Who Currently Pays for Elemental Formulas?

Right now, the majority of families who need to purchase this expensive formula do so out of pocket.  The second most common method of payment is state aid.  It is our goal that passage of this bill will help the private insurance companies step up to the plate and provide the services these families so desperately need.

The State of Utah Pays More than Private Insurance

57% No Coverage – these families have private insurance but no coverage and pay out-of-pocket, rely on assistance programs, or go without the prescribed treatment they need

19% State Coverage – these families rely on state programs such as Medicaid, WIC, and CHIP (some are forced to qualify to get the coverage they need)

12% Commercial Insurance Coverage – in some cases the state will help pay insurance premiums because it is cheaper for the state to help pay for private insurance than to pay 100% of the medical bills (i.e. Medicaid Buyout Program)

8% State & Commercial Insurance Coverage – some depend on partial coverage through state programs because their private insurance doesn’t provide the full coverage that they need

4% Commercial Insurance Partial Coverage – some are only provided partial coverage