Myth: Real Food Blends Isn’t Covered by Insurance – Unpacking the truth about enteral nutrition formula coverage and how to access whole food options.
Is Real Food Blends Covered by Insurance?
If you’re a healthcare professional supporting patients with a feeding tube, you’ve probably heard the question: “Is Real Food Blends covered by insurance?”
It’s a common myth — and one we’re here to bust.
The truth: Real Food Blends is covered by many insurance plans, including Medicare, select state Medicaid programs, and some private insurers. While coverage varies, access may be possible with the right documentation and support – and we’re here to help make the process easier.
How Coverage Works: The Basics
Real Food Blends meals fall under the blenderized tube feeding formula category and billed as HCPCS Code B4149 – Enteral Formula, Manufactured Blenderized Natural Foods with Intact Nutrients.
Here’s what you need to know:
- Coverage is available through Medicare, select state Medicaid plans, and some private insurance companies.
- Coverage varies by insurer and individual plan.
- A Letter of Medical Necessity and other
clinical documentation may be required.
To help patients get started, encourage them to:
- Contact their insurance provider to ask about coverage for Real Food Blends.
- Speak with their Durable Medical Equipment (DME) or home infusion company, who often manage the billing.
- Request a list of required documentation like physician notes or prior authorizations.
We offer a Letter of Medical Necessity template to make this easier. Just fill in your patient’s information and send it to the DME with the prescription.
Tip: Visit our Insurance Coverage webpage to search by state and find DME/home infusion companies that may supply Real Food Blends in your area.
Meet Nutricia Navigator: Personalized Insurance Support
Navigating insurance coverage can feel overwhelming – that’s why we
created Nutricia Navigator. This free program offers one-on-one support to help healthcare professionals and families navigate formula coverage and access.
Nutricia Navigator can help in the following ways:
Investigate
- Call the insurance company to check if an enteral nutrition formula, such as Real Food Blends, is covered and ask if approval is needed before starting.
- Work with families, healthcare professionals, and insurance representatives to make sure everyone understands the steps for getting covered.
- Explore other ways to get coverage, including asking an employer for special exceptions if needed.
Support
- Help explore getting insurance approval before starting the product.
- Support families (or individual) if coverage is denied by guiding them through an appeal.
- Answer questions about insurance forms, claims, and payment problems.
Supply
- Help find a nearby pharmacy, home healthcare, or medical supplier that carries Nutricia products.
- Offer advice on the most affordable way to buy products based on each family’s budget.
Over 7,000 patients using Nutricia’s products have found insurance coverage with Nutricia Navigator’s help.
Call 1-800-365-7354
Email NutriciaNavigator@Nutricia.com
Fax completed Navigator forms to 833-869-0554
Watch our Nutricia Navigator webinar to learn more or visit our insurance page at www.realfoodblends.com/insurance.
What If Insurance Denies Coverage?
Despite their best efforts, some families may experience delays or denials. In some cases, denials can stem from documentation issues – like missing clinical notes or lack of prior authorization. We recommend working closely with your patients care team, supplier, and insurance company to understand the specific reason behind the denial.
However, a denial doesn’t always mean the journey is over. There may be opportunities to clarify or resubmit documentation, and in some cases, appeal the decision with supporting clinical information.
We offer tools to support this process, including:
- A customizable Letter of Medical Necessity
- An Enteral Referral Order Form to send to DME/home infusion suppliers
- Support from Nutricia Navigator to help guide the process
Access all reimbursement tools here.
Tips for a Smoother Insurance Process
Every insurance plan is different, but here are a few steps that may help improve the likelihood of a smoother coverage experience when recommending Real Food Blends:
- Start early: Begin conversations about coverage as soon as you’re considering Real Food Blends as part of your patient’s care plan.
- Provide clinical documentation: Include your patient’s medical history, tolerance
concerns, or history of what
hasn’t worked – including
context can help show the need for a different approach. - Use the right codes: Real Food Blends falls under HCPCS B4149, categorized as a blenderized tube feeding formula.
- Include a Letter of Medical Necessity: We’ve created one to make this step easier for your team.
