enterade® may be eligible for reimbursement from health insurance plans.

Coverage depends on the insurance provider and plan. Check with your insurance company to see if they cover medical foods when prescribed for a medical need. enterade must be used to treat a medical condition and be prescribed by a licensed healthcare professional to treat an illness or condition.

As the manufacturer, enterade cannot bill insurance directly.

For information regarding FSA/HSA reimbursement, see below.

To check if enterade is covered by your insurance plan, follow the steps below:

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IF COVERED:

Ask what they need: prescription, clinical notes, and/or letter of medical necessity. Ask if you can purchase product directly from manufacturer and submit for reimbursement with a claim form

If enterade is covered, obtain a prescription from a physician or a health care provider

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Needs to Include Diagnosis/Reimbursement Codes (ICD 10)

Code Examples: 

a. Irritable bowel syndrome: K58.9
b. Diarrhea: R19.7
c. Electrolyte imbalance: E87.8
d. Dehydration: E86.0
e. Leaky gut syndrome: K59.9

For HCPs: If Prior Authorization is Required, Follow These Steps:

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Complete Letter of Medical Necessity

For Flexible Spending/Health Spending Accounts

enterade is covered by a FSA/HSA when prescribed by a health care professional to treat a medical condition 

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Submit to your FSA Carrier for Reimbursement

Submit prescription (including diagnosis and reimbursement code) & a copy of your receipt