Alimentum and Apria/Cigna

Updated on July 02, 2010
R.M. asks from Aurora, CO
6 answers

Apria has been sending me 10 cans of Similac Alimentum (16oz each) every month for my son. Each can costs about $27 retail but they are charging me $816 for 10 cans. Cigna covers 80%, so I have to pay the remaining $160. When I called them to ask why they are charging $81.6 for 1 can,I was told it was a contracting price. Has anybody else faced this?

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answers from Richmond on

contact the local paper or 12 on your side and explain the situation, once the fleecing hits the newstands, the insurance company will more than likely change their tune. contracting price, my [email protected] when i was pregnant, and on medicaid, i was told i had to get all the receipts for services rendered, and then mail them into medicaid, well, that was all fine and good, until one secretary couldnt be bothered to give me the "paid for"information,when i informed her that 1) i was pregnant and 2) how was i supposed to buy groceries without that money ? she suddenly heard me when i demanded to talk to her supervisor
K. h.



answers from New York on

I think you're lucky to have an insurance company that covers any of it! Both my boys were on Alimentum and our insurance didn't cover anything.


answers from Boca Raton on

When my son was on Alimentum and we had Aetna, what my insurance company required was a doctors note from the gastroenterologist stating why my son had to be on Alimentum... When it was approved by Aetna I would then buy the cans from the store myself, keep the receipts and mail them in to get reimbursed (making a copy for myself).. If Cigna is charging that much you might as well buy them in bulk off of Ebay.. I used to do that as well...That is VERY high for a contracted rate.. I would dispute that..



answers from Denver on

You should be grateful most insurances don't pay. My kids where on Alimentum and Aetna never paid, but son now was on Neocate and we have BC/BS and where fortunate they paid some since it was $500 a month for him to eat :) We bought and submitted receipts.



answers from Denver on

I think you can look into purchasing the product outright and then making a claim with Cigna and get the retail price. You might also want to touch base with Cigna on what is going on, typically they like to work out better deals in these situations.

Good luck



answers from Denver on

Things are almost always more expensive through insurance. They have overhead they have to cover. We have often paid for things out of pocket rather than go through insurance. I agree with the mom who said you should be grateful it's covered at all. We paid 100% of our daughter's. If you're getting it through Apria, you're paying their overhead, as well. It sounds like you'd be better off just paying retail. Not to mention, it's not counting against your lifetime benefits that way. You might see if you can get reimbursed, but I've never been able to make that work. You'll see the same thing at pharmacies and laboratories, even doctor's offices. The patient pay cash rate is always cheaper than the insurance rate.

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