Question for those who get their formula covered by insurance

DD is on Nutramigen and I'm going through the painful process of trying to find out if my insurance covers it. The doctor already sent the letter of medical necessity.

For those that were successful..

1) What did you need to do to get it covered?

2) Do you mind telling me what insurance you have

3) How is it covered? Do they send you a supply? Do you have to buy it somewhere specific? Do you have to submit claim forms and recipts?

Thanks!

Re: Question for those who get their formula covered by insurance

Andy is on Neocate. My doctor's office just had to call our insurance (United Healthcare) and they approved it. Then I took a prescription to my local pharmacy and they filled it.

My doctor's office said it's never been that easy for them, they were shocked.

Re: Question for those who get their formula covered by insurance

we have empire blue cross/shield and initially they denied us. we then called apria thanks to the help of some wonderful ladies on this board!

we needed to provide a letter to the company of medical necessity. after that they took care of everything and called to let us know that we did not have to pay a dime! every month we get a supply of powdered formula delivered.

(800) 277-4288. that's aprias number. ask to speak to someone in the enterol dept and ask them about getting the nutramigen covered and delivered.

good luck!

Re: Question for those who get their formula covered by insurance

ok I have united Healthcare and they confirmed they have my letter of medical necessity on file. They gave me the Aprias number as well...I just had my doctor fax over a prescription. So hopefully this works!!!

Groovypeg - is it covered 100%? How does Aprias work?

Thank you both for your help

Re: Question for those who get their formula covered by insurance

DS is on Nutramagen as well. We have Cigna. It literally took a day to get it approved. The doctors office wrote a letter and called the insurance company and the next day (Thursday) I got a phone call saying they received the prescription and I should have the formula by Monday Tuesday the latest. We received it today. They sent 10 16 oz cans of powder

Re: Question for those who get their formula covered by insurance

Re: Question for those who get their formula covered by insurance

Posted by lo13lo13

Posted by CathyB

Andy is on Neocate. My doctor's office just had to call our insurance (United Healthcare) and they approved it. Then I took a prescription to my local pharmacy and they filled it.

My doctor's office said it's never been that easy for them, they were shocked.

We have united healthcare also and it took us months to finally get it approved!!! We kept getting the run around!!

Re: Question for those who get their formula covered by insurance

Posted by CathyB

Posted by lo13lo13

Posted by CathyB

Andy is on Neocate. My doctor's office just had to call our insurance (United Healthcare) and they approved it. Then I took a prescription to my local pharmacy and they filled it.

My doctor's office said it's never been that easy for them, they were shocked.

We have united healthcare also and it took us months to finally get it approved!!! We kept getting the run around!!

I really think we got lucky and whoever the doctor's office spoke to was in a good mood that day. It seems so random.

Re: Question for those who get their formula covered by insurance

I used Apria and they sent it to me every month. I have Aetna and it was paid at 90% so it cost me 19.50 per month for his formula.

Re: Question for those who get their formula covered by insurance

United Health Care...had no problems getting approved

Message edited 1/23/2007 3:43:32 PM.

Re: Question for those who get their formula covered by insurance

We have Aetna US healthcare and we're in the process of trying though she's already almost 8 mos old so by the time I get it she'll probably be on whole milk