- Submit an Enteral Referral Form: This form can be sent to DME or home infusion suppliers to help ensure they receive all necessary documentation.
If questions come up, our Nutricia Navigator team is here to help guide you and your patients every step of the way.
Request Free Samples
Before going through the steps to secure insurance coverage, it can be helpful for patients to try Real Food Blends first. That’s why we offer free samples* for healthcare professionals – to support the decision-making process and help determine tolerance and fit.
What You Can Request:
- Trial Pack: One of each of our 6 original meals (6 total)
- Select™ Trial Pack: Our calorie-dense (1.6 Cal/mL), high-protein options (3 of each, 6 total)
- Mini Snack: Good source of fiber in a 4oz snack-size format (3 total)
Samples can be shipped to your office or directly to your patient’s home — whichever is easier for you.
About Whole Food Tube Feeding & Real Food Blends Products
Why Blenderized Tube Feeding Matters
A growing body of evidence indicates that Blenderized Tube Feeding may improve common symptoms of formula intolerance, such as:
- Nausea and vomiting1,2
- Gagging/retching3,4
- Reflux associated with tube feeding5,6
- Bowel irregularity1,7
Real Food Blends is The Closest to a Homemade Blenderized Tube Feeding**
Real Food Blends meals are a true blenderized diet and are:
- Ready-to-feed and shelf-stable
- Made from 100% real foods, free from synthetic ingredients
- Designed for both kids and adults with a feeding tube
With 8 different meals and 1 snack, Real Food Blends offers a variety of protein sources, fruits, vegetables, whole grains, and fat sources. Each product contains 5-8 simple ingredients and provides a whole food tube feeding option.
Real Food Blends is available through:
- Insurance-covered DME/home infusion companies
- Realfoodblends.com (subscription available, 10% off)
- Amazon.com
Take the First Step
Request a sample today and discover how Real Food Blends can fit into your patient’s tube feeding plan.
- Request samples for your patients Limit 1 of each sample per patient
- Access tools to support reimbursement, like a Letter of Medical Necessity and Enteral Referral Form for DME/home infusion companies
- Visit our Insurance Coverage page for more information on how to find a DME/home infusion company carrying Real Food Blends, Nutricia Navigator forms, and more
- Spurlock, et al. Nutr Clin Pract. 2022;37:615-624. 2. Hron, et al. J Pediatr. 2019;211:139-145. 3. Kernizan, et al. JPGN. 2020;71:124-128. 4. Batsis, et al. Nutr Clin Pract. 2020;35:282-288.5. Pentiuk, et al. JPEN. 2011;35:375-379. 6. Gallagher, et al. JPEN. 2018;42:1046-1060. 7. Schmidt, et al. Clin Nutr. 2019;38:332-240.
*Samples can only be requested by licensed healthcare professionals. Limit 1 of each sample per patient.
**Compared to other blenderized enteral formulas.
John’s Story
My name is John and I’m a 68-year-old retiree from Austin, TX. On October 3rd, 2017, I had major jaw replacement/reconstruction surgery. Bone and tissue were harvested from my body to construct a new mandible. I had oral cancer 42 years ago, and the long-term side effects of the radiation were the cause of my reconstruction. I’m one of the longest oral cancer survivors in the US. I stayed in the ICU/hospital for a month and ended up having 3 more surgeries during this time.
Because of my surgeries, I was unable to eat or drink, so I was given a standard commercial tube feeding formula using a machine that continuously fed me during the day/night. I think this nutrition was the source of several issues like constipation and possibly high blood sugar, and that’s a problem because I’m diabetic. My doctor and dietitian didn’t offer any other alternative at that time.
When it was near the end of my hospital stay, I had a G-tube placed to receive nutrition at home. This was supposed to be temporary until I fully recovered from my surgery but unfortunately it was not. We got home on November 3rd, and my wife Peggy went to search on the internet, looking for alternatives to what we had. At the time, we thought it would be a short-term only issue but still wanted to find something like real food.
Peggy found Real Food Blends and we knew we were on to something, so we ordered several cases. After a few days of consuming Real Food Blends meals, it was apparent that we had hit the jackpot. I felt normal. Real Food Blends offers 6 different meals and I felt like I was finally giving my body what it needed.
