Provider updates

Confused by all the possible prenatal vitamins on the market and how to find one that is covered? Us, too! According to our list, there are nearly 300 different NDCs on the market for prenatal vitamins (and this is likely an undercount). Even more incredible, this represents roughly 125 different product formulations! Most of the differences between products is the amount and type of iron as well as the amount of folic acid. Others might advertise having DHA in them. The clinical significance of these different formulations is not well established, but pricing can range drastically. Some formulations cost nearly $5 per tablet. The majority are less than $1 with the average being less than $0.25. The wide variety in costs and possible formulations with very similar names can make for a difficult experience finding which prenatals are covered vs. not. Despite this difficulty, we see well over a 90% paid claim rate meaning non-preferred products are not picked very often, but we are working to make the paid claim rate even higher to improve access to this critical supplement.  

We recently looked at our paid and rejected claims to try to optimize the formulary. Here’s a handy guide to try to help.  It’s not an all-inclusive list, but we hope it helps simplify the covered options: