Author Topic: insurance not covering formula for MSPI baby  (Read 922 times)

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Offline Austin's mom

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insurance not covering formula for MSPI baby
« on: March 23, 2010, 02:43:21 am »
I just called the insurance company today, we have Aetna, through my husbands work. They gave me a link to their policies which very specifically stated that unless the baby was on a feeding tube (thank God  he isn't!) they will not cover special infant formulas (nutramigen, alimentum, etc) even with a prescription. Says only if the state mandates it. Which we are in Tennessee, and as far as I can tell, they dont.


Anyone else have this problem? What should I do? Is there a supplemental insurance that would work? any ideas? This stuff is soooo expensive!


Offline birdie

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Re: insurance not covering formula for MSPI baby
« Reply #1 on: March 23, 2010, 06:53:27 am »
Yep!!  I had little luck.  Check out the Neocate website.  They have great sample letters.  Also talk to your doctor for ideas.
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Offline Mashi

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Re: insurance not covering formula for MSPI baby
« Reply #2 on: March 23, 2010, 10:35:21 am »
It might also be worth getting some free samples sent from Enfamil - they do it for many of their products but not sure if they do Nutramigen specifically.  If they have a limit to the number you can get sent per household, don't be shy in asking friends and family if you can sign up with their names and have them bring it to you when it arrives!

Offline birdie

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Re: insurance not covering formula for MSPI baby
« Reply #3 on: March 23, 2010, 20:12:00 pm »
I guess we should ask which formula you LO is on?  When you mentioned price, I immediately thought Neocate.
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Offline Rachel_Momto3boys

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Re: insurance not covering formula for MSPI baby
« Reply #4 on: March 23, 2010, 20:43:25 pm »
Not sure what formula you are using but you could always check out our website, neocate.com for ideas.  We have a section called "Reimbursement Support" which might be helpful no matter what formula you are using.  And you're right, it looks like Tennessee does not have any legislation mandating coverage (at least for Neocate).  Good luck!

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Decemberboy04 - former reflux baby
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Rachel
Mom to 3 boys
Augustboy02 - Sensational Sensory Kid
Decemberboy04 - former reflux baby
Augustboy10 - MSPI Baby - EBF w/elimination diet

Offline Austin's mom

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Re: insurance not covering formula for MSPI baby
« Reply #5 on: March 24, 2010, 00:59:35 am »
hmmm.... ok thanks. We go back to the dr. tomorrow so I'll see if they have any better ideas. He is on Nutramigen for the moment...although just had another terrible outbreak of rash/eczema so I'm not sure what they will tell us to do. I'm out of ideas!

Offline grace annes mommy

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Re: insurance not covering formula for MSPI baby
« Reply #6 on: March 24, 2010, 01:05:42 am »
Any chance you qualify for WIC?  We did, and it saved us!


Offline Austin's mom

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Re: insurance not covering formula for MSPI baby
« Reply #7 on: March 24, 2010, 01:10:40 am »
unfortunately not right now... but my husbands job is about to go through a transition, so I may very well then... bitter/sweet.