Insurance Coverage for EleCare Formula

Easier Access & Assistance

If you have concerns about being able to afford EleCare, insurance coverage may be available. Pathway Plus is here to help navigate you through the coverage process and connect you with a supplier who can deliver EleCare right to your door. All you have to do to get started is contact Abbott Nutrition's Pathway Plus Reimbursement Support at 1-855-217-0698 (Monday through Friday from 8:30 AM to 5:00 PM, EST) and speak with a Pathway Plus Reimbursement Counselor. You can also visit Pathway Plus for additional information.

A Simpler Path for Access.

Pathway Plus Offers Insurance Coverage Verification & Assistance with Access to EleCare Formula.

Call Today to Get Started

1-855-217-0698

View Pathway Plus

Pathway Plus is here to offer easier access to the relief children need.

You Call:

Patient Name & Insurance.
Prescriber Information & Diagnosis.
Complete & Fax EleCare Prescription Request Form.

We Help:

We research available insurance coverage options.
If needed, we offer prior authorization and appeals support.

Product Delivered:

We’ll connect you to a supplier who can help deliver EleCare right to your door, regardless of the insurance coverage outcome.

Download the Pathway Plus EleCare Prescription Form

Mandatory insurance coverage may be available in your state

There is a growing list of states that have mandated elemental formula coverage to help support families with children needing medical nutrition such as EleCare and EleCare Jr.^*

^*The coverage requirements of each state’s insurance mandate all vary and may not apply to all insurance plans.

WIC Coverage and Medicaid

There may be other payers or programs that can help your patients access EleCare and EleCare Jr if their insurance plan is excluded from legislative mandated insurance coverage.

WIC-eligible^† in 48 states, regardless of who holds the WIC state formula contract.

Medicaid – Some Medicaid plans will cover elemental formulas. Each state plan establishes its own criteria for coverage of elemental formulas.

^† Visit your state’s WIC website for additional information on allowable products and conditions. WIC is a service mark of the US Department of Agriculture and an abbreviation for the Special Supplemental Nutrition Program for Women, Infants, and Children. No endorsement of any brand or product by the USDA is implied or intended. Excludes Washington and Arkansas.

Each health care provider is ultimately responsible for verifying codes, coverage, and payment policies used to ensure that they are accurate for the services and items provided. Providers should consult with the insurance plan for complete and accurate details concerning documentation for claims. Abbott does not guarantee reimbursement by any third-party insurance plan and will not reimburse physicians or providers for claims denied by third-party insurance plans.