Insurance: Using Animas and OmniPod...?

So as I posted earlier, I'm on the OmniPod now, and I like it...when its working. Sometimes I get so frustrated when a pod errors on me I just go to shots for the rest of the day because I don't want to change my pod again. And that is causing me high blood sugar readings.

So I've had my doctor write me a note and sign the prescription for the new Animas Ping. The Animas rep said that should be okay for my insurance to approve it, because my doctor wrote the letter explaining the situation.
(Usually, with my insurance [Regence], if you have had it for less than 3 years--I got mine June 2011--its still under warranty in my insurances mind and they won't approve you for another.)

So what I'm wondering is--if they approve as everyone is telling me they hopefully will with my doctors letter--will I be able to switch back and forth? Has anyone tried this?

Ideally, I'd like to use the OmniPod in the summer and the Animas in the winter/fall/Spring time. However basically, depending on the situation, I want to switch between them spradically month by month (not daily or weekly).

Would my insurance, if they approve the Animas, still allow me to get OmniPod pod refills as well as the Animas infusion set "refills"?

Does anyone know anymore about this they can share?
thank you!
Danielle

No, I don't think they will. As far as I know, unless there is some really extraneous reason, insurance will only pay for one mode of treatment and will not cover the costs of two different pumps. Once your supplier bills your insurance company, the other company would not be able to bill for whatever length of time you've just ordered supplies for (the claim won't go through). Now, they might let you alternate (i.e., one month you get Omnipod supplies and the next month you get Animas supplies), but even that I'm not sure about. If they do allow this, though, you might be able to stash enough extras to go between pumping devices.

However, for consistency in treatment, I would think it'd be best to stick with one pump (in this case, the Ping). This will keep all your data in one place and give you the best info to identify trends and patterns.

I even previously ran into problems getting basal insulin paid for by an insurance company. Their "perspective" was that because i was on the pump, I didn't need a prescription for basal insulin. Seriously, I had to call them and ask what I was supposed to do if my pump died on me and go through a brief appeals process to get the basal insulin paid for.

I agree insurance is only going to pay for one of the pumps...either the omnipod or the Animas but not both, I don't think they will pay with alternating supplies. I mean the reason u are wanting them to pay for a new pump is because the Omnipod isn't working well. If it in their eyes is working well enough for you to alterate with, I imagine then they are going to say you don't need the animas pump until your warranty is expired.

I also agree that consistency in treatment will be best achieved with using only one pump.

I would only switch off every several months or at least when my Pods are not working.

But I have come to the conclusion, unless I fall in love with the Animas (a nice person on here offered me to borrow their old one to "try out") I will probably be purchasing a "used" one and then have both!

Thank you!!!

From an insurance perspective I don't think they would approve, but it's worth trying.

I would not recommend the Animas Ping, based on my experience on calling the support line that states, 24/7, they take too long to get back to you if you have an emergency, no consistency in their CRM system to follow upon your pump history, we asked to have a pump trainer stop by and they declined to set up an appointment. We needed some extra infusion set's while traveling and after 14 hours of waiting they referred us to the order desk, who declined, since they could not find our Rx for infusion sets, another indication that their CRM system does not communicate with all departments.
As you know as an insulin pumper,you cannot have the delivery interrupted, which will result in high glucose reading.
Save your insurance dollars, do not buy the Animas Ping.

I think since Johnson and Johnson Life Scan took over Animas the support has declined, I would not recommend the Animas Ping. Last time we called the support line, it took over 12 hours to get a competent person to call back, 24/7??? Once that delivery of basal rate is stop, the blood sugar can spike fast.

I agree that your insurance company probably won't be interested in paying for supplies to maintain both pump systems.

A cannot disagree more with Tough Type1 concerning the Animas Ping. The customer service that I have received in the last year from Animas has been nothing less than steller. They handled all the paperwork necessary for me to get the pump, through two attempts. The first attempt was declined by my insurance carrier. They never gave up. When I finally got my pump approved, they have stood by me through wonderful pump training, excellent customer service with supplies and tremendous telephone support whenever I have a question.

I understand all the horror stories with the Omnipod. While I have no personal experience with it, I can understand why people can become frustrated with it. I have had no problem with the tubing on the pump. I usually carry it on my belt, although it has been carried successfully in a pocket or under clothing. It stays warm under a coat. (I live in a cold climate) The pump has never failed. I like the meter communication, the colour screen and the failsafes that are built into the operation program. The infusion sets have their own inserter which is very easy to use.

Personally, I don't know why anyone would choose another pump.

Good luck, keep us informed with how this project is handled.

Be well.

Brian Wittman

Thanks guys! I'm getting someone to lend me their pump so I will be able to see how it is before I "buy".

I honestly have loved the OmniPod from day one...just the times I have had pod errors (only the last two months I've had it) have been frustrating. I should be more patient because I adored the omnipod with no fail for a while...

maybe a part of me...a small but large (really) part...is just major curious if I'm missing out on something with tubed pumping...maybe I would like it more because I never got to try it...

I don't know but well see with this "trial" if it is worth it. But in all serious, the OmniPod is amazing.

Brian, I chose the OmniPod for some of the reasons that you state that you don't have a problem with the Ping. I was already a Dexcom user when I recently started the OmniPod so I don't want to have to carry a pump on my belt or in a pocket because I already have the Dexcom receiver. And the insertion devices with some pumps intimidate me. I also don't want to have to deal with tubing.

So, for me, the benefits of the OmniPod being tubeless and not having to carry the receiver and having an automated insertion process outweigh any frustration that may occur with pod failures. That's why I chose OmniPod.

We're talking about treatment that involves technology and you're going to have frustrations no matter which you choose.

I think it's a very personal decision as far as choosing a treatment plan, whether to pump or not, and which pump to use, and emotions come into play as well. I don't think it's fair to any pump to imply that one is better than the other, particularly if we haven't actually used them all.

Good luck, Danielle, in figuring out which pump works best for you right now. :)