Ben, Age 5
Though I’m on an employer plan, we contribute another $9000 a year to cover premiums for our 5 member family. That plan has a $6000 deductible. We are approximately $15,000 in each year right of out the gate. I believe our son’s Elecare Jr. intake keeps him growing and not falling off the growth chart despite his allergies to dairy, egg, peanuts, treenuts, soy, sesame, and flax seeds and EOE. So we spend another approximately $400 a month to purchase Elecare Jr and treat it like liquid gold. Ben cannot drink milk, soy milk, regular formulas, or the trendy nut milks. Elecare Jr. is a perfect safe nutritionally loaded drink for him and it’s shocking and frustrating to me it is not covered by our already very costly medical insurance. We’ve been on different plans during the last 5 years since Ben was diagnosed, included being self-insured on the healthcare exchange. All have excluded coverage for this costly and necessary item. I’ve never succeeded with an appeal to any. Medical nutrition (the amino acid based formula Elecare Jr in my son’s case) is specifically excluded from coverage.