Empire Plan & Nutramigen

Do anyone know if the Empire plan (NYSHIP) will cover nutramigen? DD just had a bunch of tests done and the found blood in her stool. The dr wants me to switch to nutramigen which is much more expensive. I called today and they said NO but I could appeal. Anyone have any experience with this??

Re: Empire Plan & Nutramigen

Yep.. they have covered it for DD since she was 3 weeks old. I call once a month and they ship the cases to my door, usually the next day.

Its AWESOME.

Re: Empire Plan & Nutramigen

Did you call empire directly or medco? Did you have to appeal it first? I called and went through medco they told me it wasn't covered but to try to appeal. What did you have to do? I have the ped. writting a letter that it is a medical reason due to an allergy.

Thanks in advance for your help!

Re: Empire Plan & Nutramigen

I fmed you back...

Re: Empire Plan & Nutramigen

Hello:
New to boards and my 11 day old was just put on Nutramigen.

I too have NYSHIP Empire plan and am wondering the keys to your success of getting it paid for by insurance.

Thanks!
Tiffany

Re: Empire Plan & Nutramigen

If the MD writes a letter most time they do cover it.

Re: Empire Plan & Nutramigen

Re: Empire Plan & Nutramigen

We had the hardest time with the Empire Plan. DS was originally put on Nutramigen. It took numerous phone calls and letters to get it done. Then when we finally got that taken care of, he was put on Elecare. They kept refusing to pay for it. At 50 dollars a can, we couldn't afford it. We called everyday for over a week. We never got anywhere. The doctors office even had a hard time. Finally after a bunch of threats and a stern letter from the pedi office, they decided to cover it. We get it through a medical supply company called Landauer. We got our first shipment last week. Elecare is not available in stores. It has to be ordered through a pharmacy.

Re: Empire Plan & Nutramigen

I started the process on 12/16 and I have called almost daily to check on progress. The first 3 calls where setting things up then they were waiting on my ped office to fax back the form. Then they claimed they did not get it, but ped office claimed they faxed it so they re-faxed. That was on 12/23. I called on 12/24 and they said I should hear from them today. I have spoken to a lady Kristen almost every time and she has been so nice. But I still have not heard from them I will be calling them first thing in the morning.

My issue is I think we are going to have to change formul because DD is still having issues.

Anycase the number is 1-877-769-7447, then it is option 1, then opition 3, then option 4. It is the divison that deals with home delivery of medical supplies. The prescription department was a dead end!! Good luck keep us posted!!