Shrine hospitals for children are a network of 22 non-profit pediatric specialty hospitals in the United States, Canada, and Mexico, operated by Shriners International, that provide expert care for children with orthopedic conditions, burns, spinal cord injuries, and cleft lip and palate, regardless of the family’s ability to pay. They are not general hospitals; they focus on a specific set of conditions, and they are funded through Shriners philanthropy and donations, not by charging families directly.
Background and History
The first Shriners Hospital for Children opened in Shreveport, Louisiana, in 1922. The initiative came from the Shriners, a fraternal organization founded in 1870 (originally as the Ancient Arabic Order of the Nobles of the Mystic Shrine). The idea was born at a 1920 Shriners convention, where members voted to create a network of hospitals to help children with polio, which was then a major cause of disability. Over the following decade, 13 more hospitals opened across North America.
Today, the system has evolved well beyond its early focus. The hospitals now treat a wide range of conditions, and they have become known for research and innovation in pediatric orthopedics and burn care. The organization also operates three research centers and provides education to medical professionals.
What Conditions Do They Treat?
Shrine hospitals specialize in a limited but impactful set of conditions. The most common categories are:
- Orthopedic conditions: This includes scoliosis, clubfoot, limb length differences, hip dysplasia, osteogenesis imperfecta (brittle bone disease), and juvenile arthritis.
- Burns and scar management: They provide acute burn treatment and long-term reconstructive surgery and rehabilitation.
- Cleft lip and palate: Comprehensive care includes surgery, dental work, speech therapy, and psychological support.
- Spinal cord injuries: They offer rehabilitation and ongoing care for children with paralysis.
- Other conditions: Some hospitals also treat conditions like cerebral palsy, spina bifida, and certain genetic disorders affecting the musculoskeletal system.
Each hospital may have slightly different specialties, so it is important to check the specific location for the conditions it treats.
How the Hospitals Are Funded and Who Pays
One of the most distinctive features of Shrine hospitals is their financial model. They do not bill families for their services. The care is provided free of charge to the child and family, and the costs are covered by:
- Earnings from the Shriners International endowment fund
- Donations from individuals, corporations, and foundations
- Fundraising events such as the Shriners’ circuses and golf tournaments
- Insurance reimbursements when available (but families are never billed for the remainder)
Because they are a charitable organization, they are able to accept children regardless of the family’s financial situation. There is no income test or requirement to pay. However, the child must be eligible for care based on the medical condition and age (typically up to 18, sometimes 21, depending on the program).
How to Get a Child Admitted
Referrals are usually made by a pediatrician, family doctor, or specialist. The process is straightforward:
- Contact the nearest Shriners hospital or the Shriners International patient referral line.
- Provide the child’s medical records, including diagnosis, imaging, and any prior treatment history.
- The hospital’s medical staff reviews the records to determine if the child’s condition falls within their scope of care.
- If accepted, the family works with a care coordinator to schedule appointments and arrange travel (which may be partially funded through Shriners transportation programs).
It is important to note that the child does not need to be a relative of a Shriner. The service is open to any child who meets the medical criteria, regardless of connection to the organization.
Common Misconceptions and Realities
A frequent misconception is that Shrine hospitals are only for children of Shriners or that they are religious institutions. In reality, they are secular medical facilities open to all children, and membership in the Shriners is not required. Another misconception is that they are low-quality or outdated; in fact, they are accredited by the Joint Commission and are often at the forefront of pediatric research. For example, Shriners hospitals have contributed to the development of the Ilizarov apparatus for limb lengthening and have pioneered burn care protocols.
However, there are limitations. They do not treat every pediatric condition—only those within their specialty areas. They also do not provide primary care, general pediatric checkups, or emergency services. Families should not expect a Shriners hospital to replace their regular pediatrician.
Costs and Insurance
Because the care is free to the family, there is no cost for medical treatment, surgery, hospital stays, or therapy provided at a Shriners hospital. This does not mean that there are no out-of-pocket expenses at all: travel to the hospital, lodging for the family (though some hospitals offer on-site housing), and meals are typically the family’s responsibility, though the Shriners may provide assistance through their transportation fund in certain cases.
If the family has insurance, the hospital will bill the insurance for the services they can cover, but they will not charge the family for co-pays, deductibles, or any balance. The hospital absorbs those costs.
Safety and Quality of Care
Shrine hospitals are fully licensed and accredited. They employ board-certified pediatric specialists, including orthopedic surgeons, plastic surgeons, burn specialists, and rehabilitation therapists. They are also teaching hospitals, meaning they train residents and fellows, which often brings access to the latest research and techniques.
Patient safety is a priority, and the hospitals follow standard pediatric protocols. They have dedicated child life specialists to help reduce anxiety, and they are designed to be child-friendly environments. The hospitals also participate in national quality improvement programs.
Alternatives and Comparison
If a child has a condition that Shriners does not treat, or if a family prefers a local option, there are alternatives:
- Children’s hospitals: Most major cities have a dedicated children’s hospital that offers a wide range of specialties, but they bill insurance and may leave families with significant out-of-pocket costs.
- University medical centers: Many academic medical centers have pediatric orthopedic and burn units that are equally advanced, but again, they are not free.
- Non-profit organizations: Groups like the UnitedHealthcare Children’s Foundation or the Children’s Miracle Network help with medical costs, but they do not provide direct care.
- State programs: Medicaid and CHIP cover many pediatric specialty services for eligible families.
For families with good insurance, a local children’s hospital may be more convenient. But for those without insurance or with high deductibles, Shriners is a unique option that removes financial barriers.
Frequently Asked Questions
Do you have to be a Shriner or related to a Shriner to get care?
No. The hospitals are open to all children who meet the medical eligibility criteria, regardless of any family connection to the Shriners organization.
Is there any income limit or asset test?
No. Shriners hospitals do not consider family income when deciding eligibility. They treat children based on medical need alone.
Does insurance cover treatment at Shriners hospitals?
If a child has insurance, the hospital will bill the insurance for covered services. However, the family is never responsible for co-pays, deductibles, or any balance. The hospital covers those costs.
Can adults be treated at Shriners hospitals?
Generally, no. The hospitals are for children up to age 18 (or 21 in some programs). There are a few exceptions for patients who have been under care since childhood and need to transition, but new adult patients are typically not accepted.
How do I get a referral to a Shriners hospital?
You can contact the Shriners International patient referral line or the nearest Shriners hospital directly. They will guide you through the process of submitting medical records for review.
Are Shriners hospitals religious institutions?
No. They are secular medical facilities. The Shriners are a fraternal organization with a charitable mission, but they are not a religious group and do not require any religious affiliation for care.
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