Insurance companies: 0
Mama: 1
Honestly, when I found out about this I was literally doing a cabbage patch-esque white girl dance in front of my desk silently as I was still hearing the news from Derek's nurse. Apparently Derek has MSPI, aka Milk Soy Protein Intolerance. We tried him on all kinds of milk-based formulas and he was still spitting up half of what he was eating. After talking to the pedi, she recommend Similac Alimentum which is hypoallergenic and hella expensive. However, before trying that we decided to try soy based formula to make sure that he didn't do better with that than the milk-based formula. Ha! Instead of spitting up half of what he ate, he was spitting up the majority of what he ate. Exorcist style. While smiling the.whole.time.
Yeah, you know you're jealous of having spit up projected onto your face by an adorable smiling wee one. Admit it.
Thus, we moved onto the hypoallergenic formula. Ready to feed works wonders, powder = big.fat.fail. I tried calling the insurance company to see if by chance they covered the formula. The lady laughed at me and said formula would never be covered by insurance. I was so pissed that she'd laugh at a new mom like that who was more than willing to pay for formula, prepared even, however since this formula is 3-4 times more expensive than the regular kind I was just checking. Off to the pedi we go with Derek for a weight check and ask her if he might have an intolerance, and we mention we'd researched that some babies that need the hypoallergenic formula have MSPI. She said, well that makes sense and talked to her nurse. She proceeded to write us a prescription for the Alimentum and said she'd talk to the referral specialist who would talk to our insurance.
And then the miracle happened.
I received the call from the nurse that the specialist had talked to the insurance company and that the Alimentum was approved for a 30 day supply every month until 2011.
So who's laughing now insurance lady who said no formula was covered?!?! Yeah that'd be me. Loudly in hysterics. This will save us $250/month which equates to $3k a year. He won't be on it a year, but seriously yo. I'm fist pumping the air in excitement as that's a boatload of savings!!
OH, MY GOD. This is amazing!
ReplyDeletewas the referral specialist through your insurance company or your pedi???
It was through the pedi. Once the pedi diagnosed him she wrote a prescription for the formula and talked to their referral specialist in house. I'm guessing they're who called the insurance company. I lurve them a lot right now!
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