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Am J Perinatol
DOI: 10.1055/a-2601-8941
Original Article

Delayed Enrollment in Medicaid by Eligible Families with Children Admitted to the Neonatal Intensive Care Unit

Authors

  • Jessica Eubanks

    1   Division of Neonatology, East Carolina University Health Medical Center, Greenville, North Carolina

  • Dmitry Tumin

    2   Department of Pediatrics, Brody School of Medicine at East Carolina University, Greenville, North Carolina

  • Uduak S. Akpan 

    2   Department of Pediatrics, Brody School of Medicine at East Carolina University, Greenville, North Carolina

Funding None.
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Abstract

Objectives

All children, including infants admitted to the neonatal intensive care unit (NICU) require health insurance. However, despite eligibility for Medicaid, many children are uninsured due to barriers in the enrollment process. Therefore, we studied the prevalence of and reasons for delayed insurance enrollment among families with Medicaid-eligible infants admitted to the NICU.

Study Design

This was a single-center, prospective survey study conducted in a seventy-one-bed level IV NICU. All neonates eligible for Medicaid enrollment and hospitalized for at least 21 days were eligible for the study. The primary outcome variable was enrollment in public insurance by the time of survey completion. We also examined the reported barriers to insurance enrollment.

Results

We enrolled 102 infants in this study, 76% of whom were already enrolled in Medicaid at survey completion. Common barriers to Medicaid enrollment reported by infants' parents were difficulty understanding the application process and the Medicaid application forms.

Conclusion

Although most Medicaid-eligible neonates in the NICU had obtained insurance coverage prior to the fourth week of life, simplifying the application process (including the application forms) can remove the remaining barriers to coverage enrollment.

Key Points

  • Health insurance coverage is vital for all children.

  • Medicaid is the largest insurer of children.

  • Identifying barriers to insurance enrollment is critical.

Keywords

Medicaid - prematurity - underinsurance - enrollment barriers

Supplementary Material



Publication History

Received: 30 January 2025

Accepted: 06 May 2025

Article published online:
28 May 2025

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