Special foods

MSD must check if the client qualifies for Disability Allowance for special foods.

If the client qualifies for a Disability Allowance, it must be granted before MSD assess if the client qualifies for Temporary Additional Support.

The client may have allowable health and disability costs for Temporary Additional Support where they do not qualify for Disability Allowance because:

• they do not meet the Disability Allowance income limit or
• their disability will last less than 6 months or
• they are certain refugees, protected persons or residence applicants

A registered medical practitioner or nurse practitioner must complete a Disability Allowance medical certificate confirming the client's disability, the need for treatment and that special foods are necessary. The certificate must also confirm the treatment is beneficial and of therapeutic value and that the costs are:

• additional and
• ongoing and
• directly related to the client's disability

Note when a medical practitioner or nurse practitioner indicates on the client's Disability Allowance medical certificate that treatment by another registered health practitioner is necessary, that practitioner must verify the costs of their services.

Allowable costs for Temporary Additional Support can include additional costs of special foods that a client needs because of their disability.

The cost of special foods can be included if they are:

• for additional food or food supplements beyond most people's everyday needs and
• above usual food costs (e.g. soya milk costs more than cow's milk) and
• part of a diet that has been supervised by a registered dietician, if relevant

Note MSD only pays the difference between a special food item and its non-special equivalent (e.g. lactose-free milk vs normal milk, and gluten-free bread vs gluten-containing bread).

Some examples of special food costs included as allowable costs are:

• gluten free food for people who are diagnosed with Coeliac disease or gluten intolerance (such as gluten free flours, bread or pasta)
• low or no dairy foods for people who are diagnosed with a dairy allergy or intolerance (such as soy or coconut milk alternatives)
• high protein and high calorie foods for people who are diagnosed with 'Failure to Thrive' (such as chickpeas or yoghurt)
• greater quantities of foods than is normally expected i.e. the product is not necessarily special, but the amount is (such as people who are diagnosed with 'iron-deficient anaemia' and require additional silver beet or meat in their diet)
• low or no sugar food for people with diabetes or sugar intolerances (such as whole grains like barley or quinoa or sugar alternatives)
• food and vitamins, supplements, herbal remedies and minerals when these are recommended as necessary by a client's registered medical practitioner, nurse practitioner or dietician, such as for people with terminal illnesses

Note the issue of special foods is not always straightforward and needs to be treated with sensitivity and discretion. When it is unclear refer to the Regional Health Advisor and Regional Disability Advisor [no link find out why] for more information and advice.

Allowable costs for Temporary Additional Support do not include:

• specialist foods fully funded, subsidised or provided through the Health New Zealand - Te Whatu Ora or
• extra costs of a self-imposed diet or lifestyle choice or
• the normal costs of healthy eating (e.g. fresh vegetables and fruit)

The diet or special food must be confirmed as not being fully funded, subsidised or provided by another agency such as Health New Zealand - Te Whatu Ora.

For further information about specific food items that may be subsidised through PHARMAC see: PHARMACs online schedule Special foods.

The client must provide:

• a Disability Allowance medical certificate completed and signed by a registered medical practitioner or nurse practitioner and
• proof of their extra food costs and
• evidence that the treatment is being supervised by or provided by a registered dietician, if relevant