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What formula can you get covered by insurance?

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BaroqueMama
Chase is one!

Member since 5/05

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me

What formula can you get covered by insurance?

Is it only Neocate? I know not every insurance covers it, but is there any other formula besides Neocate?

Posted 8/2/06 1:52 PM
 
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NJmom
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Re: What formula can you get covered by insurance?

I think you may be able to get Nutramigen or Alimentum covered.

Posted 8/2/06 1:58 PM
 

AnnBrunoXO
2 Girls For Me!

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MaMMa

Re: What formula can you get covered by insurance?

Posted by BabyInMarch

I think you may be able to get Nutramigen or Alimentum covered.



Aetna does not cover Allimentum - at least not in our situation - but im curious if others cover it....

Posted 8/2/06 2:00 PM
 

BaroqueMama
Chase is one!

Member since 5/05

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me

Re: What formula can you get covered by insurance?

Posted by AnnBrunoXO

Posted by BabyInMarch

I think you may be able to get Nutramigen or Alimentum covered.



Aetna does not cover Allimentum - at least not in our situation - but im curious if others cover it....



Do they cover Nutramigen? We have Aetna and Ava needs to be put on either Nutramigen or Allimentum.

Posted 8/2/06 2:13 PM
 

CheeChee
HI THERE!!!!

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Re: What formula can you get covered by insurance?

I have aetna (just switched from vytra as per my husbands company) and they do not cover any special formula unless the baby is getting it thru a feeding tube. Lovely thought huh? Chat Icon Vytra was covering nutramigen for us and so since aetna doesnt cover, my ped decided to wean him off nutramigen and back to similac. Worked like a charm and he has been on similac now for a month and since i get the checks in the mail it is sooooooooo much nicer and cheaper!! Thank God something worked out!!! Good luck. I know how much these ins. co's can be a PITA!!!Chat Icon Chat Icon

Message edited 8/2/2006 3:10:30 PM.

Posted 8/2/06 3:10 PM
 

AnnBrunoXO
2 Girls For Me!

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MaMMa

Re: What formula can you get covered by insurance?

Posted by prncssrachel

Posted by AnnBrunoXO

Posted by BabyInMarch

I think you may be able to get Nutramigen or Alimentum covered.



Aetna does not cover Allimentum - at least not in our situation - but im curious if others cover it....



Do they cover Nutramigen? We have Aetna and Ava needs to be put on either Nutramigen or Allimentum.

I am not sure about Nutramigen - but you should contact aetna - member services and ask them. Also let them know that its imperative that your daughter be on it - and you have a doctors prescription - in some cases I was told they may waive the rule and cover it - unfortunately for us - it didn't happen. good luck!

Posted 8/2/06 3:14 PM
 

BaroqueMama
Chase is one!

Member since 5/05

27530 total posts

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me

Re: What formula can you get covered by insurance?

Nutragimen is made by Enfamil, right? Only because I hve like 40 or 50 dollars in coupons from them. I also have tons of similac coupons, so I guess using them is better than nothing.

Posted 8/2/06 3:29 PM
 

antoinette
boy mamma

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Antoinette

Re: What formula can you get covered by insurance?

my ins. co covered alimentum it was great I just picked up a months supply at my pharmacy.

Posted 8/2/06 3:38 PM
 

Michelle
My Little Yankee Fans

Member since 1/06

4018 total posts

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Re: What formula can you get covered by insurance?

Posted by AnnBrunoXO

Posted by BabyInMarch

I think you may be able to get Nutramigen or Alimentum covered.



Aetna does not cover Allimentum - at least not in our situation - but im curious if others cover it....



I have Aetna and they cover it at 90%.

When I called them they said no, but when I ordered the forumla from Apria Healthcare and they handled it it was covered.

Posted 8/2/06 3:42 PM
 

BaroqueMama
Chase is one!

Member since 5/05

27530 total posts

Name:
me

Re: What formula can you get covered by insurance?

OK, so how do I go about ordering it so that it gets covered? Even partially is good!

Posted 8/2/06 3:52 PM
 

dee7772
My Loves

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Re: What formula can you get covered by insurance?

I used to have blue cross/blue shield and they coverd the Nutramitgen. When I went to my husbands plan also blue cross they would not coer it. I guess it really just depends on the company.

I would call your porvider and ask them if they cover the formula. Tell them it is a medical necessity that they need this formula to thrive. They will sned a form to your doctor which he has to fill out. Then it has to be approved by the insurance company.

Good Luck

Posted 8/2/06 3:58 PM
 

monkeybride
My Everything

Member since 5/05

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Re: What formula can you get covered by insurance?

