Food Allergy Living Blog Tagged Results

We know what a difference getting insurance coverage makes for Neocate families. That’s why we are happy to share a new service called the Nutricia Product Coverage Navigator, currently available in New York and Texas.

About the Nutricia Product Coverage Navigator

Nutricia Product Coverage Navigator is a resource that will provide you with assistance in obtaining insurance coverage for Nutricia products, including Neocate.

All you have to do is call 1-800-365-7354 for help with:

• Obtaining prior authorization for any and all Nutricia products, including Neocate Infant, Neocate Junior and EO28 Splash;
• Answering questions regarding claims submissions;
• Drafting letters of medical necessity;
• Providing instructions on how to correct billing errors;
• Interceding with the insurance company on complex reimbursement matters; and
• Appealing a denied claim.

If you don’t live in New York or Texas, be sure to visit the Neocate website where you will find tips for getting Neocate coverage and details about reimbursement legislation in 14 states.

- Sarah

We mentioned earlier this year that a group of families in South Dakota was working to get reimbursement coverage for elemental formulas like Neocate which helps kids of all ages from infants to toddlers. A step has been made in the right direction — several insurance companies in the state have signed a voluntary agreement to reimburse for amino acid-based formula.

The insurers’ agreement to reimburse families for amino acid-based formula includes the following insurance companies:

• Avera Health Plans (effective 7/1/2010)
• HealthPartners (effective 4/1/2010)
• Medica (effective 4/1/2010)
• South Dakota State Employee Health Plan (effective 7/1/2010)
• Wellmark BlueCross BlueShield (effective 7/1/2010)

The specific conditions for which amino acid-based formulas are covered varies by plan. Be sure to check with your insurance company for details about their specific policy and when it goes into effect. Co-pays and other terms will also vary by plan.

If you want to introduce reimbursement legislation in your state, be sure to visit the Children’s MAGIC Web site and download the “Guidebook to Enacting Legislation,” which has everything you need to get started.

Don’t forget to keep us up-to-date on your efforts by posting a comment below, emailing us at foodallergyliving@shsna.com or connecting with us on Facebook or Twitter.

- Sarah

Great news for Texans! This weekend Governor Rick Perry signed into law a bill that will require private insurance companies to cover amino acid-based elemental formulas like Neocate, regardless of whether the formula is taken orally or via a feeding tube.

Insurance reimbursement is required for the following conditions:

• IgE and non IgE-mediated allergies to multiple food proteins (i.e. milk protein allergy);
• Severe food protein-induced entercolitis;
• Eosinophilic disorders; and
• Impaired absorption of nutrients caused by disorders affecting the absorptive surface, functional length, and motility of the gastrointestinal tract.

The law applies to health plans that are delivered or renewed after January 1, 2010. To read the entire bill click here.

Other states with reimbursement legislation include Arizona, Connecticut, Illinois, Maryland, Massachusetts, Minnesota, New Hampshire, New Jersey and New York. However, each states laws are slightly different – To view a copy of a specific state's legislation click here.

This is great news for families in Texas and I expect it will provide some much-needed economic relief. I encourage you to share the news with others. Some ideas for spreading the word:

Tweet the news: New

Texas law requires insurance reimbursement for Neocate! http://bit.ly/dy2ei Blog about the news and include the link to the legislation

Post a note on Facebook:

New Texas law requires insurance reimbursement for Neocate! http://bit.ly/dy2ei

Other ideas? Please let us know.

- Nita