Alimentum

My son is being prescribed alimentum for a protein allergy. I currently have Aetna, does insurance have to cover this? Is there anyone that has had it covered?

Alimentum

I have United Healthcare and mine was covered minus a co-pay which was $105 per 30 bottle shipment.

It was not easy trying to find out if it was covered and I had to speak to several different people at United Healthcare.

My advice to you would be to immediately ask to speak to a specialist for your specific plan and then tell them that it would be covered under Nutrition.

Once I found out it was covered, I contacted Edgepark to set up delivery. It was very easy and I was able to re-order each month through the website and pick a delivery date.

You will most likely need a medical necessity letter from your Ped which will be sent to your Insurance company and Edgepark.

Re: Alimentum

Some insurances do not cover it. My medical insurance did not cover it, but my prescription insurance covered some of it. I had to get a letter from the pediatrician stating it was a medical necessity and I had to order it from the pharmacy and fill it like a prescription.

Alimentum

We had to obtain a letter from our ped stating that it was medically necessary. I then called my insurance, sent them the letter. Once it was approved, I called Edgepark medical supplies and they set up a recurring shipment for every 30 days. We had 3 cases delivered every month for a year.

Alimentum

Thanks everyone! I called Aetna they said they need a prior authorization so the doctors office is doing that now but then I looked online and it says in general Aetna doesn't cover formula unless via feeding tube which I find crazy!

Alimentum

Aetna pharmacy denied it. Doctors office said to try and go through DME

Alimentum

I have some if you need it- not sure exactly how much but a couple cases at least.

Alimentum

Contact Corridan CVS. They will work to get it covered.

Re: Alimentum