Join the Meeting Place for Moms!
Talk to other moms, share advice, and have fun!

(minimum 6 characters)

Health Insurance paid my twins formula for a year.

Posted by on Mar. 8, 2013 at 4:01 PM
  • 36 Replies

 This is true. Before I get all the women telling me that breastfeeding is better let me explain.

I breastfed my boys and pumped milk for my nephew who couldn't tolerate any other formula ( there is more to the story about him but it's not important to this post )  for 9 months. So, I fed three babies with no other milk other than my own.

With that said, at there 9 month check up there pediatrician told me that I had to switch them to formula because they were not gaining enough weight at that point. Looking back I should of done both. But I didn't and when I fed them the formula they broke out in hives all over. My boys were allergic to the proteins in cows milk. For two months I purchased Nutramigen. This milk is twice the price of reg formula, times that by two babies, I was spending the same as if I was feeding four babies.

Until...... I called my health insurance and long and behold they covered it from that point forward. The boys were almost 2 yrs old when they were weaned off the milk. We would of never been able to afford this milk and we did not qualify for WIC or any help because they only take into account your gross income not what you are really bringing home.

Anyway, my point in writing this is to inform moms with babies who have milk allergies that it is possible to get help with the cost. I know first hand how difficult it is to buy this milk.

*BTW my boys did not gain anymore weight on formula compared to BF, they are just naturally thin.

by on Mar. 8, 2013 at 4:01 PM
Add your quick reply below:
You must be a member to reply to this post.
Replies (1-10):
Anonymous
by Anonymous 1 on Mar. 8, 2013 at 4:03 PM
Your very luck, I worked in ins for over a decade and most policy's only cover it if the child is tube fed But, it Definitely is something people should look into
LiDoMama
by on Mar. 8, 2013 at 4:06 PM
Yep. Dh's insurance pays for our youngest's Neocate. We are lucky to live in a state where insurance companies must cover medically necessary formula by law.
Posted on CafeMom Mobile
yperez0209
by on Mar. 8, 2013 at 4:08 PM

 Yep, that was one of the issues I had to overcome. And they fought me hard, when the doctor would fax papers they would never get it... just annoying. But eventually it was covered, I had some type of specialty pharmacy deliver it to my house once a month. Some months it would get paid in full some months I had to fight a little, but it was worth it.

Quoting Anonymous:

Your very luck, I worked in ins for over a decade and most policy's only cover it if the child is tube fed But, it Definitely is something people should look into

 

mommieof38829
by on Mar. 8, 2013 at 4:09 PM
My son is on nutramigen, but we get wic. However we still have to buy it because we run out. He will be one in April so we will be put on elecare jr. It is very hard to feed ds because of his milk and soy allergy.
Posted on the NEW CafeMom Mobile
mom2ljh
by on Mar. 8, 2013 at 4:10 PM
Most insurances will not cover it. We paid OOP for Nutramigen for 15 months.
Posted on the NEW CafeMom Mobile
Roo1234
by Platinum Member on Mar. 8, 2013 at 4:15 PM

You are very lucky.  Our insurance wouldn't cover the cost of the formula, it was deemed "not medically necessary" even though two of my three children were MSPI (milk soy protein intolerant).  I ended up living an dairy and soy free lifestyle for more than 6 years.

yperez0209
by on Mar. 8, 2013 at 4:16 PM

 Did you try to get yours to cover it? The rep will always tell you no, I had to contact a dept called (something ) management. If I remember I will tell you. At this point your little one is older, but it is possible. And it doesn't depend on Ins. companies the law is what matters. I believe it has to do with the state you live in. And even for me I had to fight, they kept playing stupid, for a lack of a better word. But we were spending tons on it and couldn't do it any longer.

Quoting mom2ljh:

Most insurances will not cover it. We paid OOP for Nutramigen for 15 months.

 

MomofSCMJJA
by on Mar. 8, 2013 at 4:16 PM
1 mom liked this

My 5th child weaned himself at 5 weeks.  Just stopped nursing.  Cold.  Nothing we did was going to make him drink my milk.  Then he could not tolerate regular formula, or soy.  We went through 4 different formulas with him throwing up everything he ate until he had lost more than a pound and a half.  More than 10% of his bodyweight.  Finally we found Alimentum, a coconut milk-based formula.  It cost over $300 per month!  His insurance covered it completely. 

CookieMom108
by on Mar. 8, 2013 at 4:18 PM

That's excellent.  I paid for Alimentum when my son was a baby.  We could afford it, but it wasn't exactly cheap.  

yperez0209
by on Mar. 8, 2013 at 4:19 PM

 How can they say it's not medically necessary when they are allergic to it? That's just nuts. My boys slowly grew out of it, today they are 4 yrs old almost five and they can have dairy in moderation. After the allergy started to ease, it was more of an intolerance and eventually they were able to have dairy. I'm so lucky... it was heart braking to buy ice cream for the other kids and they couldn't eat it, for example.

Quoting Roo1234:

You are very lucky.  Our insurance wouldn't cover the cost of the formula, it was deemed "not medically necessary" even though two of my three children were MSPI (milk soy protein intolerant).  I ended up living an dairy and soy free lifestyle for more than 6 years.

 

Add your quick reply below:
You must be a member to reply to this post.
Join the Meeting Place for Moms!
Talk to other moms, share advice, and have fun!

(minimum 6 characters)