Medically necessary pasteurized donor human milk and donor human milk-derived products for a covered infant when a written order is issued by a licensed medical practitioner. The milk must be obtained from a human milk bank that meets the quality guidelines of the Massachusetts Department of Public Health. The covered infant must be: under the age of six months; and undergoing treatment in an inpatient setting for a congenital or acquired condition that places the infant at a high risk for development of necrotizing enterocolitis or a congenital or acquired condition that may benefit from the use of such human breast milk as determined by the Massachusetts Department of Public Health; and medically or physically unable to receive maternal breast milk or participate in breastfeeding or whose mother is medically or physically unable despite receiving lactation support to produce maternal breast milk in sufficient quantities or caloric density.