Medically necessary formula has given Caleb back his health, allowed him to continue to advance in sports and school. Not knowing if our family will have enough resources financial to sustain his needs puts stress on all of us but also creates undue burden on him, a child who just needs the formula to keep his Eosinopilic Esophagitis under control. Our insurance is a union-provided self funded PPO, using BCBS- able to make several appeals (valid medical necessity documented by their 3rd party), able to add EOE as a covered condition but deductibles/out of pocket/co-insurance and partial script percentages still seem to be applying in various ways each month. Not everyone has the same appeal options however our plan being self funded we were able to.
- Ben, Age 5
- James, Age 12