Cigna insurance costs

Does anyone know what the costs of the Animas 2020 and Medtronic 722 pump are? I’m extremly interested in going back on the pump (now as an adult) and I’m really having a hard time finding out how much this will cost me after insurance. I keep getting tangled in red tape. I know it’s covered under certain conditions deemed by the insurance company, but I don’t want to get a sales rep too excited about me calling if I know their is no way I’ll be able to afford it. My deductible is 20%, so I’ll be paying that % of the whatever a pump costs. Also interested if I need to pay the difference upfront, or if either of the pump companies will let me do payments.

Any help or advice would be greatly appreciated. I live in the US if that helps.

I’m not sure about the Animas, but I pay 20% of the OmniPod. The first shipment was $340 and that included the PDM and 90 day supply of pods.
The cost of my subsequent shipments is $110 for each shipment of 90-day supplies

In terms of affordability, the OmniPod is a great option, just because you don’t have the thousands of dollars to invest up front…
I have probably the stupidest insurance on the plantet (Global Benefits Group inc.) and it took me 5 months to finally get my pump. Just make sure you can prove “good” control. I know it’s backwards but the better control you have the more likely insurance companies are to feel that you “deserve” one.

If you are having trouble, I would talk to your CDE or Endo about it. They deal with Red Tape all the time, and can probably give you some great tips…

GOOD LUCK!

I don’t know about Animas either but I know that Minimed has a person dedicated to working with the insurance companies to verify coverage and letting you know what the cost would be before you ever decide to go ahead with the shipment. The pump costs in the neighborhood of $6,000.00. I had to pay some of my pump cost and they made the payments very comfortable for me. Keep us posted what happens. Hope you are able to get the results you need and want.

Hi Trevor,

I have a Minimed 722, and it was about $6000. If your insurance covers 80%, your payment would be somewhere around $1200, and Minimed has a very nice payment program. I suspect they would be able to work something out for you that would get the payments down to a reasonable amount.

I would encourage you to go ahead and let the Minimed sales people start checking for you with your insurance. They have people dedicated just to working with insurance companies to get the best approval that you can get. If they want your business, let them earn it! You can always decline to go ahead and buy it once your find out what the bottom line is going to be.

Also, don’t forget to find out from your insurance what the ongoing cost of pump supplies is going to be. This is (sadly), almost more important than the upfront cost of the pump itself.

Good luck, and welcome to TuD!

Maia: I’ve been talking to an old high school buddy of mine who has the OmniPod. I’d like to go the same route as her, but the 200cc resevoir keeps stumping me. I’ve got a lazy man’s job (as far as excercise) so I’d need the 300cc. She said she shared similiar costs, which doesn’t seem that bad at all.

Donna and Brett: Thanks! I have a man in CA stating he’d pass off some personal diabetes info off to the insurance guy on their team to see if he could get me some more info. I’m definitly a “born again” diabetic, and I’m trying to get myself on the right track. I did well when I was on the pump and I cared enough about my diabetes. I’m trying to find my footing with MDIs and it just isn’t cutting it. I need the pump. Low b/g isn’t an issue as much as highs. I’ve reviewed what the insurance company thinks is important requirements for me to get a pump, so I know what is expected of me on that end.

I guess I’ll need to wait a few more days for the MM salesman to give me a call with the info from their insurance folks. Hopefully he’ll be able to throw some numbers at me and I’ll be sure to ask about how much supplies will cost too. Fingers crossed they won’t expect a huge down payment if they accept a payment plan. Let’s suppose I get one in January. I already have a new $300 deductible to meet first.

Thanks!

Most insurance companies have contract pricing for pumps that is less than the $6000 list price. I have Animas 2020 which lsited for $5995 when I got it. My copay was 50% and had to pay only $1950, so the contract price was $3800. Therefore, you need to contact your insurance company and find out which pumps they will cover and then get with the insurance folks at those companies (as stated in a previous post) to learn what your 20% will be.

Hi Maia,

Actually my insurance (BCBS) is totally backwards when it comes to trying to get a CGM. They said that I had too good of control to “deserve” a monitor. It’s pretty frustrating when the insurance company is basically saying you need to let yourself get in far worse shape before they will pay for a CGM.

I just got my demo Omnipod kit today. I’m SOOOOO excited now that I see just how tiny this pod is. I could care less how big the meter is, but this pod is itty bitty! I bet I could fit 7 of them in just one hand!

The start-up cost of the pumps are daunting. I’ve been talking to Medtronic and their sales rep got me an appt for a new Endo (hopefully one that won’t just annoy and belittle me). Now I’m leaning towards the Pod, but I’m worried that this Endo won’t really care much for the Pod.

As far as my insurance goes, I talked to a supervisor who has a MM pump, and he said insurance was a breeze with the DR I scheduled an appt with. That makes me really happy, but I’m worried Insulet comp won’t help me out with the insurance company like MM does. It just bugs me that they’re only in the office or whatever from 8:30-5. Is their customer service lacking? I like the Pod, but I just don’t want to do business with a company that won’t be there for me when I need it.

Some people complain about OmniPod’s customer service, but I have had GREAT luck with them, the rep I am working with has given me his direct line andthe hours he is in the office, so I can get in touch with him quickly and with no wait… Though as a new podder I havent had amny problems, and my CDE is really great with the pod and has me call her before i call the OP reps.

regarding the resivoir, you can always change your pod more often! I actually use a little less insulin now that I am on the Pod than I did on MDI (less correction I guess…)

that sucks! i’m sorry about that!
good luck with your CGM!

What about any DME cap? All you have to pay is a 20% copay? Cool.

DME cap? What’s that?

So I called Insulet today…Talked to a rep who was more than helpful. I asked her if I were a customer do they have a 24/7 help line. She said yeah. So I mentioned that I’d been getting home at 6ish and they were closed. She just skipped that part and said they’re open 24/7/365. Is this only true to CUSTOMERS and non POTENTIAL customers?

I just don’t want a $$$ piece of machinery and when I have an issue nobody is there to help me.

The DME cap is a maximum my health plan will pay for Durable Medical Equipment (which is how pump and pump supplies are usually categorized) each year. In my case the most they will pay each year is $2K. First year buying a pump would way exceed $2K.

Wow. That bites!

I know exactly how you feel. I payed 20% of my pump too.
When talking to reps about GETTING the pump, I found that they did not have 24.7 support, but once you getyour pump and need help with your actual equipment, I’ve not had any trouble getting in touch.
(Again, I always call my CDE first, she’s been more than helpful through all my diabetic troubles…I was only diagnosed 7 months ago!)

Again, when I called and talked to reps before I got the pump, I had to call during buisness hours, but aas soon as I GOT the pump, I had access to 24.7 assistance. I guess they reserve that for technical support…

Good Luck!

Just to set the record straight for others who might concerned about having a cap on DME, I called my health plan and they make an exception for insulin pumps and CGM and do not apply those expenses toward the cap. They treat it as DME but my plan’s $2000 DME cap does not apply.

Just wanted to check in and see if you had gotten anywhere… I’m winning the battle with GBGI right now, but not for long… I am fast approaching my DME cap…

have you gotten any headway?

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The MM is a bit over 6k with the insurance contract price including the first 90 days of supplies. Call MM and let them and your Dr do all the work. You really don’t ever have to talk to your insurance company.

It took about 2 weeks from Rx to delivery with MM doing all the work for me. Also, they don’t require any payment at the time of order; they will bill your insurance and then bill you once they settle. That process can take 30-90 days from time of shipment.