Expensive Formula

Updated on February 08, 2010
S.S. asks from Crystal Lake, IL
19 answers

Hi all. I'm new to this site, as it was recommended to me by another mom friend. My son is five months old and has severe food intolerances in addition to acid reflux. The specialist put him on Similac Alimentum with the hopes of being able to switch him to a more affordable formula around now (5 months of age). When we tried to switch him to a different sensitive formula he got violently ill. Now the doctor is saying that he needs to stay on the Alimentum his whole first year. It is costing us $300 a month for his formula alone and we really can't afford it. I heard that sometimes insurance will reinburse you for some of the cost. Has anyone ever tried this, and if so how do you go about that process. Thank you in advance for any advice.

S.

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So What Happened?

I want to thank everyone for their advice so far. I called Similac today and explained my hardship. They were very nice and are sending me a sample can of formula and additional coupons. They are also reinbursing me for the container of Similac sensitive that I had attempted to switch my son to with no luck. I also went online and signed up some of my family members to receive coupons as well. My little guy has his 6 month check up in 3 weeks at which time I will be asking his dr if they have any free samples (which I have never been given by the way) and about having a prescription written out. My next step will be to call my insurance company to see if they will cover any of the cost with a prescription (although I'm not getting my hopes up :) To all of you in similar situations, my heart goes out to you. We don't make so little that we qualify for assistance, yet I don't know how these dr's and formula companies think that middle income families who just get by every month can afford $300 to $600 a month in formula costs alone! To answer a question that was asked of me, when I tried to switch my son's food, I did only give him one scoop of the new formula along with one scoop of the Alimentum (4 oz bottle) and he vomitted for hours from that little bit. He cannot handle soy products either. I am fortuate that he can handle most fruits and veggies so far and he is growing and thriving on the Alimentum. Thank you all again. Please keep the advice coming and I will keep you posted.

S.

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I.G.

answers from Seattle on

I know this may sound weird, but if you REALLY cannot afford it, you could consider relactating and breastfeeding you son at least partially (saving some money may make it more affordable).
http://www.kellymom.com/bf/supply/relactation.html
In addition to saving you money you son will also benefit from the allergy reducing effect that breastfeeding has.
Good luck!

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K.S.

answers from Chicago on

This might not help at all but I thought I would throw it out there. My son have severe reflex, it took so many formulas to get one that he would not throw up on. In the end we did a combination of a special formula and Thicken Up. It is stuff they put in older peoples food or drink to thicken it up. It help it sit better in his stomach and NO throwing up. I have no idea if that would help but I just thought I would let you know another options. Good Luck and I hope you find something that works for you!

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L.C.

answers from Dayton on

Hi S.,

My son was born with an intollerance to the proteins in dairy and soy, so we ended up having to put him on alimentum, too. Aparently, it is made out of pulverized gold, precious stones and minerals. That's the only reason I was able to come up with why, by them time he was 7 months old, we were spending $600/month to feed just one of our (at the time) 4 children. My heart goes out to you and your wallet.

I was able to get a letter or perscription to take to WIC, so that we qualified for WIC formula, and they do have allimentum on there for special needs like this. I never thought of going the insurance route, but I would ask for a perscription from your dr and a letter to give to your insurance company. If you call them, you should be able to find something out, and call the local WIC office, too, to see what you need to do to qualify.

Hope this helps, and I hope the little guy feels better soon!

L.

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M.B.

answers from San Francisco on

My son was on Alimentum and our insurance (Blue Shield of Ca) would not cover it. When he was close to a year I noticed Target had their Up and Up brand (compared to Alimentum) for half the price. I didnt try to switch because he was so close to his birthday that I figured why switch at that point. I would look into it and maybe compare ingredients.

I also talked to our pediatrician who gave us free samples as well. And I signed up on the Similac website (and had friends and family do it) and they send you monthly coupons. They can be combined so if you get several people to do it you can save a lot. Good luck, I know its expensive.

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J.L.

answers from Chicago on

Hi S.,

Oh boy do I feel your pain...We are currently using Nutramigen the Enfamil counterpart to alimentum.... Yes indeed it is expensive...What I might say is repetitive but go to the Similac website and sign-up for the family beginning's to get free samples...I would also call them and explain what is going on. All three of my kids had to be on nutramigen...My third child (my son) is a month old and I called Enfamil and got on their program for samples and coupons. Call them. Get samples from your pediatrician regularly if you can.

Most importantly!!!!! TRY EBAY...I just won a 12 can lot where I saved $120!!!!! I can get the Nutramigen with tax for $24 a can on Ebay I paid $14 a can...That was a $10 savings per can.

