Skip main navigation

Military Health System

Hurricane Milton & Hurricane Helene

Emergency procedures are in place in multiple states due to Hurricane Milton & Hurricane Helene. >>Learn More

TRICARE Answers Your Questions About Baby Formula

Image of Baby_smiling. The shortage of baby formula is having an impact on millions of families, including military families. Learn what TRICARE does and doesn't cover.

FALLS CHURCH, Va.  –  The shortage of baby formula is having an impact on millions of families. This includes military families living in the U.S. and overseas. It's important you know what TRICARE does and doesn't cover. Here are a few questions and answers about infant formula coverage to help.

"The formula shortage is a concerning and challenging situation and one that the Defense Health Agency is taking seriously," said Elan Green, chief of TRICARE Health Plan's Member Benefits and Reimbursement Section. "We understand that parents are worried. We know that clear information can help you navigate this difficult time."

Q: Does TRICARE cover baby formula?
A: TRICARE covers baby formula that's medically necessary. This includes:

  • Regular infant formula for children who have feeding tubes (separately, TRICARE also covers specialized formulas for adults or older children with feeding tubes or who can't eat solid foods)
  • High-protein formula for infants on ketogenic diets to control seizures
  • Special formulas for those who can't digest certain foods or nutrients

Your child's doctor must diagnose and prescribe a special formula. Note: TRICARE doesn't cover formula for healthy infants and children.

Q: Who is eligible to get medically necessary formula?
A: If you meet conditions of coverage on medical foods, TRICARE may cover your specialty formulas or other medical foods. Remember that care must be medically necessary and appropriate. You can review the kinds of medically necessary foods that TRICARE covers by checking out the Nutritional Therapy page. The type of formula depends on the medical need.

Q: Does TRICARE ship formula?
A: No. TRICARE doesn't directly ship formula to families.

Q: How much does the prescribed formula cost?
A: Your costs for covered medical foods depend on your health plan. It also depends on your beneficiary category. Visit the TRICARE Costs page and look under "Medical Supplies" to learn more.

Q: What if I can't get my baby's prescription formula?
A: If you have a child whose medically necessary formula is unavailable, you should work with your pediatrician, primary care manager (PCM), or specialist such as a pediatric registered dietitian. TRICARE will cover your appointments to talk about options for your child.

Q: What suggestions are there for parents trying to feed their infants?
A: Do not attempt to make your own formula. The Food and Drug Administration (FDA) "advises parents and caregivers to not make or feed homemade infant formula to infants. Homemade infant formula recipes have not been evaluated by the FDA and may lack nutrients vital to an infant's growth … The agency has received reports of hospitalized babies who had been fed homemade infant formula … which can be life-threatening." The FDA recommends asking your child's pediatrician, PCM, or specialist for guidance on changing your child's formula or feeding practices. You can go to the FDA website to find other recommendations and warnings for parents trying to find formula.

The American Academy of Pediatrics also encourages you to talk with your child's doctor if you have any concerns about your baby's health and nutrition. If your child has special health needs, be sure to check with their doctor about medically appropriate and safe feeding alternatives.

"We understand that this is a very stressful time for military families with babies," said Green. "Because TRICARE doesn't have a supply of infant formula, it's best you consult with your pediatrician, PCM, or specialist."

If you have questions about TRICARE covered services or costs, you can refer to the TRICARE website. You can also reach out to your TRICARE regional contractor for more information. Remember that your best resource for guidance and advice on your options is your child's health care provider.

You also may be interested in...

Publication
Jun 3, 2020

Communication to ABA Providers Regarding Continued Temporary Authorization to Utilize Telehealth for CPT Code 97156 During the COVID-19 National Emergency

.PDF | 122.59 KB

TRICARE is announcing the continuation of the temporary exception to policy regarding the use of synchronous telehealth (TH) capabilities (both audio and video) for Applied Behavior Analysis (ABA) Family Adaptive Behavior Treatment Guidance services specifically during this COVID-19 pandemic.

Publication
Apr 7, 2020

Decision Memorandum on TRICARE Implementation of the "Families First Coronavirus Response Act"

.PDF | 1.06 MB

The Families First Coronavirus Response Act, Public Law 116-127, Division F, Section 6006(a), limits TRICARE authority to impose copayment or other cost-sharing for novel coronavirus (COVID-19) testing and related provider visits that result in orders for or administration of Food and Drug Administration (FDA) approved, cleared, or authorized ...

Publication
Aug 27, 2019

Guide to Update DEERS

.PDF | 464.82 KB

This is a beneficiary guide to updating DEERS. It is critical for sponsors to keep their DEERS eligibility information up to date so there is no break in healthcare coverage eligibility.

Publication
Aug 9, 2019

FEDVIP Vision 2019 Toolkit

.PDF | 7.93 MB

This toolkit is full of materials to disseminate information about FEDVIP Vision including: infographics, logos, screensavers, articles, and sample social media posts. FEDVIP Vision is a beneficiary-centric campaign with eye-catching products and succinct messages to raise awareness about the FEDVIP Vision plans and coverage.

Skip subpage navigation
Refine your search
Last Updated: August 30, 2024
Follow us on Instagram Follow us on LinkedIn Follow us on Facebook Follow us on X Follow us on YouTube Sign up on GovDelivery