Alimentum

  • Hello!

    My daughter is now on Similac Alimentum. She is doing great on it but its so expensive! I do not qualify for any assistance nor does my insurance cover it at the moment (awaiting appeal). Any suggestions on making it more affordable?

    Thanks!

  • It certainly is expensive. But the way I like to look at it is that you save money on doctor's visits and other health expenses when you invest in it. I would also look at the rest of your household budget to see where you might be able to save some extra money that could go toward formula. You might check to see if you could get a discounted price by ordering in bulk online. Also, have you checked out the coupons available on this website?

  • Hi. I had triplets on Alimentum so I understand the expense. After appeal my insurance did cover it so please follow up on the appeal because it should absolutely be covered.  I called constantly and never let up. It helps to ask for a supervisor if necessary. Good Luck!

  • What dialog did you use with the insurance company to get them to cover the cost? Assuming you secured a prescription from the doctor.
  • Yes, I did get a prescription from the children's doctor. Since they had an allergic reaction to all other formulas that were used we had no other option but to use Alimentum. It is medically necessary to use that formula therefore it should be covered. I also wanted to mention asking for coupons and samples at your pediatrician's office. If you become friendly with the nurses they are almost always happy to share! We are fortunate to have such a nice office staff.

  • Question ? How did you have to purchase it to get Insurance to pay for it? ( Through pharmacy, or turn in reciepts?) Thanks

  • I was only required to get a prescription from the doctor and send it into Medco. Happy to say that I was finally approved! Waiting for them to ship is turning into a long wait. Its a wait that I don't mind though, LOL! Turns out that our prescription coverage will pay for formula only if its mail order, so it will not reimburse you directly. Copay was $20 for a three month supply . Powder is considered generic, liquid is considered name brand.  Hope this helps! 

  • My son is on the same formula and I'm having problems with the cost as well. His doctor did give us coupons and samples. I'm definitely going to check with his insurance company to see if they cover it. Thanks for the info. 

  • My daughter is on this formulas as well and our insurance covers 70% of the cost as long as we go through medical supply company and it is billed as a medical food as opposed to a prescription. There was no waiting for an approval this way either our order shipped the same day and we received it the following day. Hope this helpsSmile

  • That is very true. As an FYI, many insurances will cover A&D Ointment or Desitin if its ordered as a medical supply. Some mail order pharmacies will also cover it. Just want to pass on any money saving tips I come across! We have insurance and might as well get the full benefits of having it.

  • Do you have to get a prescription for the A&D ointment for the insurance to cover it?

  • you can sign up for WIC (women, infants, and children) at your towns health department. to get a specialty formula like alimentum you need a pediatritions prescription (at least that is what the health department here tells me) if you get it prescribed by a pediatrition then they make you some WIC checks to pay for them in full. you can only get a certian amount a month though. but my daughter is on the same formula cause she had a bit of bleeding in her diaper from not being able to digest regular food enough. but sign up for WIC. it'll help a lot. 

  • A&D is not that expensive over the counter. As for WIC as long as you stick with Similac brand formula they will approve it w/o a RX.

  • WIC will approve for any formula that is Similac. As for qualifying, it is considered a medial condition so there fore the financial rules donot apply. My son has Pyloric Stenosis at age 4 weeks and is allergic to Allimentum. He can only drink Isomil and we did not need any proof of this to get it approved here where we live. They said as long as he is on Similac they wil approve it.

  • Not sure if this will help you personally but thought it may help someone. My daughter is also on Alimentum and I recieve it in bulk shipments paid for in full from my insurance company. Never thought this would be possible but here is how it happened for me. We tried a bunch of other formulas (and had several doctors visits) and the only one that she could tolerate was the Alimentum. I do qualify for WIC which provided either regular or soy formula. Once I had the doctor tell them she was on Alimentum they gave me a month worth of checks for the Alimentum and they handeled all the paper work for the insurance. I know the doctor had to fill out a form to submit to insurance. I call a company (Denmark home medical) every month to order more and they ship it within 2 days I get it at my door step. I recieve 11 cans a month which is awesome because WIC only gives 6 - 9 depending on age. Definately worth looking into for anyone using this formula because it would be IMPOSSIBLE for me to pay for it on my own and for her it is an absolute necessity. Hope this helps someone Smile