We got Neosure covered by insurance!

ashleybritton · July 2012

I just wanted to let people know to check with your insurance. We have BCBS and I originally called under our prescription plan, but was told it wasn't covered. I read somewhere to call insurance and ask if it was covered under major medical because it was a medical necessity and it was approved!

I just wanted to let you know because I was denied at first. Obviously every insurance is different, but it's worth a try!

Missa_g · July 2012

That is awesome! Did you have to do anything special? I have Blue Cross Blue Shield and it was denied.

ashleybritton · July 2012

Nothing special other than using that exact terminology. I asked if it would be covered under major medical because he was a preemie and his doctors said it was a medical necessity. I just need his dr to write "for nutrition as a result of premature birth" on his prescription.

Pips09 · July 2012

CurlingRocks:
Wish we'd have thought of that last year.... Way to go!

DItto- I really wish I had thought to ask when we needed it.

t1nkfan · July 2012

Ours was covered under a Home Medical Equipment clause - we had to order through a specialty equipment company, but they covered a year's worth of formula. We paid maybe about $500 for the whole year - shipped right to the front door. We used the company edgepark.com to order online.

Our BCBS rep had to look into it, but I insisted several times that they should look under the HME clause as a "medical necessity" to find it, and they finally did.

PPs are correct - precise terminology is needed for them to keep looking for it.

t1nkfan · July 2012

Ours was covered under a Home Medical Equipment clause - we had to order through a specialty equipment company, but they covered a year's worth of formula. We paid maybe about $500 for the whole year - shipped right to the front door.

Our BCBS rep had to look into it, but I insisted several times that they should look under the HME clause as a "medical necessity" to find it, and they finally did.

PPs are correct - precise terminology is needed for them to keep looking for it.

shanlubey · July 2012

Sam is considered Failure to Thrive (as a technical diagnosis) and they still do not approve it. I am on the phone with BCBS about the HME medical necessity but their pharmacy program keeps denying it. They say it's state law, but I have friends with preemies NOT FTT getting Pediasure in MA. Insurance company logic blows my mind.

Want a personalized experience?

We got Neosure covered by insurance!

Re: We got Neosure covered by insurance!

Choose Another Board

Search Boards