I’m so very grateful that companies like Real Food Blends exist. Trying to blenderize food can be messy and a lot of work. Today I’m happy and healthy and grateful to be alive.
-John
*I was paid by Nutricia for my time to write this blog post, however my opinions are my own*
This is one person’s experience with Real Food Blends and may not be the experience of others. Individual results may vary.
Evely’s Story
My daughter, Evely, is an amazing 6-year-old who loves music!
Our G-tube journey began when Evely was just 3 months old and recovering from heart surgery. This was initially thought to be temporary, but we would eventually receive several diagnoses that made swallowing challenging. We were prescribed several different commercial formulas. They made Evely sick every single time. Finding a tube feeding option with whole foods was very important to me. Reading the ingredient label on the commercial formulas was especially hard because I would maybe not have chosen them for Evely from a shelf in a supermarket.
I stumbled upon Real Food Blends website while doing some late-night research on G-tubes. Blending foods for Evely had become extremely time-consuming with the amount of time we were spending in hospitals and doctor’s offices. I was so grateful to have found a company that we could trust to bring ease to our situation. I also love that there is such a variety of options.
Evely has grown so much since starting Real Food Blends, “failure to thrive” has now been removed from her diagnosis list.
I recommend anyone part of the feeding tube community speak with their registered dietitian about a blenderized diet.
– Tameka
*I was paid by Nutricia for my time to write this blog post, however my opinions are my own*
This is one mom’s experience with Real Food Blends and may not be the experience of others. Individual results may vary.
Caroline’s Story
My daughter Caroline is a bright and smiley 3 year old who loves to play! She is a very active child but things haven’t always been this way. Caroline suffered severe oxygen deprivation known as Hypoxic Ischemic Encephalopathy during labor resulting in a brain injury that left her unable to coordinate oral movements necessary to drink from a bottle. She started with an NG tube at birth and had her G-Tube placed while she was recovering from her brain injury in the NICU at only 2 months old.
The NICU was the beginning of a long journey trying to find the right nutrition for our daughter. Soon after our daughter was born, we noticed that tube feeding times were very stressful and uncomfortable for Caroline and she was struggling to keep her food down. We tried one commercial formula after another, hoping to provide relief to our daughter, but none worked. She was incredibly uncomfortable and unable to keep food down. Reflux and tummy troubles ruled her life and ours.
Out of desperation, I scoured the internet and discovered parent forums discussing Real Food Blends as an option for kids like Caroline. As I read, I knew we needed to give it a try. I contacted her dietitian who ordered some samples for us to try over the course of a couple weeks. We created a feeding schedule, started Real Food Blends and sure enough, life for Caroline started to get a whole lot better.
As she transitioned onto Real Food Blends, we noticed a significant shift in our daughter’s comfort levels. She was finally able to relax and take a full feed without losing any food. Her growth became more stable and feeds changed from a time of high stress to a time of comfort. This newfound comfort opened the door to new opportunities which seemed impossible before starting Real Food Blends. She began to tolerate therapy, sleep, car rides, stroller rides and play time in a way that she never had before.
Now that we are able to get out of the house more without concerns of tummy troubles striking, I bring her food everywhere we go. We are a very active family so having her food conveniently packaged helps a ton. We use a combination of pump feeding and bolus syringe feeding with Caroline’s Real Food Blends, which has worked beautifully for our family.
As a mother, it means the world to me to know that my child is receiving high quality nutrition every day. I love being able to mix up the different flavors and talk with her about what she’s having for the day! For example, it was so fun to be able to give her the turkey flavor on Thanksgiving. I know it might seem like a small detail, but it opened a door for Caroline to relate to her peers. Her cousins and friends had a turkey dinner for Thanksgiving and so did Caroline!
Caroline has been on Real Food Blends for a year and a half now and we have never looked back. It has truly changed her life for the better and we couldn’t be more thankful that something like this exists as an option for families like ours.
– Lauren
*I was paid by Nutricia for my time to write this blog post, however my opinions are my own*
This is one mom’s experience with Real Food Blends and may not be the experience of others. Individual results may vary.
