The Metabolic Formula Program provides financial assistance to Missouri residents who meet the financial and medical eligibility criteria of the program. If you are not financially eligible for the program, service coordination is available to help you find providers of service for your condition.
Program Services
- The Department of Health and Senior Services (DHSS) will provide financial assistance to program participants for the purchase of metabolic formula. Prescriptions for formula must be filled at a DHSS contracted provider.
- DHSS will provide financial assistance for an annual examination from one of the listed treatment centers below.
Eligibility
The participant must:
- Be a Missouri resident.
- Have a medical diagnosis of one of the inborn errors of metabolism screened for on the Missouri Newborn Blood Spot Screening panel. Examples of these disorders include phenylketonuria (PKU), maple syrup urine disease (MSUD), homocystinuria (HCU), tyrosinemia and propionic acidemia. (For other possible eligible diagnoses which have a metabolic formula need, please go to Missouri Blood Spot Screening Panel.
- Meet financial eligibility guidelines:
- Birth through five years of age: any child is eligible; regardless of financial status.
- Six through 18 years of age: a co-pay for formula is required based on the percent of Federal Poverty Level (FPL) calculated from the adjusted gross income and the number of family members.
- Nineteen years and above: 185% of the FPL with an adjustment of two to the family size.
- Apply for MO HealthNet (Medicaid) benefits or medical assistance and complete the application process to obtain or maintain program eligibility.
MFP is the payer of last resort. All third-party payment sources must be utilized before reimbursement is considered.
Laws
Infants to be tested for metabolic and genetic diseases--reports --exceptions--refusal to test--fee for screening test, department may impose by rule, use of fees--formula provided by department, when.