Multivitamins

For Members

• What are multivitamins?
  • Multivitamins are a combination of many different vitamins that are normally found in foods and other natural sources.
  • Multivitamins are used to treat vitamin deficiencies (lack of vitamins) caused by illness, pregnancy, poor nutrition, digestive disorders, and many other conditions.
  • Most of the people do not require Multivitamins because a healthy balanced diet provides all essential vitamins. However, if vitamins that are not taken in through the diet and results in deficiency, those can be provided through Multivitamins.
  • Long term usage of Multivitamins might have serious side effects because certain minerals contained in a multivitamin can result into serious overdose symptoms. Seek emergency medical attention if you think that you have used too much of multivitamins. An overdose of vitamins A, D, E, or K can cause severe or life-threatening situations.
  • Always discuss with your treating Physician before using Multivitamins, especially if you are pregnant or breastfeeding.

• Insurance Coverage of multivitamins:
  • Coverage of multivitamins by insurance varies according to the table of benefits, some policies are covering multivitamins only when prescribed with antibiotics.
  • Nextcare is covering multivitamins if covered by policy terms and conditions in cases of Increased requirements for nutrients due to medical condition, such as celiac disease, cancer, cystic fibrosis, or inflammatory bowel disease (IBD), surgery that impacts the intestines or stomach.
  • Nextcare is not covering multivitamins that are result of general dietary deficiencies.

For Healthcare Providers

• All types of multivitamins require Pre-Authorization from Nextcare.
• multivitamins that are results from general dietary deficiencies are not covered.
• Requests for vitamins or multivitamins should be sent along with clear medical indications or laboratory test results.

• In case of multivitamins rejection, the rejection reason will be:
  • M010: Vitamins/supplements are not covered
  • NCOV-003: Service(s) is (are) not covered
  • NCOV-027: Non Coverage of certain medication as per policy
  • MNEC-007: Service is not clinically indicated based on good clinical practice, without additional supporting documentation
  • MNEC-004 Service is not clinically indicated based on good clinical practice, without additional supporting diagnoses/activities