unless we win.
Related reading:
- NICU Errors and Medical Malpractice
- Understanding the NICU Equipment and Environment
- How does noise affect the health of NICU babies?
- Addressing PTSD in NICU Parents
Sources:
- Frazier, A. (2018, November 13). NICU Costs Could Skyrocket Under The AHCA. Retrieved May 6, 2024, from https://www.romper.com/p/how-much-would-a-nicu-stay-cost-under-the-american-health-care-act-things-may-change-57765
- Mostafavi, B. (2021, June 17). 1 in 6 families in new study spent more than $5,000 to have a baby. Retrieved May 13, 2024, from https://www.michiganmedicine.org/health-lab/1-6-families-new-study-spent-more-5000-have-baby
- March of Dimes. (n.d.). How to pay for your premature baby’s care in the NICU. Retrieved May 6, 2024, from https://www.babycenter.com/baby/premature-babies/7-sources-of-financial-help-for-you-and-your-preemie_10371026
- Bird, C., & Forman, J. (n.d.). Parents Have Different Options for Paying a Preemie’s Hospital Bills. Retrieved May 6, 2024, from https://www.verywellfamily.com/help-paying-your-premature-babys-medical-bills-2748682
- Disability Benefits Center. (n.d.). Retrieved May 6, 2024, from https://www.disabilitybenefitscenter.org/faq/SSI-benefits-premature-children