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J.K.

answers from Chicago on

We used Nutramigen for a year -- wow is that expensive. Our pediatrician got lots of free samples. I stopped by every time I drove near the office to pick up as much as I could. Also, while we could not get it covered through our health insurance, we were able to pay for the Nutramigen with pre-tax dollars via our health care flexible spending account. If you have an FSA, you just submit your Nutramigen receipts along w/ a note from your ped saying that it is medically necessary, and they will reimburse you.

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S.K.

answers from Chicago on

Hi, I haven't done this but my girlfriend did. She was able to get it paid for by the insurance company 100%. I think she said she just had to submit the note from the doctor explaining things/giving a diagnosis. They are on the east coast so not sure what type of insurance it is. I would say its definitely worth a try to call both the insurance company and/or Similac directly. I hope it helps! I know it can be so expensive. Perhaps posting a request on Freecycle http://www.freecycle.org/ might be able to tide you over. Folks might have an extra can that they are trying to/willing to get rid of. Good luck!

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J.E.

answers from Chicago on

PLEASE DO NOT relactate, you do not know what foods he is intolerant to or are safe for him and breastfeeding him wiht the foods will jsut make him worse. My twins too werer like this and even intolerant and allergic to nutramagin and aliementium, they were put on Neocate, a hypoallergenic formula that cost $40 a can (a SMALL can) . no not to scare you, but they told us too , keep them on it for a year, a year got cloes and they still could nto tolerate any food but squash for one child and apples for another, yes my children were one years old living off one food and this million dollare formula. We could not switch this formula was keeping them alive and somewhat growing. My son was great but my daugher was 2 and still 19 pounds. So we started to buy it on ebay and craigs list and all our friends would call in for free samples to the SHS company. We found out what there disease was luckily and made friends in a support group on line and they too shared the formula when their child didnt need it or swithced to the second stage neocate etc. But it was costing us $1000 a month to feed and grow our babies, we couldnt afford it anymore and our parents helped the dr too did give us free samples and our friends gtttig nthe free sample and then we went on ebay and got it down to $800 a month, but that alone was as much as our mortgage payement! it was impossible and we had adopted a child who ended up after 3 years being trated for Cystic fibrosis. So we had three sick kids wiht majo mediacl issues, besdies ,the money we were exhausted, scared and broke. So our twins even up to the age of two were still on this formul, we kept praying they would outgrow the allergies and theywere able to add some more foods to their list but not enought to gain nutrition from it though. So finally by the third year we got our insurance company to cover it we went to our town legislature and had them help and every dr we know wrote letters and called nd called rejection letters to the company and well by age 4 and on our last leg emotionally, physically and financaily our prayers were ansered, it is covered so now my kids are 5 and we go to walgreens and pick up $1600!!!!!!!!!!!!!!!!!!!! woorth of fourma every month. My son can olny eat 5 foods and my daughter about 20 however she is still 5 years old nd 34 pounds so you know some of the foods are still damaging her but my son is 48 pounds at 5, big and strong. i am blessed by this formula and I know that your son is too. You are an amazing mom and will find the resources to keep your son healthy and pain free. This unfortunately sounds like you are not only dealing with reflux here, I can tell from my experiences a bit here. I will pray for you and for now talk to your drs, the Gi, the llergist, the pedatrician, everyone and get a can and even the nurses, tellthem your sotry tell everyone, tell your friend so tget free samples, not sure if you are religious but callyour church or sinagaug and ask them to call or if there is a donation fund you can sign up for. R U kidding anyone would give a dollar to feed a child in need. Have your dr write a note to the insurance company and start fighting that fight. Please know I am here and if i can find out letters i will e-mail them to you to get you started. plese do the ebay thing for now. We ended up making friend on ebay that felt so sorry for us they would send free cans when they could, three families did this for us and we usually got the cans for half price when we paid attention well, sat nights were always good time to be in bidding wars, not too many people home i guess. you will learn the tricks ofthe trade as you do it. Take care of that sweet child boy he was really born to the right mom! you two are both so lucky!
hang in there !
J.

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M.C.

answers from Detroit on

My son had to be on Nutramigen for a few months and it too is very expensive. My pediatrician gave me several free samples which I was grateful for. I would explain your situation to your pediatrician and see if they can provide samples to you. Also, if the insurance won't pick it up, I would call the maker of the formula and see if they can send you coupons or maybe sell the formula at a discount to you. It doesn't hurt to ask. I get coupons in the mail quite often for formula. You can also check online to see if you can purchase the formula for cheaper than in the stores. Diapers.com offers first time buyers a discount. Also, if you are low income, I would call the local family independence ageny or WIC for help.

Wishing you the best,

M.

