If you had insurance coverage, how much did you end up paying for it? I called my insurance and they cover 90%, it actually will end up being cheaper than our Gerber formula - does this sound right?
If you had insurance coverage, how much did you end up paying for it? I called my insurance and they cover 90%, it actually will end up being cheaper than our Gerber formula - does this sound right?
grapefruit / 4213 posts
I was pleasantly surprised to find out our insurance covers LOs Alimentum 100%. So 90% coverage doesn't seem too strange to me. That's a great savings!
pear / 1974 posts
@MapleMoose: wow 100%!!!! that's amazing! do you buy a month's supply at once?
grapefruit / 4213 posts
@chibee: I know! I was expecting to pay a lot out of pocket. We get a month's supply from the pharmacy. The GI specialist wrote a prescription for LO due to her food allergies.
honeydew / 7283 posts
My (otherwise pretty crappy) insurance covered M's Nutramigen 100%. I still can't really believe it. I had to order it from a medical supply company every month and it was shipped to our door for us. It really seemed too good to be true!
honeydew / 7283 posts
@Mae: We're in MA. I was SHOCKED that they paid for it. As a matter of fact, when she was 11 months old I think the insurance company realized they were paying for million-dollar formula. They gave me a hard time with my order and said they needed another GI eval to determine if she could switch to regular formula. By that time our GI was already helping us transition to WCM and I had some extra Nutramigen so it was a non-issue. Scraped by by the skin of our teeth!
GOLD / wonderful olive / 19030 posts
Wow, that's incredible, we paid out of pocket for DD formula even with a Rx, they said it wasn't "medically necessary."
papaya / 10343 posts
@LuLu Mom: Our insurance didn't say it wasn't medically necessary. Just said they didn't cover it. I think that's an ohio thing.
blogger / pomegranate / 3044 posts
I think ours (Elecare) is totally covered since it's medically necessary. It's hard to tell since we get the G tube supplies and pay some amount for that.. but I know I'm not paying the $40/can price it is on Amazon!
hostess / wonderful grape / 20803 posts
I had to fight for it and demonstrate that it was medically necessary, but Nutramigen was covered at 100%. At the time we lived in MA.
pear / 1974 posts
We will also order from a medical supply store, i am guessing on a monthly basis? did you guys buy the liquid or powder?
grape / 84 posts
Our insurance will cover the amino acid formulas if necessary, but not Nutramigen/Alimentum.
hostess / wonderful grape / 20803 posts
@chibee: I was permitted to buy it anywhere and then submitted for reimbursement (I did that every few months). I could also get through a medical supply store but it was for whatever reason very difficult to find one that contracted with my insurance and sold nutramigen.
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