How often does Insurance usually allow new pumps?

Hi there,
How often does Insurance usually allow new pumps? I recently got new insurance and know im eligible to get a new pump. But i know I’m going to want the iLet when it comes out… If it comes out in 2 years, and insurance only allows a new pump every 5 years, will i have to pay out of pocket for the ilet?

I hope my question makes sense.

It’s always been four years for me. I’m not someone who upgrades right away (pumps, cell phones, or any other kind of technology), so I’ve always waited until it was time for a new pump to explore my options.

Your question is understandable. Many of us have been playing this game for a while. When I was working, I could usually get a replacement pump when the four year warranty ran out. Sometimes they wanted a good reason that the 4-year old pump could not continue in service. I found that I would just call the customer service or sales line of the pump I wanted and let them shepherd the process. They knew the right words to use.

As to very attractive new technology coming out in year two, it’s been my experience that you’re stuck until the warranty on your current pump runs out. Sometimes a company will offer you an upgrade path if you buy the currently available model and then be able to get the upgrade with little to no cash.

If I wanted to get the iLet as soon as its released, I think I’d let my pump warranty expire and keep my pump eligibility fresh and waiting for the iLet to come out. The problem is that sometimes this technology can stall and years can go by. And usually there’s a news blackout as a new model gets closer to release.

As @Pipli infers, sometimes being the first customer for technology is not always the best experience. It’s not so bad buying in the second wave. The kinks have been worked out and your overall experience might be better.

Just as a general tangent, from what I have seen, pumps are always on the later side of their announced anticipated release dates. The FDA never causes it to go faster!

Because of the glucagon component, this one may be a while. I first heard of a combined glucagon/insulin pump 6 or 7 years ago. Waiting on something like that may lead to frustration if it never materializes.

If you re-upped now, yes, it is possible you would have 3 years left on your contract when the iLet came out. But it is also possible the iLet release is delayed, and you’d only have 1 year or less when it was available, and you could easily wait that out.

Research it, call them, ask your endo. Try to get some insight on how close they actually are. One way to do that is to search the clinical trials website, and see when they are actually doing a clinical trial. They can’t release it without clinical trials first. The clinical trials go in this order (I think) 1) in-patient adult, 2) in-patient pediatric (if approved for children) 3) out-patient adult, and finally 4) out-patient pediatric.

So, no matter what their website claims, the clinical trials give a much better indicator of how close they are.

A quick check of the site didn’t give me any indication they were close, but you should look a bit closer! :relaxed:

I seemed to remember hearing or reading that the initial iLet pump would be insulin only. I think they concluded that the shelf stable glucagon would need more time. I also remember that the pump form factor would have space for the glucagon but it wouldn’t be added until after the insulin only model appeared.

Ok. Then scratch much of what I said, about the glucagon part and refer to the clinical trials site.

Insulin pump releases are so cloaked in mystery, eh?

I just switched HMO’s and Medtronic told me the insurance companies check with each other and will not allow a new pump for four years. My clinic said no, that isnt necessarily true. I wish I knew but I have never had a company allow me to purchase until the warranty was exactly one day up.

Terry, I have also read that the pump will be out but without the glucagon component. And as you said it will have the the capability for it, when they figure it out.

Unfortunately every insurance company is different. Many say four, some say five and mine is three. That being said in the 26 years I’ve been pumping, I am on only my fourth pump. I don’t do change very often. I tend to get very comfortable with what works. That being said, I can’t wait for a system that will do all the thinking for me. So while my pump is up end of this year, I’m going to wait and see. I so want the iLet. Been following and dreaming for years. But I will wait another year I think after it hits the market for all the kinks to be worked out. My husband is one who has to be the first for everything no it has burned us a few times. Anyone remember Beta machines vs VCR’s. Or how 'bout HD DVD players vs blu-Ray. Doesn’t always pay to be first.

I’ve been pumping for 10 years and am only on my second pump. What I find frustrating is that they don’t seem to make pumps like they used to. I am still happy with my Ping and would gladly use it for the next several years, but the battery compartment is severely cracked and and the screen has faded so much that it’s difficult to read. So I’m doubtful that it will last several months, much less years. The pump was apparently manufactured in 2014 (it was a replacement for a pump that also cracked on the cartridge compartment while still under warranty), which makes it not even three years old. I don’t know if companies are using cheaper materials while charging the same prices for pumps or what, but I’m pretty sure that the older pumps lasted a lot longer before starting to break down (my 10-year-old Cozmo still works perfectly).

As to insurance, I think others in this thread have gotten it right when they say it depends. I’m in Canada, but my insurance through work covers one pump per lifetime. Although, they have said that if a pump stops working they will “consider” covering a new one, but no guarantees. So I am holding off getting a new pump until I either switch jobs or one of the semi-closed loop systems come out.

That’s a good rule of thumb for technology in general. To use a really obvious example, I never install a new operating system until it has been in common use for at least a year. There will always be exceptions, of course, particularly in sensitive areas such as health care, but it’s a good general principle.

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I’m sad my Ping thinks it’s 2007 all the time…

Is it usually the warranty on the pump placed by the manufacturer?

Yes, it is the manufacturers’ warranty I referred to. Was that your questions?

I learned this when the LG Chocolate was released in 2006. I had to learn it again with the Samsung Note 7 last fall.

for me its when my warranty is up. recently i wanted to go with the tandem as animas is going out of business. i was told i have to wait until my warranty is up. so every 4 years for me.