1 mom found this helpful
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C.C.

answers from Tampa on

I know this may sound strange, but you can sometimes find them on Craigslist. I have to buy Nutramigen and have found women who either buy in bulk, or their children either don't tolerate it, or outgrow it. One woman bought a whole case from Babies R Us and her child couldn't tolerate it. So she sold it to me at half the price. I only buy unopened, SEALED cans, with expiration dates within my timeframe. And I always take my husband with me... just in case :) Just a thought. Also, on Craigslist, many times women will post to give away free coupons to Similac or Enfamil.

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D.W.

answers from Chicago on

Having worked with insurance companies on different issues, I would suggest that you Call your "800" number if you have one and get some direction from them as each insurance company does things differently. They should be able to provide you with information you will need or direct you to the proper person to help. Sometimes, the best person to talk to would be the head of that department where you are calling. I have done that before for other things and it is amazing how helpful they can be. The other thing is to contact Similac direct and they may be able to help you as well. I have known companies to sell direct and at a different cost, especially if they can get something specifically from the physician. They want to keep your business and they are sometimes in a position where either coupons, special ordering, whatever to help you defer some of the cost. That formula is expensive; my sister-in-law had to use it for her daughter as well.

I hope that these suggestions help.

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B.W.

answers from Minneapolis on

I agree with Ina... relactation is a great thing for food intolerances.
Your insurance will likely not cover the formula unless the food allergies are tested for. And then thye will fight it because food allergy testing in babies is almost always wrong.

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A.P.

answers from Chicago on

HI S.!

My twins were on Similac Neosure and my daughter also had severe reflux. We were spending a fortune on formula, especially as they got older and were using almost one can a day. Although my insurance would not cover their formula (but my insurance stinks!), I tried to find ways to save some money. I found that CVS ( at the time) had the cheapest formula. I signed up on the similac website for coupons, and had my mom do the same so that she would receive coupons, too, and I used those as well. As others have said, I started purchasing formula on ebay. I was really able to save quite a bit by doing this. Just be careful with expiration dates and with liquid formula. I found that the liquid formulas also contained soy, which our kids had severe intolerances to.

Just one more thing, you didn't say how you tried to switch your son's formula, but here's how we were finally able to do it: They were taking 8oz of formula at the time, so the first week, we gave 1oz of new formula with 7oz of the old one. We did that for an entire week. When it seemed like they tolerated that okay, The next week, we went up to 2 oz. of new to 6 oz of old, and so on. Yes, it took 7 weeks for the entire process, but it worked, and eventually, we were able to wean them to a less expensive formula. It might be worth a shot. We were finally able to wean my daughter from the prevacid for reflux when she was 19 months old.

Good Luck!
A.

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J.G.

answers from Chicago on

Insurance will sometimes reimburse you. Your first step would be to call your insurance company and ask them if a formula is medically necessary will they cover some/all of the cost. They should be able to explain the reimbursement process to you.

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C.H.

answers from Chicago on

Have you tried the perscription previcide (chewable) - you can crunch it up and add it to his bottle/soft food. My son had reflux extremely bad, but he was seen my our family doctor who claimed he wasn't throwing up, just spitting up and that I was just over reacting because I was a new mom. By the time he hit 1, he wasn't even on the weight chart anymore and the first time his pediatric doctor saw him, he prescribed the chewable previcide pills and it worked that same day. I only gave him a 1/4 of the pill twice a day and he completely stopped throwing up.

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M.A.

answers from Chicago on

Hi S.. I had a similiar situation with my mother. She had a medication that cost about $300.00 a mont hand could no way afford it. The pharmasist gave me the manufatorers phone number and I called them and explained the situation. I had to send them copies of her in come taxes and her income and sure enough they sent her the pills every month FREE. It's kind of a pain at first with all the paper work but once that is done they just kept sending them every month. Well worth the time put into it.

Good Luck

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A.W.

answers from Chicago on

Best of luck to you and your son. I was greatful that I always recieved sample formula cans from our peds office. Our first daughter spit up alot and the dr offered to try an acid reflux med but we opted to "thicken the formula" with rice cereal instead......it was cheaper and no meds involved ! It worked well , so we did this right away with our second daughter and again had success.

Keep pushing the solids and as long as he continues to gain his weight maybe you can "cut back " on his formula thru the day ? This would be something to speak to your Pediatrician about first. I suggest this becuase as soon as our girls could eat solids they didn't want their bottles anymore , so we just weaned the amount.

We did contest a charge from the insurance company which was fully covered in the end, and had no troubles doing this. this charge did was not related to formula, but if it considered a prescription hopefully it will be covered for you !

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M.C.

answers from Chicago on

Have you tried the WIC program. It helped me out when I had my daughter nine years ago.
Maybe this website will help
http://www.fns.usda.gov/wic/

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A.M.

answers from Chicago on

Relactation is still possible even 5 months postpartum as breastmilk is the best for any situation but aside from that have you looked into Good Start? It is made with a different type of protein compared to the other major formula brands. Good luck.

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