I am in the process of changing jobs. My current job offers BCBS. I had no problems getting approval for the Omnipod and Dexcom over a year ago. My next job offers Aetna. I am a little nervous about going through the hassle of insurance approval all over again - anyone had any experiences with Aetna that they are willing to share so that I can be prepared (even if I need to be prepared for the worst)? Thank you!
Funny, we had lots of issue with BCBS when our daughter started the OmniPod. Haven’t heard a peep from Aetna in 3 years; they just keep paying the bills (well, 80 percent of the bills). Hope your experience is the same! Can’t tell you about their CGM coverage though, because our daughter’s not interested in a CGM.
I just recently switched from BCBS to Aetna. Got a call from OmniPod yesterday to discuss how Aetna will be covering stuff… They said Aetna is paying 100%, with no copay. That could be my specific plan, and it could be a mistake (since it’s new and technically hasn’t completely gone through yet)… but so far, so good!
I have Aetna and they cover all the expenses of the Omnipods. The PDA and all the pods. Never a problem in 3 years.
Almost 3 years with my omnipod and aetna has covered 100% once I reach my out of pocket expense. I have been very pleased with aetna. I don’t have a cgm so I hope to hear you have positive results with that as well. Let us know!
We got approval from Aetna in just days after the paperwork was submitted by the Omnipod rep. It is based on a doctor’s recommendation and records that your BG is over 7.0, that you have been to diabetes education to try to correct the problem without the pump and that it is 6 months after intial diagnosis. (Per Aetna’s website). It may be different if you are already on a pump. It does depend on your company’s plan under Aetna as to how much they pay. We pay 10% of the auto pod order which is every 90 days or so.
The test strips that go with the pod and the insulin costs are higher than some relatives pay but they are also not on a pump. We now order both every 90 days through CVS instead of the previous Medco mailorder required by our Aetna plan. It is a lot more convenient that waiting for the iced down package to arrive in the Texas heat. We do use the Apidra and Freestyle discount cards in addition to the Aetna insurance.