Coverage for special formulas.(Health Insurance Troubleshooter)

The Exceptional Parent | November 1, 1995| | Copyright

Q Our four-year-old daughter has Opitz syndrome, Turner syndrome and a multitude of medical problems. She has never eaten food; she has always been on a special formula.

Since the age of 10 months, she has been fed by gastrostomy-tube. Our private insurer covered the pump and home care supplies, but not the formula. The company told us they never pay for "nutritional or dietary supplements." We contended that this formula is in no way a "supplement" - in fact, it is the only nutrient that keeps our daughter alive - but the insurer would not pay for the formula.

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