What is the Medical Foods Insurance Coverage Act of Pennyslvania?

The Medical Foods Insurance Coverage Act of Pennsylvania requires insurance coverage for amino acid-based elemental products. The mandate requires insurance coverage of elemental formula for infants and children with food protein allergies, food protein-induced enterocolitis syndrome, eosinophilic disorders and short bowel syndrome.
Conditions covered by mandate:

• Cow Milk Allergy (CMA)
  
• Eosinophilic Disorders
  
• Short Bowel Syndrome (SBS)
• Food Protein-Induced Enterocolitis Syndrome

View Mandate Full Text

I am a Healthcare Professional. How does it impact me?

The Pennsylvania Medical Foods Insurance Act provides coverage for products with a protein source of 100% free amino acids. This covers all products within the Neocate portfolio. The law does not differentiate on use of formula and will provide coverage for patients who use these products as a sole source of nutrition or as supplements.

Need help with getting insurance reimbursement for your patients? Contact our Navigator team today.

I am a Consumer. How does it impact me?

If you or a family member require medical foods such as Neocate and live in the state of Pennsylvania, your insurance will now help cover the cost of such products.

The Medical Foods Insurance Coverage Act of Pennsylvania will cover any new patients who require products categorized as medical foods. For patients who are currently using such products, the law will take effect on your insurance renewal date.

The law does not apply to individuals who work outside of Pennsylvania. Many insurance policies have not been updated to reflect this new mandate. If this applies to you, we encourage you to contact our Navigator team to determine how to attain coverage for medical food products.

How do I know if Neocate is right for me?

It is important that you speak with your healthcare team to confirm that Cow Milk Allergy or a related GI condition is contributing to your child’s symptoms. Have questions about Neocate? Visit our Frequently Asked Questions on Neocate.com.

Don’t live in Pennsylvania? See which other states have similar mandates.

Insurers in 14 states provide some form of reimbursement to families for medical foods and exempt infant formulas like Neocate. Check out our insurance coverage map to see if your state is covered.

Live in a state that is not covered? Get involved and help eliminate the barriers to medical nutrition.

Unsure if this regulation applies to you or still have questions?
Let our Neocate Navigator team do the work for you!

Navigating through insurance jargon and required paperwork can be intimidating. Let our Navigator team help guide you through the insurance reimbursement process. This is 100% free service.
Our team will assist with:

• Obtaining prior authorization for any and all Neocate products
  
• Answering questions regarding claims submissions
  
• Drafting letters of medical necessity
  
• Instructions on how to correct billing errors
  
• Working with the insurance company on complex reimbursement matters
  
• Appealing a denied claim
  
• .....And much, much more

Contact Navigator today or call 1-800-365-7354 .

Have questions about Neocate? Visit our Frequently Asked Questions on Neocate.com.

Where to Find Neocate

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Have More Questions?
We are happy to help and answer your questions.
Questions on where to find/purchase Neocate, call our Customer Service team - 1-800-365-7354, Mon - Fri, 8:30 am - 7:00 pm EST or email customerservice@nutricia.com
Questions on nutrition or product information, call our Nutrition Services team – nutritionservices@nutricia.com