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Teri
my girls!
Member since 2/06 1491 total posts
Name:
Teri
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? for moms that had formula covered thru insurance
My daughter is 7 wks old and our allergist had us put her directly on hypoallergenic formula due to my other dd's severe milk allergy. She is doing well on Nutramigen now so I am beginning the battle for my insurance to cover.
I just spoke with my allergist and she's righting a letter to UHC for them to cover. What are my next steps? How long do you wait before you hear back from them? Did many of you get denied first and then fight them on it? I called Apria Healthcare directly (I read on these boards some did that too) but they said I should go through UHC first.
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Posted 7/19/07 12:42 PM  |
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Susan
Loving Mommyhood!
Member since 5/05 2391 total posts
Name:
Susan
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Re: ? for moms that had formula covered thru insurance
I'm in the battle right now - for Alimentum - on the phone they say they will pay but I have not yet seen one cent. Good Luck.
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| Posted 7/19/07 12:46 PM |
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CathyB
Member since 5/05 19403 total posts
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Re: ? for moms that had formula covered thru insurance
Our Neocate is covered by UHC. First our ped sent a letter of medical necessity, but that wasn't what UHC wanted. I called their toll free number that the pharmacist uses (1-800-922-1557) and spoke to the customer service person. They faxed a form to the ped to be filled out and faxed back, and once they got that it was fine.
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| Posted 7/19/07 12:46 PM |
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Smileyd17
kids
Member since 5/05 20997 total posts
Name:
Mommy
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Re: ? for moms that had formula covered thru insurance
Im working on it too...almost there with getting it covered.
I was asked for a letter of medical necessity and a prescription. I sent that to ins and then called Apria 877-536-8372 (the place that will be delivering the formula) to set that up. A good way of getting them to call/contact your ins company and get it going.
Message edited 7/19/2007 12:49:08 PM.
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| Posted 7/19/07 12:47 PM |
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Teri
my girls!
Member since 2/06 1491 total posts
Name:
Teri
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Re: ? for moms that had formula covered thru insurance
maybe that's when it'd be a good time to get Apria involved....when teh insurance first approves it, you can follow up with Apria (or whomever your company uses for the delivery) and get things going.
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| Posted 7/19/07 12:47 PM |
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Sharon
So Big... So Fast!
Member since 5/05 2959 total posts
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Re: ? for moms that had formula covered thru insurance
I had Neosure covered by insurance.
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| Posted 7/19/07 12:47 PM |
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Teri
my girls!
Member since 2/06 1491 total posts
Name:
Teri
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Re: ? for moms that had formula covered thru insurance
Posted by CathyB
Our Neocate is covered by UHC. First our ped sent a letter of medical necessity, but that wasn't what UHC wanted. I called their toll free number that the pharmacist uses (1-800-922-1557) and spoke to the customer service person. They faxed a form to the ped to be filled out and faxed back, and once they got that it was fine.
that's what makes me wonder if they'll cover us. How did you know it was actually necessary? GI tests and such? We're not going through any of that bc technically Sarah is fine. We're doing this as a precaution due to family history (and that the AAP recs that we do this for allergic siblings) but therefore, there are no tests to prove her allergy.
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| Posted 7/19/07 12:48 PM |
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Smileyd17
kids
Member since 5/05 20997 total posts
Name:
Mommy
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Re: ? for moms that had formula covered thru insurance
Posted by Teri
that's what makes me wonder if they'll cover us. How did you know it was actually necessary? GI tests and such? We're not going through any of that bc technically Sarah is fine. We're doing this as a precaution due to family history (and that the AAP recs that we do this for allergic siblings) but therefore, there are no tests to prove her allergy.
Family history should be one reason. My DD suffered colickyness and was serverly fussy so that was considered any allergy to mik.
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| Posted 7/19/07 12:50 PM |
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CathyB
Member since 5/05 19403 total posts
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Re: ? for moms that had formula covered thru insurance
Posted by Teri
Posted by CathyB
Our Neocate is covered by UHC. First our ped sent a letter of medical necessity, but that wasn't what UHC wanted. I called their toll free number that the pharmacist uses (1-800-922-1557) and spoke to the customer service person. They faxed a form to the ped to be filled out and faxed back, and once they got that it was fine.
that's what makes me wonder if they'll cover us. How did you know it was actually necessary? GI tests and such? We're not going through any of that bc technically Sarah is fine. We're doing this as a precaution due to family history (and that the AAP recs that we do this for allergic siblings) but therefore, there are no tests to prove her allergy.
Andy was diagnosed by the ped as having multiple food protein allergies, atopic dermatitis due to food allergy and bloody stools. We haven't done GI tests yet, but may have to since he has a hard time with table food and gags and chokes at least once a week. 
I think people on here were denied by their insurance and then Apria was able to get them covered. I think that by NYS law if your dr says the baby needs it to thrive they have to cover it. Rachel fell into some loophole so they had to pay for Ava's neocate out of pocket.
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| Posted 7/19/07 12:54 PM |
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