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.

Click here to request samples

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 vomiting^1,2
• Gagging/retching^3,4
• Reflux associated with tube feeding^5,6
• Bowel irregularity^1,7

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

1. 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.

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 3^rd, 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.