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Does your insurance cover your formula? (Alimentum/Nutramigen)

macaroni1979macaroni1979 member
in Babies: 3 - 6 Months
What insurance do you have and what did you need to provide? I have had to stop bf'ing this week and give DS Alimentum due to some type of allergy. I cut dairy and soy from my diet, and we saw no change. The celiac disease test was negative and we are waiting on more blood work. I am going to call Carefirst tomorrow, but want to hear your experiences.
Josie Cailin 7/25/08 Asher Mason 7/19/10
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Re: Does your insurance cover your formula? (Alimentum/Nutramigen)

  • Chicka03Chicka03
    We get ours through our insurance which is Cigna. My Dr. sent an RX and medical records to get it approved. The place we get it from charges a ridiculious amount! I got 20 cans and they charged my insurance $1200!!  I only pay $20% and it is cheaper, but it unbelievable they can charge that much! GL! My DS is doing so much better on Alimentum.
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  • ctgrlctgrl
    We have anthem BCBS. They cover DD's alimentum but we had to have our dr fill out a form. The form detailed all the medical reasons why she was on the formula. It was also necessary for my dr to verify that we had tried and failed with at least 3 other formulas before it was covered.
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  • sgibson04sgibson04 member
    anyone have more current info on this?  looks like we maybe switching to a specialty formula due to milk/soy allergy.
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  • BlessUrHeart29BlessUrHeart29 member
    DS's insurance would only cover Alimentum formula if it had to be administered through a feeding tube. Thankfully we were able to identify the problem and continue nursing.

    We got 8 ready to use bottles (33oz each) from the pediatrician, and two small cans of powder from Similac bc DH wrote and asked for samples. So those are some options to try to help if your insurance won't cover it.
    Baby Birthday Ticker Ticker
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  • Marley629Marley629 member
    Our insurance refuses to cover the nutramigen unless he had a metabolic disorder. We just tried to wean him off of it at 5 months per pedis approval but he had a bad reaction to the Similac total comfort so we are on the nutramigen for the long haul.
    DH: 34 | Me: 35
    DS1 9/24/13
    DX Diminished Ovarian Reserve, Factor V Leiden Mutation, Secondary Infertility
    MFI (SA #1    Count 11mill, Motility: 18%, Morphology: 1%)
    MFI (SA #2Count 7 mill, Motility: 18%, Morphology: 1%)
    AMH .328     | FSH 13.2 
    Oct. 2016: Clomid + TI
    IVF: ER 3/1/17; 5 retrieved, 3 mature & fertilized
    Results: 2 PGS normal embryos
    Planned on August 2017 transfer
    **TW**
    Natural BFP 4/3/17,Expecting baby boy via RCS 12/7/17

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  • cagoldicagoldi member
    DS is on Neocate. We have United Healthcare and it isn't covered. We're paying $41 per 14 oz can, all OOP.
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