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Food Allergy
MrsT0514
member
New to the boards/food allergies (sort of long, sorry!)
MrsT0514
member
in Food Allergy
Hi Ladies,
I usually just lurk and read posts on the boards but wanted to introduce myself. I've found tons of really helpful info on these boards, and decided it was time to finally come out and say hello. I'm a FTM, my son is 6 weeks old and was just diagnosed with a (severe) milk protein intolerance. We started out breastfeeding from birth to 3 weeks old, but unfortunately that did not work out due to very low supply caused by breast hypoplasia/ insufficient glandular tissue in my breasts. From there I continued to pump while supplementing with Enfamil Newborn, but this only ended in frustration because despite my best efforts, I couldn't produce enough, so we switched over to formula exclusively. Enfamil Newborn made my son extremely gassy/fussy, so we switched to Gentlease which made no improvement, in fact it constipated him. He still had issues with gas, reflux, fussiness during/after/between feedings, and blood/mucus in his stool. After trying Zantac (with no improvement), the dr suggested Nutramigen. After a week and a half on Nutramigen, his stool tested positive again for blood and he is still arching his back during/after feedings. He is also having a BM after almost every feeding, which has caused a horrible diaper rash.
I feel horrible that he's so uncomfortable! The dr has now put him on PurAmino (formerly Nutramigen AA) but I've had a hell of a time getting any pharmacy to special order this formula. Fortunately it will be covered by our insurance (United Healthcare), but we may be switching to Blue Cross Blue Shield in the near future. Has anyone had issues with Blue Cross covering this formula? It costs an arm and a leg and is hard enough to get as it is! Any insight/help is greatly appreciated. Sorry I practically wrote a novel. If you were patient enough to read all of this, thank you! 
This discussion has been closed.
Re: New to the boards/food allergies (sort of long, sorry!)
I don't have Blue Cross, I have Aetna, but my state (MA) requires that formula be covered in certain cases. My dr prescribed formula for my daughter, and my insurance will cover 80% of the cost, up to $10,000 a year. However, I can't just go to cvs and buy it there, because it's covered by the medical insurance, not the prescription coverage. I have to mail order it from a durable medical equipment provider - kind of like getting crutches.
My company benefits include a Health Adviser, which is a person who will figure out your coverage for you and fight the insurance company if need be, so I just called them and they found all this out for me. But you should be able to call your insurance and ask whether prescribed formula is covered as durable medical equipment, and if your state requires it.
Thanks for your input. After speaking with a few pharmacies as well as a medical supply company, and a rep at enfamil, I'm pretty sure I'll have to end up like you said, going thru a medical supply company (and insurance will pay) or order through enfamil directly (and insurance will reimburse).