Insurance
Coverage
Does Insurance Cover
Physicians’ Elemental Diet?
Contact your insurance company to see if the product is eligible under your insurance plan. Here are some resources to help you.
LETTER OF MEDICAL NECESSITY
Start by proactively having your healthcare practitioner provide a letter of medical necessity regarding your use of Physicians’ Elemental Diet. We have provided a downloadable example for you below.
Download LetterCONTACT YOUR INSURANCE COMPANY IN ADVANCE
Because Physicians’ Elemental Diet is a medical food available without a prescription, you may have to reactively appeal a claim instead of proactively obtaining coverage. Contacting your insurance company in advance will allow you to prepare the necessary documentation and paperwork with your healthcare practitioner.
CHECK STATE REQUIREMENTS
Double check your state’s laws and reach out to your insurance company. Each state has different mandates around the coverage of enteral nutrition products, and depending on the state, they may recommend different documentation regarding the diagnosis and/or reason for use. Always check the specific requirements for your state.