Medical Insurance Reimbursement: States Requiring Coverage for Amino Acid-based Formulas


Posted 5.20.10 | Sarah O'Brien

With the help and hard work of many families, there have been several states that have mandated legislation for medical insurance coverage of amino acid-based formulas such as Neocate. This is fantastic news that will help to provide financial relief for families.

The current states that require coverage for amino acid-based formulas:

  • Arizona
  • Connecticut
  • Illinois
  • Maine
  • Maryland
  • Massachusetts
  • Minnesota
  • New Hampshire
  • New Jersey
  • New York
  • Oregon
  • Rhode Island
  • South Dakota
  • Texas

Every state and every law/agreement is different so be sure to read thoroughly to understand the limitations before contacting your medical insurance company. For example, the Maine legislation only pertains to children under the age of 2. In the state of Minnesota, there is no law requiring coverage, however, the state’s six largest insurance plans have agreed to reimburse families for amino acid-based formula. We have a full list of the states that reimburse and information on each law at Neocate.com.

Tips for Amino Acid-based Formula Reimbursement

A few tips to keep in mind when pursing reimbursement in each of these states are listed in the reimbursement section of Neocate.com. For instance, most of the mandates/agreements only require coverage of amino acid-based formulas for the diagnosis and treatment of certain medical conditions (i.e. eosinophilic gastroenteritis or multiple food protein intolerance).

If your state is not listed and you would be interested in joining the fight for coverage in your state, check out the guidebook for enacting legislation from Children’s Magic. Children’s Magic is an organization committed to promoting reimbursement for elemental formulas. They have put together this guide to help point you in the right direction.

Stay tuned for a guest blog post from Brenda Eich next week. We are honored to have her share her story on her successful fight for medical insurance reimbursement in South Dakota! Does anyone else have success stories or tips to share with getting insurance coverage for Neocate?

- Sarah

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About Us

Food Allergy Living is a resource for parents of children with food allergies, brought to you by Nutricia, the makers of Neocate. For more in-depth information about our purpose & authors, see our About Food Allergy Living page.