Mandated Insurance Coverage
No
Coverage by State
Click on a state to view coverage.
Medicaid Coverage
Individual consideration-case-by-case
Other State Programs
Children’s Rehab Services
334-281-8780
334-281-8780
State Medicaid Contact Information
800-362-1504
x
Mandated Insurance Coverage
Yes, PKU only
Medicaid Coverage
Limited
Other State Programs
Center for Children W/ Special Needs
866-987-2500
206-884-5735
866-987-2500
206-884-5735
State Medicaid Contact Information
907-269-6529
x
Mandated Insurance Coverage
Yes, select inborn errors of metabolism
Medicaid Coverage
Yes
Other State Programs
Children w/Special Healthcare Needs
State Department of Health
602-542-1860
State Department of Health
602-542-1860
State Medicaid Contact Information
800-352-8401
602-542-9935
602-542-9935
x
Mandated Insurance Coverage
Yes, select inborn errors of metabolism
Medicaid Coverage
N/A
Other State Programs
Children’s Medical Service
870-612-5223
870-612-5223
State Medicaid Contact Information
800-482-5850 ext 22277
x
Mandated Insurance Coverage
Yes, PKU only
Other State Programs
California Children’s Services-GHPP
800-639-0597
800-639-0597
State Medicaid Contact Information
916-440-7400
x
Mandated Insurance Coverage
Yes, all inborn errors of metabolism
Medicaid Coverage
Yes
Other State Programs
HCD-Healthcare Program for Children w/Special Needs & Child Health Plus
303-692-2370
303-692-2370
State Medicaid Contact Information
303-866-5700
x
Mandated Insurance Coverage
Yes, all inborn errors of metabolism
Medicaid Coverage
Yes
Other State Programs
Family Health Service Division (BCH)
860-509-8074
860-509-8074
State Medicaid Contact Information
800-842-1508
x
Mandated Insurance Coverage
Yes, all inborn errors of metabolism
Medicaid Coverage
Yes
Other State Programs
Children w/ Special Healthcare Needs (CSHCN)
State Medicaid Contact Information
800-372-2022
x
Mandated Private Insurance Coverage
No
Insurance Coverage of Formula and Limits
None
Insurance Coverage of Low Protein Foods and Limits
None
Metabolic Conditions Covered by Insurance
None
WIC Coverage
Yes
Medicaid Coverage
Enteral not oral
Other State Programs
Health Services for Children W/ Special Needs
State Medicaid Contact Information
202-442-5999
x
Mandated Insurance Coverage
Yes, all inborn errors of metabolism
Medicaid Coverage
Yes-PKU
Other State Programs
Children’s Medical Service
850-245-4209
850-245-4209
State Medicaid Contact Information
850-412-4000
x
Mandated Insurance Coverage
No Mandated Coverage
Medicaid Coverage
Enteral not oral
Other State Programs
State Medicaid Contact Information
404-656-4507
x
Mandated Insurance Coverage
Yes, select inborn errors of metabolism
Medicaid Coverage
Yes
Other State Programs
Children w/Special Healthcare Needs (CSHNB)
State Medicaid Contact Information
800-316-8005
x
Mandated Private Insurance Coverage
No
Medicaid Coverage
Enteral not oral
Other State Programs
Children’s Special Health Program
877-887-3075
877-887-3075
State Medicaid Contact Information
208-334-5747
x
Mandated Private Insurance Coverage
No
Medicaid Coverage
Yes
Other State Programs
May be considered upon by request
State Medicaid Contact Information
800-843-6154
x
Mandated Private Insurance Coverage
Yes, select inborn errors of metabolism
Medicaid Coverage
Yes
Other State Programs
Riley Children’s Hospital
317-233-1351
317-233-1351
State Medicaid Contact Information
317-233-4455
x
Mandated Private Insurance Coverage
No
Medicaid Coverage
Yes
Other State Programs
Children’s Special Health Care Services (CSHCS)
State Medicaid Contact Information
800-972-2017
x
