Medical Foods Coverage

Without easy access to prescription medical foods, patients will continue to suffer.

Prescription medical foods safely and effectively manage the underlying causes of many chronic diseases without harmful side effects. Yet, Medicare and many health plans won’t cover these affordable options. Take action now and let Congress know it’s time to #covermymedicalfoods.

Take Action

Email your legislators and demand better access to prescription medical foods. You will be able to add personal content about why this is important to you. Your story can make a difference!

Share Your Story

If you are a patient, physician or caregiver, sharing your story about how medical foods have helped you raises awareness about their importance in managing chronic diseases.

Spread The Word

Raise awareness with social media. Share interesting facts and information. The more people know, the more you can make a difference.

What Are Medical Foods?

Patients want medicines that work, but don’t always realize they are compromising their safety. Medical foods are safe and effective for the dietary management of many chronic conditions.

Why Advocate For Medical Foods?

Medical foods are safe and effective for the dietary management of many chronic diseases. They address deficiencies of naturally occurring substances that may be low due to serious drug treatments or from the effects of the disease itself. Similar to drugs, medical foods are used to manage diseases and require supervision. Unlike drugs, prescription medical foods generally do not cause severe adverse events or dangerous drug-on-drug interactions.

 

Many Americans depend on prescription medical foods, yet face undue burden caused by a lack of insurance coverage for these medicines, limiting patient access to safe and effective options to manage their conditions.

 

It’s time to create real healthcare reform and usher in a better way to improve the quality of life for Americans suffering from chronic diseases. Take action now and let Congress know it’s time to act and provide coverage for prescription medical foods. 

Clinically Proven to Meet Unmet Needs

Rare Diseases

Increase therapy options

Vascular

Restore vein health in the management of chronic venous disease

Joints

Reduce osteoarthritis joint discomfort and inflammation

Bones

Build stronger, quality bones

Gastrointestinal

Minimize harmful GI side effects

Renal

Improve safety for patients with kidney disease

Cardiovascular

Improve safety for patients with heart disease

Chronic Disease

Manage conditions safely with no black box warnings

Share Your Story. Read Inspiring Stories.

Have you benefited from using a medical food for your condition? What experience did you have with your health plan covering the cost?
 
Share your experiences so that others can benefit. We’d love to hear what better coverage of medical foods could mean for you. Need inspiration to write your story? Read other stories about how medical foods have helped people just like you.

In The News

In order to advocate for change, it’s important to stay informed about medical foods and healthcare reform.
We bring you the latest news from across the country to stay up-to-date with the changing healthcare climate.

FAQs

What is a medical food?

Medical foods are regulated by the FDA, but are in a separate category than drugs and supplements. The effectiveness of a medical food must be proven by sound laboratory and clinical science. A medical food is intended for the dietary (metabolic) management of a disease and must be used under a doctor’s supervision. The term “food” speaks to the safety of these products because they must contain only ingredients that have been designated as GRAS (Generally Recognized as Safe), a strict food-safety standard set by the FDA.

Why do I need to have a prescription from my healthcare provider to obtain a medical food?

Medical foods are regulated by the FDA and must be used under physician supervision according to federal statutes and regulations.

What types of chronic diseases do medical foods manage?

Medical foods are intended to manage many different chronic diseases. Some of these include inborn errors in inflammatory conditions such as osteoarthritis , osteopenia, chronic venous disease, amino acid metabolism, hyperhomocysteinemia, pancreatic exocrine insufficiency, cancer cachexia, gastrointestinal disorders, neurological disorders, microcirculation conditions and other diseases.

How is a medical food different from a supplement?

Medical foods and supplements are defined as separate regulatory categories by federal statutes. Each category’s regulations are enforced separately by the FDA, the Federal Trade Commission (FTC) and state laws. A medical food is for a specific disease, prescribed and supervised by a physician, whereas a supplement is a consumer product for healthy populations that can be purchased by anyone without medical supervision.

Some of the differences between medical foods and supplements are:

  • Medical foods require physician supervision, whereas supplements are intended for use by the general public without medical supervision.
  • Medical foods make disease claims (i.e., to manage the disease), but supplements are forbidden to make disease claims.
  • Medical foods are intended for the dietary management of a specific disease at a specific dose. Supplements are intended to maintain structure and/or function.
  • Medical food ingredients require a higher standard of safety (GRAS – Generally Recognized As Safe per FDA standards). Supplements only need to have a “presumption of safety.”

How is a medical food different from a prescription drug?

Similar to drugs, medical foods are used to manage diseases and require physician supervision [By law in the Orphan Drug Act]. Prescription medical foods generally do not cause severe adverse events or dangerous drug-on-drug interactions.

Both medical foods and prescription drugs are for people with disease, require physician supervision, and are regulated by the FDA. Whereas medical foods contain highly purified nutritional ingredients not achievable by dietary change, prescription drugs are composed mostly of synthetic chemical ingredients. Medical foods have achieved GRAS affirmation (Generally Recognized As Safe) status, the highest standard of safety at the FDA. Most prescription drugs do not have GRAS status.

Do medical foods have side effects?

Medical foods are generally recognized as safe by the FDA with no significant side effects.

As with any other prescription product, you should discuss the benefits versus the potential for side effects or allergies with your physician before using a medical food.

Does Medicare Part D cover medical foods?

Unfortunately, Medicare Part D does not cover medical foods. Some people with diabetes or kidney disease receive coverage under Part B for some medical nutrition therapy services.

CoverMyMedicalFoods.com is your resource to help make your voice heard with legislators and demand coverage under Medicare Part D for safe and effective medical foods. Click here to email your elected officials…

Do any health plans cover prescription medical foods?

Insurance coverage for medical foods varies by state and by health plan.

How can I get my health plan to include prescription medical foods on its formulary?

If your medical food is not covered by your health plan, you can ask for a formulary exception. Check with your health plan to find out how its exception process works. Your healthcare provider may need to provide a letter of medical necessity. Unfortunately, there is no guarantee that a health plan will grant the exception and cover the medical food.

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