Hypoallergenic Formula through Insurance

Hi Mommas! My poor baby boy has been through the ringer in his first 2 months. He was diagnosed with pyloric stenosis at 1 month old and had surgery to correct it. Now we find out he has a cows milk protein allergy and soy allergy so we have to be on hypoallergenic formula - Enfamil Nutramigen - which costs $55 for basically 1 weeks supply (and that’s the value size). I spent hours on the phone with insurance companies to find out that if your little one is diagnosed with reflux or a milk protein allergy, you can qualify for this formula to be paid through insurance under medical devices. Calling the insurance company to get this information was not easy or clear so I wanted to outline it for you mommas here.

Edgepark healthcare (Google name for website - they have Similac Alimentum as well) can create you an account so that you can order from them and they will submit a claim through your insurance. Within 15 minutes, I was able to order a 3 month supply for only $250 (would’ve cost me around $500). Plus, this is now going towards my out-of-pocket costs and our deductible. I was told, once we meet our maximum our of pocket, our formula will be covered 100%. If I would’ve learned about this months ago, I could’ve saved a fortune in formula expenses.

I’m sharing so hopefully you moms out there who need hypoallergenic formula for your little one don’t have to break the bank to feed your baby!

Please let me know if you have any questions, I’m happy to help!

**For reference, we have UHC and BlueCross insurance and Edgepark works with more!**