Medicare Plan Coverage OmniPod & Dexcom

Type 1 and LADA
1

I need to select a Pard D or Advantage plan that covers Omnipod 5 & Dexcom G6. Would appreciate any suggestions.

Thanks Andy

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Andy,

I believe either part covers Omnipods. I like the flexibility of Part B and I like the separate Part D.

It is better to contact a medicare insurance advisor. There are several in all areas. They are free and they will take a list of all your meds and they will give you the options. Honestly there is no right or wrong answers and everywhere is different.

again it is free and you will get good answers.

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Under Medicare, Omnipods always fall under Part D pharmacy. Dexcom G6 is Part B. Whether you go for a Part D plan or an advantage plan, it will be tied to your particular circumstances and preferences. Advantage plans are cheaper, and offer you some extras. But you are tied to using their doctors, their particular formulary lists etc. That’s how they cut down on costs to offer you other stuff. Medicare so far has been pretty liberal in what they cover and you can go to almost any doctor, and most Doctors take Medicare. But you will have copays. I have a supplemental/Gap plan that covers any payments so it doesn’t cost me anything in copays or the donut hole gap at the first of the year. My husbands past employer’s policy automatically switched to a GAP insurance when we hit Medicare. Employers sometimes offer supplemental/gap plans with Medicare so you want to check that out.

But once you pick an advantage plan, I have heard it is a problem to find a Gap insurance if you want to switch back to regular Medicare, plus I believe you pay a slight penalty for the time you weren’t paying for Part D.

ttps://www.medicare.gov/drug-coverage-part-d/how-to-get-prescription-drug-coverage/6-tips-for-choosing-medicare-drug-coverage

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I called last week. We’re pretty low income, and I was getting nervous. Need to make a decision by October. I wanted to stick with Aetna Part D, because my husband has that and it’s working pretty well. But they told me he has a different plan. I would need to do the “Plus” plan, pay $70 a month for that, and then pay for pods and insulin. We didn’t even get to the Dex. I was pretty surprised. The DASH and the 5 are both “Preferred Tier 3”. Didn’t expect the DASH to be there, since it’s not the newest model. None of this is particularly fun.

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