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Covered by Exception:
* Special Authorization Form Completed by Registered Dietitian (AB Government Programs)
** Prior Approval Form Completed by Physician (NIHB)

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Family Support for Children with Disabilities (FSCD) is contract based and subject to approval


Formula Formula Category AISH (Assured Income for the Severely Handicapped) Income Support Alberta Child Health Benefits Alberta Adult Health Benefits Children's Services Alberta Blue Cross Non-Group Coverage Interim Federal Health Program for refugees (IFHP) Non-Insured Health Benefits (NIHB)
Nutren Junior Oral Liquid Pediatric Covered Covered Covered Covered Covered Not Covered Covered By Exception * Covered By Exception **
Pediasure Oral Liquid Pediatric Covered Covered Covered Covered Covered Not Covered Covered By Exception * Covered By Exception **
Pediasure Peptide 1 Cal Oral Liquid Pediatric Covered Covered Covered Covered Covered Not Covered Covered By Exception * Covered By Exception **
Pediasure Plus with Fibre Oral Liquid Pediatric Covered By Exception * Covered By Exception * Covered By Exception * Covered By Exception * Covered By Exception * Not Covered Covered By Exception * Covered By Exception **
Pediasure with Fibre Oral Liquid Pediatric Covered Covered Covered Covered Covered Not Covered Covered By Exception * Covered By Exception **
Peptamen 1.5 Oral Liquid Adult Covered By Exception * Covered By Exception * Covered By Exception * Covered By Exception * Covered By Exception * Not Covered Covered By Exception * Covered By Exception **
Peptamen AF 1.2 Oral Liquid Adult Covered By Exception * Covered By Exception * Covered By Exception * Covered By Exception * Covered By Exception * Not Covered Covered By Exception * Covered By Exception **
Peptamen Junior Oral Liquid Pediatric Covered Covered Covered Covered Covered By Exception * Not Covered Covered By Exception * Covered By Exception **
Peptamen Oral Liquid Adult Covered By Exception * Covered By Exception * Covered By Exception * Covered By Exception * Covered By Exception * Not Covered Covered By Exception * Covered By Exception **
Peptamen with Prebio 1.0 Oral Liquid Adult Covered By Exception * Covered By Exception * Covered By Exception * Covered By Exception * Covered By Exception * Not Covered Covered By Exception * Covered By Exception **