Some will cover Alimentum or Nutramigen. We couldn't get anything covered.

Posted 8/2/06 4:43 PM
 

Michelle
My Little Yankee Fans

Member since 1/06

4018 total posts

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Re: What formula can you get covered by insurance?

Rachel I sent you a fm.

Posted 8/2/06 5:03 PM
 

groovypeg
:)

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Re: What formula can you get covered by insurance?

There was a major lawsuit of which Aetna lost and was required to reimburse MANY whom they denied coverage of formula that was medically necessary. This was previously defined as needing it administered via feeding tube. It now includes colic, GER/GERD (which Hannah has Chat Icon ) and other gastrointestinal disorders

I will try to find the site.

Hannah is now on Elecare which OMG is a fortune and I will sure as hell make sure that our insurance covers it.

Good luck!!

E ( This is Hannah's daddy and Jo's "DH")

I hope I'm not intruding.

Thank you! You all have taught me a bunch!
Chat Icon

Message edited 8/2/2006 7:45:35 PM.

Posted 8/2/06 7:44 PM
 

BaroqueMama
Chase is one!

Member since 5/05

27530 total posts

Name:
me

Re: What formula can you get covered by insurance?

Thank you so much for the info! We will hopefully get whatever she needs covered by the insurance. Although, I have a feeling it's going to be a bumpy road to our formula solutionsChat Icon

Posted 8/2/06 8:03 PM
 

groovypeg
:)

Member since 5/05

2423 total posts

Name:

Re: What formula can you get covered by insurance?

If they give you trouble, you can site this!

AN ACT CONCERNING INSURANCE COVERAGE FOR MEDICAL NUTRITION THERAPY SERVICES

"This bill requires health insurance policies to cover medically necessary specialized formula for children of any age........."

I'll be fighting with ya.


Hannah's DaddyChat Icon

Posted 8/2/06 8:14 PM
 

BaroqueMama
Chase is one!

Member since 5/05

27530 total posts

Name:
me

Re: What formula can you get covered by insurance?

Posted by groovypeg

If they give you trouble, you can site this!

AN ACT CONCERNING INSURANCE COVERAGE FOR MEDICAL NUTRITION THERAPY SERVICES

"This bill requires health insurance policies to cover medically necessary specialized formula for children of any age........."

I'll be fighting with ya.


Hannah's DaddyChat Icon



Thank you SOOOOOOOOO muchChat Icon

Posted 8/2/06 8:15 PM
 

groovypeg
:)

Member since 5/05

2423 total posts

Name:

Re: What formula can you get covered by insurance?

I promise to keep all of your mommy secrets to myself.

Just looking for some knowledge for my lil girl.

Thank you!!!

I hope it was cool for me to have posted.

You all have been so very supportive to my wonderful wife and of course now our daughter.

Just wanted to help.

E

Posted 8/2/06 8:19 PM
 

BaroqueMama
Chase is one!

Member since 5/05

27530 total posts

Name:
me

Re: What formula can you get covered by insurance?

It's nice to see a daddy posting!Chat Icon

Posted 8/2/06 8:45 PM
 

antoinette
boy mamma

Member since 5/05

2975 total posts

Name:
Antoinette

Re: What formula can you get covered by insurance?

Posted by prncssrachel

OK, so how do I go about ordering it so that it gets covered? Even partially is good!



you need to get the dr to call the ins company and get the fax # to fax over a letter saying that the child has a milk protein allergy and w?o this formula they will not thrive. then the ins company will send you a letter if they approve-- then you bring that to the pharmacy, with a written prescrpition from the dr - lets say 32 oz rtf bottles per day -- and then the pharmacy orders it -you pay co-pay, mine was 50 $ not bad for 400$ worth of formula nad thats about it, every month my dr would write out a new script. My ins. co is blue cross blue sheild hmo...

Posted 8/2/06 8:52 PM
 

BaroqueMama
Chase is one!

Member since 5/05

27530 total posts

Name:
me

Re: What formula can you get covered by insurance?

Posted by antoinette

Posted by prncssrachel

OK, so how do I go about ordering it so that it gets covered? Even partially is good!



you need to get the dr to call the ins company and get the fax # to fax over a letter saying that the child has a milk protein allergy and w?o this formula they will not thrive. then the ins company will send you a letter if they approve-- then you bring that to the pharmacy, with a written prescrpition from the dr - lets say 32 oz rtf bottles per day -- and then the pharmacy orders it -you pay co-pay, mine was 50 $ not bad for 400$ worth of formula nad thats about it, every month my dr would write out a new script. My ins. co is blue cross blue sheild hmo...



Thank you for the info!!!

Posted 8/2/06 9:47 PM
 
 

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