Understanding Insurance Cover Nutramigen Benefits

Understanding insurance cover for Nutramigen can be a game-changer for families with infants who require this specialty formula.

Nutramigen is a hypoallergenic formula designed for babies with severe eczema, colic, or other gastrointestinal issues. It's a pricey product, which is why insurance coverage is crucial.

Insurance coverage for Nutramigen can help alleviate the financial burden of this specialized formula. Many insurance plans, including Medicaid, cover a portion of the cost.

With insurance coverage, families can focus on their baby's health rather than financial stress.

Nutramigen is a specialty formula that can be quite expensive, costing between $21 and $25 a can, depending on the size. Some insurance companies may cover the entire cost, as katiekate1974's insurance did, which is fantastic.

Katiekate1974 has Harvard Pilgrim insurance, which covers a lot, including Nutramigen. NJmeetsNH has Kaiser insurance, but they didn't cover the cost, even with a food allergy diagnosis. It's worth noting that prices can vary, with NJmeetsNH finding it for $20.80 a can on a website.

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Medical assistance may also cover the cost of formula, as Kris&Amymember's friend found out after appealing to her insurance company twice. Jam425 has BCBS and they covered some of the cost of the powder Nutramigen.

Here's a breakdown of some insurance companies and their coverage:

TRICARE may also cover medically necessary formula, including Nutramigen, but the type of formula depends on the medical need. Your costs for covered medical foods depend on your health plan.

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Insurance coverage for Nutramigen can be a challenge, but it's not impossible. KatieKate1974 has insurance that covers the entire cost of Nutramigen, which is fantastic since it costs between $21 and $25 a can.

Some insurance companies, like Kaiser, may not cover Nutramigen, even if it's due to a food allergy. NJmeetsNH's insurance company, Kaiser, denied coverage, but they were able to find a better deal by ordering from the manufacturer's website.

Harvard Pilgrim is another insurance company that covers Nutramigen, and KatieKate1974 is thrilled with their coverage. They get a lot of benefits that wouldn't have been covered otherwise.

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Medical assistance may also cover the cost of Nutramigen, as Kris&Amymember's friend found out. They appealed to their insurance company twice before getting approved for medical assistance, which covered the cost.

The experience of getting insurance to cover Nutramigen can vary greatly. Adamwife's insurance company denied coverage for their child's soy and dairy allergies, despite blood test results and anaphylactic reactions. In contrast, Kris&Amymember's friend was eventually approved for medical assistance, which covered the cost of Nutramigen.

It's worth noting that some insurance companies may cover Nutramigen, but only if it's prescribed through a medical supply company. A pharmacist for Walgreens, who wishes to remain anonymous, has filled prescriptions for Nutramigen before, but it depends on the specific insurance plan.

Here are some insurance companies that have covered Nutramigen:

Ultimately, the best way to get insurance to cover Nutramigen is to contact your insurance company and ask if it's covered. If it's covered under your prescription insurance, you can have it filled at a pharmacy. If it's covered under your medical insurance, you'll likely need to get it from a medical supply store.

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If you have a child whose medically necessary formula is unavailable, you should work with your pediatrician, primary care manager (PCM), or specialist such as a pediatric registered dietitian.

TRICARE will cover your appointments to talk about options for your child.