Ky.gov

Cabinet for Health and Family Services

Metabolic Foods and Formula Program

​​​​​​​​The Metabolic Foods and Formulas Program was established to assist patients with inborn errors of metabolism who have:

  • No insurance;
  • Insurance that has been denied; or
  • Exhausted their insurance benefits.

The program works with durable medical equipment providers, pharmacies and university metabolic centers to help those with inborn errors of metabolism and genetic conditions receive metabolic formulas and low-protein modified food products as funding allows.

PKU Education Series

Patients who qualify for another insurance program that covers medically necessary metabolic formulas, supplements and low-pr​otein modified food products, with or without a co-pay are ineligible for this program.

See information and videos at ​right for more information.

Metabolic Disorders Essentials​

Inborn errors of metabolism are rare disorders that prevent the body from properly turning food into energy. The disorders are usually inherited and caused by defects in specific proteins that help break down food so it can be converted to energy in the body.

Food that's not broken down can build up in the body and cause a wide range of developmental delays or other medical problems if not controlled.

There are many different types of inborn errors of metabolism, including:

  • Phenylketonuria (PKU)
  • Galactosemia
  • Maple Syrup Urine Disease
  • Cystinuria
  • Tyrosinemia type I

The most common of these is PKU.

Registered dietitians and other health care providers can help develop a diet for each disorder to enhance physical and mental well-being for those with inborn errors of metabolism.

​Too much whole protein in the diet causes dangerous build-up of protein that can lead to learning problems, brain damage and other medical conditions if not well managed.

A diet with the right balance of food and a metabolic formula is vital for proper growth and development. Regular blood monitoring determines if dietary changes are needed. 

PKU is a lifelong condition. In addition to brain and central nervous system damage, women with PKU that's not well-controlled before and during pregnancy are at increased risk of having babies with birth defects and intellectual disabilities. Women with PKU who follow prescribed diets before and during pregnancy have a better chance of having a healthy, normal baby.

​Many insurers cover medical formula, supplements and some low-protein modified foods for treatment of these disorders. However, the Kentucky Metabolic Foods and Formulas Program can cover many costs denied by insurance. Proof of insurance denial is required to qualify for KMFF program assistance. Contact the program to obtain the required forms and information.

If you have insurance and your metabolic claim has been denied coverage in the past, you have the right to file an appeal.

Documentation

For Metabolic Foods and Formulas program call:

(502) 564-2154

Metabolic Clinics In Kentucky

University of Louisville Metabolic Clinic - (502) 588-0850
University of Kentucky Metabolic Clinic - (859) 323-2513

Additional Information

Contact Information

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