New here....Insurance q

Pink253

HI There

I have been struggling with my poor baby's digestion since he was born 6 mos ago. Trial and error brought the Dr to the conclusion yesterday that he has a milk sensitivity and needs to be placed on special Hyperalergenic formula. We are trying the Enfamil Pregestimil and already we have noticed a change. He is much happier and his stools are finally starting to look more normal. 

I worry that with my husband recently laid off that we won't be able to afford this formula. I have insurance through my work. Does anyone know if insurance will cover this?

ANy other newbie suggestion are welcome

Sept1799

Well, the only way you know is to call them and ask. I know that in ny state if you work for the state, LIRR, school system ect, they cover it. Mine here in Florida with the school system did not cover it. Your baby needs the formula so either way you have to make it work on the budget, you can't make her suffer if you found something out there for her, 

gl 

PipSqueak0313

The only other thing I could think of if the insurance route doesn't work is to contact Enfamil.  I would think they would know of programs/ways to assist families in similar situations to be able to afford their products.

Pink253

Thanks! Im working with the Dr's office and insurance to see if we can get it covered. From what I hear it might be a bit of a struggle but im hoping the insurance will cooperate.  I will deffinetely look into your suggestion if it doesn't work.  THanks again!

Nita14701

With our insurance they cover a few of the specialty formulas under our durable medical equipment benefit if you use one of their vendors. The dr sends the vendor the info and the vendor sends it out via UPS. I ended up calling a few of them to see who carries formula and came up with Apria. My daughter started on nutramigen this week for a possible milk protein sensitivity. Our insurance is personal choice- but I think the benefit varies by the type of plan and how it was set up.

pixiem38

I am going through the exact same thing right now with my twins. The pediatricians office is useless. The insurance keeps giving me different answers. It has been a long frustrating week and I am no closer today than I was a week ago. I know it will eventually be covered, but how to get there from here is mysterious and difficult. Good luck

browneyedgoil

my daughter was put on neocate. alimentum did not work for her. my insurance did cover it. here is neocate's link on how to get approval. they have specialists that can help you. it differs by state but it's a starting point. 

https://www.neocate.com/reimbursement/insurance-coverage-map/