Insurance covering peptamin/formula

[Guest guest]

You know, I am having problems with this myself. My insurance co said that

" I would be buying food anyway " so they won't cover the cost of his formula,

even though he is 100% tube fed. He has to stay on Isomil infant formula

(mixed to 27 cal) because he is allergic to the proteins in cows milk. (he also

has

reacted to peptamin, and complete.) I was really miffed..I mean, I go through

3 of those big cans a week. They are $22 a piece at Walmart! That really

adds up. So is this true of all ins. co's, that they have to cover the food if

they are 100% tube fed?

Jen

Xavier 15months, 15lbs!, 27in RSS, G-tube, Fundoplacation, 27 cal Formula,

Myrilax, ST, OT, PT, FT

Emerald, 5, Non RSS

Wyatt, 4, Non RSS

[Guest guest]

I dont think insurance are required to cover tube fed formula. Last

year we were on my huspands so-called open insurance (self funded by

the employer, quasi PPO, no monthly premiums but lot of out of

pockets with deductibles and cost sharing), and they did not cover

tube feeding formula. This year we have Aetna HMO through my employer

(we still have the other one as secondary) and Aetna is paying for

pediasure without question. Aetna has been wonderful so far, we had

Aetna last year would have saved thousands.

Sabina

[Guest guest]

Depends on what is written in the policy. We at the point where they will cover

100% tube feed right now up to 1 year.

Our policy states anything by mouth (1 sip, 1 cheerio) and they have the skills

to eat by mouth so they won't cover anything that would deal with the g-tube.

I have been stock piling now for awhile. The ins. co. cutting us off is coming

soon.

maloy

Insurance covering peptamin/formula

You know, I am having problems with this myself. My insurance co said that

" I would be buying food anyway " so they won't cover the cost of his formula,

even though he is 100% tube fed. He has to stay on Isomil infant formula

(mixed to 27 cal) because he is allergic to the proteins in cows milk. (he

also has

reacted to peptamin, and complete.) I was really miffed..I mean, I go through

3 of those big cans a week. They are $22 a piece at Walmart! That really

adds up. So is this true of all ins. co's, that they have to cover the food

if

they are 100% tube fed?

Jen

Xavier 15months, 15lbs!, 27in RSS, G-tube, Fundoplacation, 27 cal Formula,

Myrilax, ST, OT, PT, FT

Emerald, 5, Non RSS

Wyatt, 4, Non RSS