Reimbursement of Nutricia Products in your Province

Provincial Health Programs

Our products are recognized throughout the country as being helpful for the nutrition of infants and older children with cow milk allergy, multiple food allergies and related GI and allergic conditions. Therefore, Neocate products may be eligible for reimbursement, in total or in part, by provincial health systems or private insurances.

Reimbursement may also depend on the patient’s insurance coverage. When contacting the insurance provider, a letter of medical necessity and a prescription will help the claim.
Validate with your health care professional whether you are eligible for coverage.
Your patient might qualify for one of the following programs:

• Ontario Drug Benefit (ODB) Program – to find out if they are eligible, please refer to the website https://www.ontario.ca/page/get-coverage-prescription-drugs
• Trillium Program – Please refer to the website for eligibility: https://www.ontario.ca/page/get-help-high-prescription-drug-costs
• Assistance to Children with Severe Disabilities (ACSD) Program – Please refer to the website: www.children.gov.on.ca/htdocs/English/specialneeds/disabilities.aspx

This is not an exhaustive list of existing programs, and you may qualify for others. Please contact your social worker to find out about other programs available in Ontario.

Reimbursement in Ontario

You may qualify for the following programs:

• Ontario Drug Benefit Program (ODB): Nutrition Products – The Ontario Drug Benefit (ODB) Program – Public Information – MOHLTC (gov.on.ca)
• Get coverage for prescription drugs | Ontario.ca
• Ontario Trillium Benefit Ontario Trillium Benefit | Ontario.ca
• Assistance for Children with Severe Disabilities Program Children with disabilities (gov.on.ca)

This is not an exhaustive list and you may qualify for other programs. Please contact your medical team to find out about other programs available in Ontario.

Reimbursement in Quebec Province

The full range of Neocate products except for Neocate® Nutra is covered by

• The Régie de l’assurance maladie du Québec (RAMQ) or through your private insurance. Please visit Régie de l’assurance maladie du Québec (RAMQ) for information about procedures for reimbursement.

Neocate is reimbursed for infants or children experiencing any of the following: milk protein allergy; a soy protein allergy; a multiple food protein allergy; persistent diarrhea; or a serious gastrointestinal disorder; and where symptoms are not alleviated by the use of a casein hydrolysate-based formula.
Neocate is also reimbursed for infants or children with serious gastrointestinal disorders where the cause has been confirmed as a bovine protein allergy and that has required hospitalization.

Products reimbursed by the RAMQ are reimbursed by all private insurance providers in Quebec. Conditions and procedures for reimbursement may vary depending on the patient’s insurance coverage. The following tips may help reimbursement:

• Some insurance providers require a letter of prior authorization.
• Insurance provider may also request a “Medicament d’exception” form.
• Private insurance providers will usually ask for a prescription, and an invoice from the pharmacy.

This is not an exhaustive list and you may qualify for other programs. Please contact your medical team to find out about other programs available in Quebec.

Reimbursement in British Columbia:

You may qualify for the following program:

• BC Home Enteral Nutrition Program http://www.bchomenutrition.org/hen-patient-information.html

This is not an exhaustive list and you may qualify for other programs. Please contact your medical team to find out about other programs available in British Columbia.

Reimbursement in Alberta:

You may qualify for the following programs:

• Alberta Blue Cross Government Non-Group Coverage Sponsored Program https://www.ab.bluecross.ca/government-plan/government-plan.php
• Pediatric Home Nutrition Support Program
• Alberta Children’s Hospital Alberta Children’s Hospital – Home Nutrition Support Program – Pediatrics | Alberta Health Services
• Stollery Children’s Hospital Home Nutrition Support Program, Pediatric | Alberta Health Services

This is not an exhaustive list and you may qualify for other programs. Please contact your medical team to find out about other programs available in Alberta.

Reimbursement in Saskatchewan:

You may qualify for the following program:

• SAIL PROGRAM ( Nutritional Supplement Program) Saskatchewan Aids to Independent Living | Health Services for People with Disabilities | Government of Saskatchewan

This is not an exhaustive list and you may qualify for other programs. Please contact your medical team to find out about other programs available in Saskatchewan.

Reimbursement in Manitoba:

You may qualify for the following programs:

• Manitoba Home Nutrition Program Specialty Infant Formula | Winnipeg Regional Health Authority (wrha.mb.ca). Please visit : https://wrha.mb.ca/nutrition/manitoba-home-nutrition-program/

This is not an exhaustive list and you may qualify for other programs. Please contact your medical team to find out about other programs available in Manitoba.

Reimbursement in Nova Scotia:

You may qualify for the following program:

• Nova Scotia Pediatric Nutrition Support Program. Please refer to your medical team.

This is not an exhaustive list and you may qualify for other programs. Please contact your medical team to find out about other programs available in Nova Scotia.

Reimbursement in New Brunswick:

You may qualify for the following programs:

• Tube and Supplemental Feeding Program – Special Authorization Form – Amino-Acid based Infant Formula. Please refer to your medical team.
• Tube and Supplemental Feeding Program. Please refer to your medical team.

This is not an exhaustive list and you may qualify for other programs. Please contact your medical team to find out about other programs available in New Brunswick.

Reimbursement in Prince Edward Island

Please contact your medical team to find out about programs available in Prince Edward Island.

Reimbursement in Newfoundland

Please contact your medical team to find out about programs available in Newfoundland.

Canada-Wide Non-Insured Health Benefits program:

If you are either:

• a First Nations person who is registered under the Indian Act (commonly referred to as a status Indian),
• an Inuk recognized by an Inuit land claim organization
• a child less than 18 months old whose parent is a registered First Nations person or a recognized Inuk.

You may qualify for the following program:

• Non-insured health benefits for First Nations and Inuit Non-insured health benefits for First Nations and Inuit (sac-isc.gc.ca)

This is not an exhaustive list, and you may qualify for other programs. Please contact your medical team to find out about other programs available.

KetoCal Reimbursement

KetoCal reimbursement will depend on your individual plan and the type of reimbursement available in your province. Do not hesitate to ask your healthcare professional team for support.

Check if you might qualify for one of the following reimbursement programs such as:

• Ontario Drug Benefit (ODB) or Trillium programs – Ontario
• Régie de l’Assurance Maladie du Québec (RAMQ)- Québec
• Alberta Human Service Drug Benefit supplement – Alberta
• Other local programs available

If you do not qualify for reimbursement, you can call Nutricia to order KetoCal at 1-877-636-2283 from 8.30 am to 6.00 pm ET or by emailing us at canada.customerservice@nutricia.com.

You will get a great price & free home delivery. A consent confirming that you or your child are using KetoCal under medical supervision will be needed.