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.