Animas Ping/Medicare? (don't want to count my eggs before they hatch)

Hi Everyone! I am in the process of trying to get a pump. I will be dropping off my paperwork with my diabetes center so their rep can get insurance coverage. I am currently looking at the Ping (first option) and Omnipod (second option) and was wondering are they covered under Medicare? I have Medicare as well as a Humana Gold Choice.


I am on Medicare (plus regular insurance) with a Ping, but I'm Type 1. They definitely are more stringent with Type 2's and will want to check your c-peptide. I would ask the pump company to check it out for you.

I'm new to Medicare and have been reading a lot about its diabetes coverage. I read this Medicare document about Medicare's coverage for diabetes supplies. This pamphlet contains this:

Insulin pumps worn outside the body (external), including the insulin used with the pump, may be covered for some people with Medicare Part B who have diabetes and who meet certain conditions .

I'm not sure what "meet certain conditions" means but I've read elsewhere that Medicare may require a C-peptide blood test below a certain value to qualify for a pump. In other words, this test would indicate pump coverage for people with type 1 diabetes but not type 2. It's good that you're working with an advocate at your doctor's office to help with this. I believe that anyone who wants to use an insulin pump to treat diabetes should have access to one.

Good luck with this.

Also be aware that Medicare does not cover omnipod even if you meet the c-peptide requirements.

I assume that your Humana Plan is a Medicare Supplement. Medicare will pay for the pum, supplies and insulin depending on what your C-Peptide reading is. My medicare supplement plan is Plan F and it with Medicare cover the fulklk cost of the pump, supplies and insulin. It is my understanding that Medicare does not cover Omni-Pod. Also Medicare requires a 5 year warranty rather than the standard 4 years.

Thank you, everyone! I am dropping off my paperwork tomorrow at Diabetes America (my Diabetes Center) and the rep will contact the companies I have chosen to see what is covered (Animas, Tandem, and Omnipod.) I am leaning towards the Animas still, but we'll see what insurance says. Thank you, again!

I heard back from the tandem rep today. They were the first ones to call back. They are faxing over requests for the c-peptide blood draw. Wondering what the value needs to be in order to be covered, or in order to make my chances higher at being covered?

My Quest Diagnostics lab report shows a reference range from 0.80-3.10 ng/mL. I’m a T1D and my number was less than 0.10. Not sure what the coverage threshold would be. I would ask the tandem rep that question.

Thanks, we'll see what happens. Waiting to hear back regarding when I have my c-peptide

I believe that most insurance companies base their policies upon Medicare. Medicare requires that your c-peptide is less than or equal to 110 percent of the lower limit of normal of the laboratory’s measurement method. In Terry's example where the lower limit was 0.8 ng/mL you would have to have a c-peptide lower than 0.88 ng/mL.

A c-peptide test is only considered valid by Medicare if your blood sugar is < 225 mg/dl. If you private message me I will give you some suggestions on how to approach this test.

Thank you :)

Hi Brian, thanks! I messaged you :)

Thank for the info :)