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Covered by Exception:
* Special Authorization Form Completed by Registered Dietitian (AB Government Programs)
** Needs Registered Dietitian Recommendation or Physician Prescription (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)
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 Vanilla Oral Liquid Not Covered Not Covered Not Covered Not Covered Not Covered Not Covered Not Covered Not Covered
Pediasure with Fibre Oral Liquid Pediatric Covered Covered Covered Covered Covered Not Covered Covered By Exception * Covered By Exception **
Peptamen 1.0 Adult, Oral Covered By Exception * Covered By Exception * Covered By Exception * Covered By Exception * Covered By Exception * Not Covered Covered By Exception * Covered By Exception **
Peptamen 1.0 with Prebio Adult, Oral Covered By Exception * Covered By Exception * Covered By Exception * Covered By Exception * Covered By Exception * Not Covered Covered By Exception * Covered By Exception **
Peptamen 1.5 Adult, Oral 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 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 Adult Not Covered Not Covered Not Covered Not Covered Not Covered Not Covered Not Covered Not Covered
Peptamen AF 1.2 Adult Not Covered Not Covered Not Covered Not Covered Not Covered Not Covered Not Covered Not Covered