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clotheshorse
LIF Adult
Member since 5/12 1293 total posts
Name:
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Insurance coverage of formula-Empire NYSHIP
Good morning,
Does anyone know if this plan covers formula? Either prescription or the Similac Altimentium?
Just wondering. Thank you.
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Posted 3/9/15 9:35 AM  |
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PotofLuck06
Our Baby Boy Is Here!!!
Member since 11/06 13241 total posts
Name:
Betsy
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Re: Insurance coverage of formula-Empire NYSHIP
DS has to take Similac Alimentium for a milk protein allergy. We have the Empire Plan and they cover the cost. Its delivered to use monthly from Catholic Health Services.
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| Posted 3/9/15 11:33 AM |
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clotheshorse
LIF Adult
Member since 5/12 1293 total posts
Name:
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Re: Insurance coverage of formula-Empire NYSHIP
Oh ok. Good to know. Not a single person, OB, pediatrician, nurse even mentioned. I'm guessing they only would if your child needed a special kind for a medical reason. Is it the kind of thing where if you don't ask, they don't tell? Lol
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| Posted 3/9/15 12:01 PM |
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Re: Insurance coverage of formula-Empire NYSHIP
If your child needed a special formula your pediatrician would discuss insurance covering it I'm sure, as most insurance would need documentation that there is a need for specialized formula. If there's no need for it I don't see why anyone would mention it.
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| Posted 3/9/15 1:43 PM |
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PotofLuck06
Our Baby Boy Is Here!!!
Member since 11/06 13241 total posts
Name:
Betsy
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Re: Insurance coverage of formula-Empire NYSHIP
Our pediatrician supplied a script to the insurance company for a year's supply. I had the supplier number already from a friend and they told me what they needed to start the delivery and the peds off dealt directly with them over the phone to expedite delivery while the insurance company dealt with the paperwork processing.
ETA: Do realize that not all Drs know what insurance you have. The front desk will know, but not necessarily the Dr unless you say something. It's your job to know what your insurance covers and doesn't - not the dr or front desk. My DH and I read each insurance update we receive in those NYSHIP newsletters, so we stay up to date on what we have to pay or not for our own care and that of our kids.
Message edited 3/9/2015 1:55:57 PM.
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| Posted 3/9/15 1:53 PM |
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clotheshorse
LIF Adult
Member since 5/12 1293 total posts
Name:
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Re: Insurance coverage of formula-Empire NYSHIP
Posted by LiveForMoments
If your child needed a special formula your pediatrician would discuss insurance covering it I'm sure, as most insurance would need documentation that there is a need for specialized formula. If there's no need for it I don't see why anyone would mention it.
I realize now & thanks for the answers. I just thought this kind of info is something medical staff would feel is worth mentioning from early on. When I contacted my Insurance to tell them I was pregnant & to discuss benefits, I just thought it would have been nice to know as a" heads up" kind of thing.
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| Posted 3/9/15 3:19 PM |
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clotheshorse
LIF Adult
Member since 5/12 1293 total posts
Name:
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Re: Insurance coverage of formula-Empire NYSHIP
Posted by PotofLuck06
Our pediatrician supplied a script to the insurance company for a year's supply. I had the supplier number already from a friend and they told me what they needed to start the delivery and the peds off dealt directly with them over the phone to expedite delivery while the insurance company dealt with the paperwork processing.
ETA: Do realize that not all Drs know what insurance you have. The front desk will know, but not necessarily the Dr unless you say something. It's your job to know what your insurance covers and doesn't - not the dr or front desk. My DH and I read each insurance update we receive in those NYSHIP newsletters, so we stay up to date on what we have to pay or not for our own care and that of our kids.
I get those letters to but never read anything about special formula coverage.
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| Posted 3/9/15 3:20 PM |
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iluvmynutty
Mom to E&M
Member since 12/08 1762 total posts
Name:
D
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Re: Insurance coverage of formula-Empire NYSHIP
I have the Empire Plan/NYSHIP and they covered Alimentium for my DD due to medical necessity (Reflux & Milk Protein Sensitivity). The Pediatrician had to write a letter of medical necessity and send it to the insurance company. I also got it sent to the house.
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| Posted 3/9/15 4:30 PM |
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