Recently, I had an expectant quad mom ask me for some resources on SSI eligibility for infants. This is something that I had no knowledge of until after our babies were born at 28 weeks. I thought it would be a beneficial post for expectant moms of multiples if I were able to share some of what I learned through our experience here.
SSI stands for Supplemental Security Income. While typically thought of for the over 65 population, SSI is a US Government program that provides stipends to low-income who are either aged (65 or older), blind, or disabled. It is very common in multiple births for infants to arrive premature. In fact, our doctors had no expectation of me carrying the quadruplets past 32 weeks. The average gestation for quadruplets is 29 weeks. I carried until 28 weeks and 5 days, 2 days short of average. Preemies and infants with low birth weights or other developmental problems are often eligible for SSI disability payments for the first year of their life.
Children born before 37 weeks gestation are considered premature and some suffer many side effects. One of the most common effects of premature birth is low birth weight. Many impairments, both short and long-term, are commonly seen with premature birth and low birth weight children. Short-term effects can include breathing problems, anemia, jaundice, low blood pressure, patent ductus arteriosus (PDA), bleeding in the brain, difficulty maintaining body temperature, which can lead to hypothermia, difficulty feeding due to an underdeveloped gastrointestinal system and poor ability to suck and swallow, hypoglycemia (low blood sugar), and infections. Long-term effects of premature birth often don't show up until later in life, perhaps even adulthood and often include: cognitive delays, psychological issues, cerebal palsy, impaired cognitive abilities and physical skills due to injury to the brain, growth impairment, learning disabilities, vision problems, hearing problems, dental problems, behavioral and psychological problems, including attention deficit hyperactivity disorder (ADHD), depression and an increased risk of Sudden Infant Death Syndrome (SIDS). Also, those who are born premature with a low birth weight are more likely to have Type 2 diabetes and cardiovascular disease as adults.
We were fortunate that the insurance department at the hospital where we delivered worked with us to help us get approval for SSI. While the stipends typically are not a lot of money, along with SSI approval, the babies are also eligible for Medicaid which helps with those pricey NICU bills. Although we had private insurance which paid for a lot of our hospital stay, Medicaid helps to pay the remaining co-pays for the babies (not for the mother). The stipends are also helpful with the expenses of having babies in the hospital (think parking, lodging, eating out, laundry, etc).
While in the hospital, SSI is determined by disability. However, once discharged, SSI eligibility is dependent upon parents' income and resources. Be prepared to provide tons of information regarding income you receive and assets you may or may not have. You will also need to be sure to check in and report any changes (ie - if you return to work after maternity leave, when baby is discharged from the hospital, etc.).
The process to apply for SSI can be long and a lot of work (especially if you are applying for four babies). To apply, you will call 1-800-772-1213 or visit your local Social Security Office. I called the day after the babies were born and was on hold for over an hour so be prepared to wait if you call in. Once you submit the application, a phone interview will be scheduled to go over more information. Here is a link from the Social Security Administration that tells you a little bit of what you can expect: http://www.ssa.gov/forms/ssa-4.html.
Once the application is submitted, SSI will review and determine if the child(ren) meet(s) certain disability guidelines. There is a list of presumptive disabilities that are automatically assumed for children born at certain gestation and birth weights. Many premature infants automatically qualify for the first six months based on this.
I am happy to provide any other advice or help if I can to other parents in this position. Please don't hesitate to reach out using the "Contact Us" form on the front page of my blog.
Here's a link to a brochure on SSI payments for children with disabilities: http://www.ssa.gov/pubs/EN-05-10026.pdf