Mandated Private Insurance Coverage
Yes, select inborn errors of metabolism
Medicaid Coverage
Individual consideration-case-by-case
Other State Programs
Services For Children W/ Special Healthcare Needs
800-332-6262
800-332-6262
State Medicaid Contact Information
800-766-9012
x
Mandated Private Insurance Coverage
Yes, select inborn errors of metabolism
Medicaid Coverage
May be considered upon by request
Other State Programs
Commission for Children w/Special Healthcare Needs
502-429-4430
502-429-4430
State Medicaid Contact Information
502-564-3232
x
Mandated Private Insurance Coverage
Yes, select inborn errors of metabolism
Medicaid Coverage
Yes
Other State Programs
Children’s Special Health Services (CSHS)
504-565-5055
504-565-5055
State Medicaid Contact Information
225-342-9500
x
Mandated Private Insurance Coverage
Yes, all inborn errors of metabolism
Medicaid Coverage
Yes
Other State Programs
Office of Genetics & Children’s Special Health Needs:
Children’s Medical Services (CMS)
410-767-5585
Children’s Medical Services (CMS)
410-767-5585
State Medicaid Contact Information
410-767-5800
x
Mandated Insurance Coverage
Yes, select inborn errors of metabolism
Medicaid Coverage
Individual consideration-case-by-case
Other State Programs
Bureau of Family and Community Health
State Medicaid Contact Information
888-665-9993
x
Mandated Insurance Coverage
No
Medicaid Coverage
Individual consideration-case-by-case
Other State Programs
Children with Special Health Needs
800-359-3722
800-359-3722
State Medicaid Contact Information
517-373-3740
x
Mandated Insurance Coverage
Yes, select inborn errors of metabolism
Medicaid Coverage
Individual consideration-case-by-case after 30 days unless, PKU, MSUD, Hyperlysinemia w/tube
Other State Programs
MN Children w/Special Health Needs
800-728-5420
800-728-5420
State Medicaid Contact Information
651-431-2000
x
Mandated Insurance Coverage
No
Medicaid Coverage
Individual consideration-case-by-case
Other State Programs
Children’s Medical Program;
State Formulary
601-713-3457
State Formulary
601-713-3457
State Medicaid Contact Information
651-431-2000
x
Mandated Insurance Coverage
Yes
Insurance Coverage of Formula and Limits
> 6 yrs. Old; up to $5K
Insurance Coverage of Low Protein Foods and Limits
> 6 yrs. Old; up to $5K
Metabolic Conditions Covered by Insurance
All Inborn Errors of Metabolism
WIC Coverage
PKU, MSUD
Medicaid Coverage
Yes
Other State Programs
State Formulary & BR
800-844-0898
800-844-0898
State Medicaid Contact Information
573-751-4815
x
Mandated Insurance Coverage
Yes, all inborn errors of metabolism
Medicaid Coverage
Yes
Other State Programs
State Medicaid Contact Information
406-444-4540
x
Mandated Insurance Coverage
Yes, select inborn errors of metabolism
Medicaid Coverage
Yes
Other State Programs
Newborn Screening Grant
402-559-3660
402-559-3660
State Medicaid Contact Information
402-471-6035
x
Mandated Insurance Coverage
Yes, all inborn errors of metabolism
Medicaid Coverage
Enteral not oral
Other State Programs
Children w/ Special Health Care Needs (CSHCN)
State Medicaid Contact Information
775-684-3676
x
Mandated Insurance Coverage
Yes, select inborn errors of metabolism
Medicaid Coverage
Enteral not oral
Other State Programs
Bureau of Special Medical Services
603-271-4595
603-271-4595
State Medicaid Contact Information
800-852-3345 ext 5254
x
Mandated Insurance Coverage
Yes, all inborn errors of metabolism
Medicaid Coverage
3 Specialty clinics
Other State Programs
Special Child, Adult & Early Intervention Services
609-292-1582
609-292-1582
State Medicaid Contact Information
800-356-1561
