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Download one of the two forms:
The Neocate Assistance Program
A special program created to assist financially disadvantaged families in getting Neocate infant formula when other forms of reimbursement assistance fall short. The program is not designed to replace other resources if available. The program is available to residents of the United States who are not eligible for other forms of assistance and do not have third-party coverage. Find out if you are eligible, download and complete an application.
Sample Letters of Medical Necessity
A Letter of Medical Necessity may be required when filing an insurance claim. It is completed by the patient’s physician and provides the medical justification for ordering a specific Neocate product. We created the following sample reimbursement letters to help you complete this process faster. Please contact your physician to complete the missing information and individualize the letters to suit your child’s needs. Select the appropriate product below to download the Word file of each sample letter
The Women, Infants and Children Nutrition Program (WIC*) is a government program designed to assist families with financial and nutritional needs. Neocate is generally covered by most state WIC programs on the basis of medical need when ordered by a physician. To find out if you are eligible to receive Neocate through your local WIC program, talk to your community health department.
Select a state to see the current WIC eligibility**
*WIC is a registered service mark of the U.S. Departement of Agriculture for USDA's Special Supplemental Nutrition Program for Women, Infants and Children.
** Information presented is subject to change at any time
