I have T1D and use a DexCom G5 cgm; I do not have a pump.
I buy test strips at my local CVS under Medicare. I complete an AOB (Assignment of Benefits) form for CVS annually. Medicare told me I could purchase any brand of test strips I wanted as long as I had a prescription for them. (Lancets are also covered under Part B.) Medicare is extremely strict about refills–it must be 90 days between refills.
I’ve been using a DexCom cgm for several years and waited until Medicare approved the G5 for coverage to try to upgrade. Medicare has some hoops to jump through to get a G5; I met all the criteria. I and my doctor provided all the documentation requested. The DME supplier contacted my supplement and said the cgm wasn’t covered and wouldn’t process a claim. My Medicare supplement also told me it wasn’t covered. After a couple months of this circus, I gave up. I researched other Part B plans and found one that covers the DexCom G5; I enrolled in this plan effective Jan. 1, 2018. My supplies arrive 2-4 days after I call in my order. DexCom makes a receiver strictly for Medicare (looks like the G4 receiver). Under Medicare rules you have to use a receiver, not a smartphone or watch and only one transmitter is sent out every 90 days. (I am not saying these are negatives, just sharing details). The Part B supplement I have covers a swipe screen receiver and sends out two transmitters at a time. This plan covers the cgm based on medical need, not by Medicare criteria–again, this is not a negative, just a comparison. Medicare plans vary a lot, You have to look at which plans are available where you live. I made a lot of phone calls to various plans to ensure I could get coverage for my DexCom items. The Part B supplement I have has a representative who handles only diabetes items; she is extremely knowledgeable and it’s a piece of cake to work with her!
I can’t address your question about Omnipod. Insulin is covered under Part D if you don’t have a pump, and it is expensive! The doughnut hole is achieved very easily. Being able to buy a 90 day supply helps significantly. I have had difficulty getting my doctor to order adequate amounts of insulin for that many days so it costs me even more. That part of Medicare is very frustrating.
It would be so helpful if Medicare published a detailed book or had a big section online about using Medicare benefits when you have diabetes. My CVS pharmacist and my diabetes educator have been the most help in wading through some of the Medicare maze. DexCom had all the info about Medicare coverage criteria for the G5, too.
I was diagnosed nearly 61 years ago. I refuse to say “I am a diabetic”. I am a person who has diabetes. I will continue to work on it, learn–and navigate insurance!