NEOCATE Infant Formula

11 Replies
frankschick2001 - April 19

Anyone have any experience with this formula? My daughter has had an allergic reaction to the Nutramigen, and this is pretty much the only formula left for her to use! I am currently fighting the insurance compnay to cover the cost because it is $135 for 4 cans which only lasts us 12 days. It is considered an "exempt infant formula" and is given a national drug code, you can't buy it, you have to order it online or asks the pharmacy or store to order it for us, but the insurance company still considers it over the counter, so we are appealing, and hopefully it will be covered. I am going crazy trying to find it cheaper, but I keep getting outbid on ebay! If anyone has some that is not expired that they no longer use (I am told NEOCATE is only used temporarily) I would happy to take it off your hands! Or if anyone knows how I can find this discounted, I would be so happy!

 

Bonnie - April 19

Ugh you poor thing, I wish I still hd some to give you. It may or may not be temporary depending on how bad her allergies are. It is ridiculous that most insurance companies won't pay for it. It was really tough on us as well because Mason was a HUGE eater and it was costing us almost $1,000 a month. I too just kept going through ebay. :( If you happen to qualify for Medicaid, they will cover it all.

 

frankschick2001 - April 19

I was infuriated when I read that people who qualify for medicaid can get it covered 100%. I mean, I understand that there are people who need more help than I do, and believe me I am grateful for everything I have, but we still cannot afford this formula! I don't understand how I pay into insurance with every paycheck and I have to beg for coverage. And my taxes go toward medicaid so not only don't I get any coverage when I need it, but I have to actually pay for someone else's baby to get it!!!!! It makes me sad and angry how this all works. The Neocate goes faster than regular formula because it is one scoop for every ounce instead of one scoop for every two ounces like the others. I could not believe how fast it went!

 

frankschick2001 - April 19

Any other advice?

 

luckynik - April 19

Frankschick - contact the social worker at the hospital where the baby was born, you may qualify for some help...since your formula is so expensive there is even a chance you could get it through WIC - depends on your state and situation. Good Luck! I BTW I hear you on paying for formula for others babies that I can't afford for my own:)

 

YC - April 19

I feel for you. My dd had lots of formula issues (milk allergy, immature digestive system, etc). We had to use Nutramigen. My ped said that ins will cover Neocate or Nutramigen if you have a prescription written for it. Can you get an actual Rx for it? That shows it is medically necessary.

 

frankschick2001 - April 19

YC: I have had my doctor write a prescription for it, as well as a letter to the insurance company stating his medical opinion. The formula we need is even more expensive than the Nutramigen which is what she was taking before the Neocate. Anyway, I called Neocate and they said in NY it is mandated by law that theinsurance company pay for it and they faxed me the law, so I am going to submit this as well. How can an insurance company break the law by not covering the special formula? I don't qualify for WIC or any goverment programs. If I were rich I could go buy it no problem. If I were poor I could have it paid by the state, but because I fall into neither category, I get no help when I need it, I am just expected to keep paying into the system.

 

Bonnie - April 19

Yes, it all depends ont he insurance company and state. I do know some people who have gotten it covered but most don't. I wouldn't feel anger towards medicaid or people that get it for free through them. I would feel the anger towards the insurance companies. This is something that most definately SHOULD be covered. It is medically necessary and unless you are rich, no one can afford it. It is absolutely ridiculous that they get away with not covering it.

 

Bonnie - April 19

BTW...I don't know that you will find much more advice about it, but join up with the forums on infantrefluxdisease.com and speak about it there. Reflux tends to go hand in hand with allergies and there are quite a lot of moms having to use Neocate.

 

frankschick2001 - April 19

Thanks for your help Bonnie, I will do that!

 

Bonnie - April 19

Goodluck, I know it really sucks. I hope you don't have to be on it too long. And you wanna talk about being p__sed? lol Mason (my son) was never allergic at all. It turned out that he had reflux and my idiotic ped just kept switching formulas on us. (I now have a new ped, lol)

 

Spicmc - September 22

I'm not sure if this will help the original poster, but I hope it will help others who are looking at options for getting Neocate. My insurance originally said that they would not cover it, but I had called the prescription line and the person on the phone was really not helpful. Then I used neocate coverage navigator, and they were able to call the insurance company with me to be able to figure out how we could get it covered. In my case, they needed to code it as durable medical equipment instead of a prescription. The person from Neocate helped me figure out exactly what information was needed from my doctor (it was a lot) and which supplies we're covered by my insurance. Their info is on the Neocate website under reimbursement or call 1-800-365-7354.

 

 

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