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Governor Eric J. Holcomb
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Metabolic Formula Program

Overview

The Indiana Department of Health Indiana Metabolic Formula Program works with families and their clinics to help them get consistent access to metabolic formulas at a reduced cost. Families are required to use all medical coverage options before applying for the Indiana Metabolic Formula Program. These medical coverage options include Medicaid, Children’s Special Health Care Services, the federal Marketplace or commercial insurance plans.

Get Started

  1. Apply for Medicaid. Medicaid covers the cost of metabolic formula.
  2. If you aren’t eligible for Medicaid, see if you are eligible for Children’s Special Health Care Services (CSHCS), an income-based program that provides supplemental coverage to help families of children who have serious, chronic medical conditions (including metabolic disorders), age birth to 21 years of age. CSHCS accepts religious exemption letters to waive the Medicaid application requirement.
  3. If you are still paying high out of pocket expenses that are creating financial burden, you may be eligible for the Indiana Metabolic Formula Program.
  4. Complete the program application, State Form 57152, with your metabolic registered dietitian (RD).
  5. Once your completed application is received, you will be contacted by the metabolic formula coordinator to set-up shipments.
  1. Discuss your current metabolic formula coverage with your metabolic RD.
  2. Determine all potential coverage options (some may be waived due to religious exemptions) to reach your maximum available metabolic formula coverage benefits.
  3. If you are still paying high out of pocket expenses that are creating financial burden, please contact your metabolic RD. Together you can decide if the Indiana Metabolic Formula Program is an option for you.
  4. If a referral is agreed upon, complete the program application, State Form 57152, provided by your metabolic RD.
  5. Once your completed application is received, you will be contacted by the metabolic formula coordinator to set-up shipments.

Contact

IDOH Metabolic Formular Coordinator
metabolicformula@health.in.gov