x
Mandated Insurance Coverage
Yes, all inborn errors of metabolism
Medicaid Coverage
Individual consideration-case-by-case if oral
Other State Programs
Children’s Medical Services
505-902-7491
505-902-7491
State Medicaid Contact Information
505-827-3100
x
Mandated Insurance Coverage
Yes, all inborn errors of metabolism
Medicaid Coverage
Individual consideration-case-by-case
Other State Programs
CSHCN
State Medicaid Contact Information
866-211-1736
x
Mandated Insurance Coverage
Yes, select inborn errors of metabolism
Medicaid Coverage
Individual consideration-case-by-case
Other State Programs
Children w/ Special Health Care Needs
800-737-3028
800-737-3028
State Medicaid Contact Information
919-707-5762
x
Mandated Insurance Coverage
Yes, select inborn errors of metabolism
Medicaid Coverage
Yes
Other State Programs
Children’s Special Health Services (CSHS)
701-328-2436
701-328-2436
State Medicaid Contact Information
701-328-2321
x
Mandated Insurance Coverage
No
Medicaid Coverage
Yes
Other State Programs
State Formulary;
OH Department of Health Metabolic Program;
Bureau for Children w/Medical Handicaps;
614-466-1700
OH Department of Health Metabolic Program;
Bureau for Children w/Medical Handicaps;
614-466-1700
State Medicaid Contact Information
800-324-8680
x
Mandated Insurance Coverage
No
Medicaid Coverage
Individual consideration-case-by-case if not PKU
Other State Programs
Children w/ Special Health Care Needs
State Medicaid Contact Information
800-987-7767
x
Mandated Private Insurance Coverage
Yes
Insurance Coverage of Formula and Limits
No Limit
Insurance Coverage of Low Protein Foods and Limits
No Limit
Metabolic Conditions Covered by Insurance
All Inborn Errors of Metabolism
WIC Coverage
No
Medicaid Coverage
Yes
Other State Programs
Children w/ Special Health Needs Branch
405-521-3646
405-521-3646
State Medicaid Contact Information
503-945-5772
x
Mandated Private Insurance Coverage
Yes
Insurance Coverage of Formula and Limits
No Limit
Insurance Coverage of Low Protein Foods and Limits
None
Metabolic Conditions Covered by Insurance
PKU, branched-chain Ketonuria, galactosemia, hemocystinuria
WIC Coverage
Limited
Medicaid Coverage
Individual consideration-case-by-case
Other State Programs
Bureau of Family Health; Newborn Screening (NBS)
717-783-8143
717-783-8143
State Medicaid Contact Information
800-692-7462
x
Mandated Private Insurance Coverage
No
Insurance Coverage of Formula and Limits
None
Insurance Coverage of Low Protein Foods and Limits
None
Metabolic Conditions Covered by Insurance
None
WIC Coverage
May be considered upon by request
Medicaid Coverage
Individual consideration-case-by-case
Other State Programs
State Formulary;
Office of Children w/ Special Needs
Office of Children w/ Special Needs
State Medicaid Contact Information
401-462-5300
x
Mandated Private Insurance Coverage
No
Insurance Coverage of Formula and Limits
None
Insurance Coverage of Low Protein Foods and Limits
None
Metabolic Conditions Covered by Insurance
None
WIC Coverage
Yes
Medicaid Coverage
Enteral not oral
Other State Programs
State Formulary;
Children’s Rehab Services
Children’s Rehab Services
State Medicaid Contact Information
800-768-5700
x
Mandated Private Insurance Coverage
Yes
Insurance Coverage of Formula and Limits
No Limit
Insurance Coverage of Low Protein Foods and Limits
None
Metabolic Conditions Covered by Insurance
PKU
WIC Coverage
PKU
Medicaid Coverage
Enteral not oral
Other State Programs
Children’s Special Health Services
State Medicaid Contact Information
605-773-2944
x
Mandated Private Insurance Coverage
Yes
