I switched to a HSA deductible insurance plan this year and had to get my omnipods through Liberty (they are the only in-network provider). They charged me $507 for a box of 10 pods - even though getting them directly from Omnipod without insurance costs only $300. Still, if I wanted the costs to be applied to my deductible, I had to go through them.
I’m pretty outraged - insurance companies are supposed to negotiate better prices for consumers not worse.
Has anyone else had a similar experience?
How much do others pay for a box of 10 pods through their insurance?
Not as dramatic, but I did, when I first started with Animas. My insurance wanted a co-pay of $60 for a box of pump cartridges, but the non-insurance price was told to me at $41. My endo fixed that, though, because I need to change sets more often than every three days, so I get two boxes for the same co-pay. Recently, they changed the level of that supply, so the copay is now $35 for me…
I believe my costs would have been less than what you paid, but still more than the $300/box (more like $390).
Looks like the issue is a fixed copay for a particular tier of medication/supply. Your HSA should allow you to purchase the pods retail, either using your HSA account and submitting the invoice, or paying out-of-pocket and submitting claim to your HSA account. The big issue is whether you’re better off paying the extra $207 per box to meet your deductible, or just paying the negociated prices for the rest of your medical care for a longer portion of the year.
FWIW, and I’m T2 on oral meds — no expensive insulin costs. The only time I met my high-deductible plan’s deductible was last year’s bicycle crash with head injury. If my preferred brand of test strips aren’t covered to the point of being cheaper than I can find them from a reputable online source (e.g. American Diabetes Wholesale), I’ll order online and pay out-of-pocket.
