FAVORABLE FOR COVERAGE: PHARMACY BENEFIT Gelmix and Purathick are favorable for coverage as over-the-counter (OTC) products with a prescription under the pharmacy benefit. Click to Search Available Pharmacies REQUIREMENTS –Prescription required –Prior Authorization required (must include quantity, day supply, diagnosis; refer to the resources below for full PA requirements) PRODUCT NDC CODES -Gelmix Infant Thickener […]
Read More »Favorable for Coverage: Pharmacy Benefit (OTC) Gelmix and Purathick are favorable for coverage as over-the-counter (OTC) products with a prescription under the pharmacy benefit. Click to Search Available Pharmacies Requirements -Prescription required Product NDC Codes in WY -Gelmix Infant Thickener (125g Jar_: 55764-0007-02 -Gelmix Infant Thickener (2.4g Sticks): 55764-0007-11 -Purathick Natural Thickener (125g Jar): 55764-0007-03 […]
Read More »Favorable for Coverage: Pharmacy Benefit (OTC) Gelmix and Purathick are favorable for coverage as over-the-counter (OTC) products with a prescription under the pharmacy benefit. Requirements -Prescription required -Prior Authorization required (must include quantity, day supply, diagnosis, and applicable ICD-10 codes; refer to the resources below for full PA requirements) Product NDC Codes in AL -Gelmix […]
Read More »Covered as an OTC Benefit Prior Auth Required
Read More »Medicaid Coverage Unknown. Check back for updates.
Read More »Covered by Medicaid: Pharmacy Benefit Gelmix and Purathick are covered with a prescription as an over the counter (OTC) pharmacy benefit. Prior authorization and a prescription are required. Ask your pharmacy if they can order or submit prescription to one of the pharmacies below. The product’s national drug codes (NDC) are: Gelmix sticks: NDC 55764000711, […]
Read More »Not Covered by Medicaid. Currently, this state does not provide Medicaid coverage for thickeners, as they are not typically classified as a medical necessity. While no thickeners are covered at this time, advocacy efforts can help bring attention to the importance of these products for individuals with specific dietary needs. Medicaid recipients qualify for our […]
Read More »Medicaid Coverage Needs Improvement. This state currently provides coverage for thickeners through DME reimbursement code B4100 (or B4100-U1). However, the reimbursement rate may be too low or is currently unclear, which can make it challenging for suppliers to offer low-weight, gum-based thickeners like Gelmix and Purathick. Advocating for updates to the Medicaid reimbursement schedule to […]
Read More »Favorable for Coverage by Medicaid. This state provides favorable Medicaid coverage for thickeners through DME reimbursement code B4100, utilizing cost-plus reimbursement rates. Gelmix and Purathick are typically covered.
Read More »Submit Referral and Request Services 866-883-1188
Read More »