Insurance Coverage of Formula and Limits
No Limit
Insurance Coverage of Low Protein Foods and Limits
None
Metabolic Conditions Covered by Insurance
PKU
WIC Coverage
Yes
Medicaid Coverage
Yes
Other State Programs
Children’s Special Services
State Medicaid Contact Information
866-311-4287
x
Mandated Private Insurance Coverage
Yes
Insurance Coverage of Formula and Limits
No Limit
Insurance Coverage of Low Protein Foods and Limits
None
Metabolic Conditions Covered by Insurance
Inborn errors of amino acid or urea organic acid metabolism
WIC Coverage
Yes
Medicaid Coverage
Individual consideration-case-by-case
Other State Programs
Children w/ Special Needs
800-252-8023
800-252-8023
State Medicaid Contact Information
800-252-8263
x
Mandated Private Insurance Coverage
Yes
Insurance Coverage of Formula and Limits
No Limit
Insurance Coverage of Low Protein Foods and Limits
No Limit
Metabolic Conditions Covered by Insurance
Inborn errors of amino acid or urea cycle metabolism
WIC Coverage
May be considered upon by request
Medicaid Coverage
Individual consideration-case-by-case
Other State Programs
Children w/Special Health Care Needs (CSHCN)
State Medicaid Contact Information
800-662-9651
x
Mandated Private Insurance Coverage
Mandated Coverage
Insurance Coverage of Formula and Limits
No Limit
Insurance Coverage of Low Protein Foods and Limits
$2500 Low-Pro foods
Metabolic Conditions Covered by Insurance
All Inborn Errors of Metabolism
WIC Coverage
May be considered upon by request
Medicaid Coverage
Yes
Other State Programs
Department of Children & Families;
Children w/Special Health Needs
802-847-4463
Children w/Special Health Needs
802-847-4463
State Medicaid Contact Information
802-879-5900
x
Mandated Private Insurance Coverage
No Mandated Coverage
Insurance Coverage of Formula and Limits
None
Insurance Coverage of Low Protein Foods and Limits
None
Metabolic Conditions Covered by Insurance
None
WIC Coverage
Yes
Medicaid Coverage
Tube
Other State Programs
Department of Health;
CSHCN
CSHCN
State Medicaid Contact Information
804-225-2773
x
Mandated Private Insurance Coverage
Yes
Insurance Coverage of Formula and Limits
No Limit
Insurance Coverage of Low Protein Foods and Limits
None
Metabolic Conditions Covered by Insurance
PKU
WIC Coverage
No
Medicaid Coverage
Yes
Other State Programs
Center for Children W/ Special Needs
866-987-2500
206-884-5735
866-987-2500
206-884-5735
State Medicaid Contact Information
800-562-3022
x
Mandated Private Insurance Coverage
No
Insurance Coverage of Formula and Limits
None
Insurance Coverage of Low Protein Foods and Limits
None
Metabolic Conditions Covered by Insurance
None
WIC Coverage
Referred to WV metabolic program
Medicaid Coverage
Referred to WV metabolic program
Other State Programs
Department of Family Health-Newborn Services (NBS)
State Medicaid Contact Information
888-483-0797
x
Mandated Private Insurance Coverage
No
Insurance Coverage of Formula and Limits
None
Insurance Coverage of Low Protein Foods and Limits
None
Metabolic Conditions Covered by Insurance
None
WIC Coverage
No
Medicaid Coverage
Yes
Other State Programs
State Formulary;
Department of Health-Newborn Services (NBS)
Department of Health-Newborn Services (NBS)
State Medicaid Contact Information
608-266-1865
x
Mandated Private Insurance Coverage
No
Insurance Coverage of Formula and Limits
None
Insurance Coverage of Low Protein Foods and Limits
None
Metabolic Conditions Covered by Insurance
None
WIC Coverage
Yes
Medicaid Coverage
Yes
Other State Programs
Genetic and Metabolic Clinic;
SCHIP
SCHIP
State Medicaid Contact Information
307-777-5775
x