Our family is currently affected by having to pay out-of-pocket for medically necessary formula (Elecare, Jr) for our now 7-year-old son. Jeremiah was diagnosed with Eosinophilic Esophagitis (EoE) back in June 2013. Prior to his diagnosis, he was very sick for 5 months. During those 5 months, we had documented over 20 doctors visits that left the doctors unsure about what was wrong with him. Our child was vomiting daily, unable to keep his food down and there was just no explanation of why he was not developing. He was eventually put into the hospital for severe malnutrition and had to stay for 9 days to regain his strength. At 15 months old, a child who could only sit up, came home crawling for the first time. The formula he was given in the hospital helped give his body the nutrients it needed. Without this formula, our son would not be able to thrive today.
For over 4 months we fought with our insurance to pay for this medically necessary formula and were denied 3 times. One of the reasons we were told by the insurance company was because he didn’t have a feeding tube. If he had a feeding tube, it would be covered. Thankfully, our son can deal with EoE without having to be attached to a feeding tube. He has been on this formula for over 6 years now without any help from our insurance.