My son began drinking Neocate junior at 12 months. It was not covered by our insurance. All formula is excluded from out plan because it is technically an over the counter product. He became tube fed at 16 months and our insurance company would still not cover it. We went through many appeals with my son’s medical team supporting us and providing documentation alongside the way. We were still denied. Finally my husband went to the benefits coordinator of his company and after a lengthy process we were granted a one year plan exclusion beginning in May 2018. My son will be on formula for years. We are not sure if they will continue coverage after May 2019. He has one safe food (apples) other than formula that he eats about 1/4 cup of each day. He needs to formula to survive but we had to fight to prove that it was “medically necessary.”
- Garrett, Age 9
- Lisa, Age 6