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blu6385
Member since 5/08 8351 total posts
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How can i get a law explained to me?
There's a law about certain formula that insurance companies must cover. Its called Hanna's Law. However I am a little bit confused about certain parts and want clarification on it. I don't want to ask the insurance companies so who can I call or where can I go to have it explained to me?
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Posted 3/24/14 2:40 PM  |
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Aries14
Can't plan life...
Member since 8/08 2860 total posts
Name:
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How can i get a law explained to me?
its for enteral formulas for certain eosinophilic disorders. Is that what you are looking for?
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| Posted 3/24/14 3:08 PM |
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blu6385
Member since 5/08 8351 total posts
Name:
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Re: How can i get a law explained to me?
yes I am looking to see what the requirements are when they have to cover elecare which is an enteral formula.
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| Posted 3/24/14 4:21 PM |
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Aries14
Can't plan life...
Member since 8/08 2860 total posts
Name:
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How can i get a law explained to me?
http://open.nysenate.gov/legislation/bill/S2287-2013
this site explains it well
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| Posted 3/24/14 4:29 PM |
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Aries14
Can't plan life...
Member since 8/08 2860 total posts
Name:
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How can i get a law explained to me?
the way I read it - sounds like a medical professional has to write that it is medically neccesary and the patient's only source of nutrition. That without it the patient will have serve malnutrition or disability. Sounds like it has to be the only option and source or food.
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| Posted 3/24/14 4:34 PM |
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blu6385
Member since 5/08 8351 total posts
Name:
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Re: How can i get a law explained to me?
Thanks what I am not she is that I have health insurance but my prescription drug plan is not with them but through another party. Would either one of them have to follow this law?
If so which one? This is what I need explained to me.
Message edited 3/24/2014 6:33:59 PM.
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| Posted 3/24/14 6:33 PM |
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Michmouse
LIF Adult
Member since 11/07 1260 total posts
Name:
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Re: How can i get a law explained to me?
Your specialist will know how to navigate the insurance companies by filling out the correct papers. Are you seeing a gastro? For it to be covered the Dr. will need to say it is medically necessary.
My DS was on Elecare and it was covered 100%. Delivered to my door free every month.
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| Posted 3/24/14 8:16 PM |
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blu6385
Member since 5/08 8351 total posts
Name:
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How can i get a law explained to me?
We are seeing the gastro but every time I called my insurance they kept telling since I don't have pharmacy through them they won't cover it. My pharmacy coverage is telling me I have to go through insurance cause it's considered a medical supply. Edge park took care of it and got my insurance to cover it sent me my first shipment I thought great everything is taken care of well it's not apparently edge park only got a referral and not pre authorization. I am going to let edge park handle it but I want to be fully prepared in case they can't get the authorization and I would like to refer to this law if it applies.
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| Posted 3/24/14 10:07 PM |
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Aries14
Can't plan life...
Member since 8/08 2860 total posts
Name:
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How can i get a law explained to me?
it does state:
"Every policy which provides coverage for prescription drugs shall
include coverage for the cost of enteral formulas for home use, WHETHER
ADMINISTERED ORALLY OR VIA TUBE FEEDING, for which a physician or other
licensed health care provider legally authorized to prescribe under
title eight of the education law has issued a written order..."
so it sounds like its under the pharmacy coverage.
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| Posted 3/25/14 8:50 AM |
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blu6385
Member since 5/08 8351 total posts
Name:
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Re: How can i get a law explained to me?
thanks
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| Posted 3/25/14 9:05 PM |
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