Insurance & Insulet OmniPods

I have very successfully worn an Omni Pod insulin pump for many years as a legally blind diabetic. It is great, Omni Pods have been a life saver for me. Unfortunately, this past March I was laid off from my job of 15 years and no longer have that insurance (Blue Cross/Blue Shield). I now have an Obamacare type insurance through my state. The insurance I have WILL pay for the pods. However, Insulet Corp. will NOT accept my insurance (!) and I have juvenile diabetes (Type 1, onset 50 years ago.)

Does anyone know of an organization, a group, a non-profit or any other place that can be a middle man for me? Insulet rep said that they would accept 3rd party payments, so if I can find a 3rd party to pay then, let my insurance company reimburse them, I think this will work.

I am desperate to stay healthy and be free from 4-5 injections a day, which I never did well on anyway Nor have other pumps been simple or accessible enough to use well. Has anyone else experienced this kind of seriously troublesome situation? What did you do? How did you manage?
Thanks very much.

Is Insulet actually refusing your insurance, or are they out of network for your insurance?

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Thats strange…if your plan will pay for Pods…then they SHOULD be contracted with Insulet. Although some insurance plans will pay for the supplies but you have to use a contracted supplier (Edgepark, Liberty) I have had both Medtronic and currently a tSlim. My insurance wouldn’t pay directly to Medtronic or Tandem for my pump or supplies, I had to go through a contracted supplier. I am currently using Edgepark. That may be the case in your situation. Contact your member service department on your insurance card and see who their diabetic supplies contracted providers are. That is most likely the case. They are contracted to deal with a supplier and not directly through Insulet.

Here’s Edgepark’s website…it looks like they do supply pods.

Your health insurer may not have a contract with Insulet if their negotiated “bulk rate” is significantly lower that the price offered by other contractors. For example, I don’t contract with a very small handful of health insurers because their offered rates are so much lower than everyone else’s that they won’t even cover my overhead costs.

I believe it is Insulet refusing this insurance. I was told by my insurance company that they would most definitely pay for the pods, considered durable medical goods. But the Insulet rep I spoke with said they do not accept this insurance. Makes no sense to me.

This makes sense. Thank you for the information. I’ll be following up with the 3 players here and see what happens. Thanks so much!. I’ll let you know how things play out.

I would contact the insurance company & ask for a list of in-network DME suppliers. I’m surprised Insulet didn’t refer you to one. Tandem is not in-network for my daughter, but they referred us to the supplier we use.

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Thanks to each and everyone of you for all of the very helpful information. I now have a game plan! Will let you know how things pan out.


That’s exactly what Tandem did for me too. I didn’t want to use Liberty again…and my insurance contracts through either Liberty or Edgepark. Tandem referred me directly to Edgepark and they processed my order for my tSlim and all the supplies. I imagine DJ15 that is how your insurance is set up. They use a supplier such as Liberty or Edgepark…versus contracting with various companies Insulet, Medtronic, Tandem. Makes payment easier when you are only dealing with one or two medical suppliers versus 4 or 5 individual companies. Good luck. Let us know how it works out. I’ve been really happy with Edgepark and working with them to get my pump and supplies.

I suggest comparing Foundation Care ( – they are like Edgepark, a third-party resource that can often navigate durable medical equipment (DME) obstacles for you by running the supplies through your prescription coverage…

Thank you, Mitch. If this last effort I’ve made doesn’t work out I’ll try the Foundation. This is a good resource.


Does anyone know of any Medicare Advantage Plan which covers Omnipod?

Hi I have a 3000 deductible and was interested in the omni pod and the pods id their a way to get some of the supplies covered


Hi Chris,

I have a $3,500 deductible with a government Marketplace insurance. (Obamacare). Premiums are $240 p/m. I use Omni Pods and love them. CCS is the distributor that sends me the pods every month. However, I am only billed for the pods every quarter. It is about $380 or so, varies a little each time as the deductible goes down. In the end, with a $3,5000 deductible I am only getting one month paid for by the insurance company.

I have not been able to find any work around to get help with these expenses. It’s terrible. The only bright light is that Insulet was kind enough to help by sending me a few free pods while I was trying to get insurance lined out. Insulet is a great corporation but pods are not cheap. Nor, insulin as you know.

Unless this current congress is willing to do something with our healthcare situation and not use it as a personal political tool (and it doesn’t look like they ever will), it looks like people who have insurance through the government and use insulin pumps and pods will eventually have to revert to multiple injections again.

Wish I could help, knew of something you could do. Check with Insulet, your insurance company, healthcare clinic, pharmacy, etc. to see if any of them have programs you are eligible for to help defray costs.

Good luck!