I have been notified that Medicare will not pay for pods and for a 3 month supply I must pay $3588 unless my private insurance would pay it. Keeping fingers crossed.
Nancy
Where did that crazy number come from?! Yikes!
If pods are roughly $30 a pod (which they very well could be more now, I’m not sure), and a box holds 10, that’s $300 a box. Even if you change every 2 days for a 90 day supply, that’s only 45 pods. Which is 5 boxes that you’d need to buy (max). Which should be $1500 right? You’re already on the pump right? You’re not buying a new PDM or something too are you? I’m just having trouble figuring out where that number came from…I mean even if you said a pod was $45 a pop, that’s still a little over $2K…
I hope that your private insurance will kick in to help w/ the cost! Crossing my fingers for you 
I thought they were less as well but the letter I got said pods were $39! I get three boxes for three months and the letter was from Insulet
WOW…
.I am on Medicare Nancy …My insurance will not pay for anything medicare will not pay for.
At first I was told I was covered…then 8 mos later the ins co said…OOPS, sorry , we made a mistake. If medicare won’t pay for it , neither will we…
The PDM was paid for, because of the mistake…,But NOW I have to pay for my pods… I pay
$300 per box, and I get a 3 month supply at a time…
My fingers are crossed for you, Nancy
Did that number, the $2588, come from INsulet? I wouldnt be surprised, they seem to have a very bad (perhaps too green) accounting dept…as they have given me bad info many times in the past. I would think, as Bradford points ouit, that a 3 month supply would run about $1,000 MAX. I also will be crossing my fingers for you!
I imagine the difference in amount it will cost has to do with how much insulet charges an insurance company vs what they charge a straight up cash paying person. If it turns out your insurance will not cover it ask insulet if the pricing would be different if they consider you a cash paying patient only.
+1
I am mailing the request today and will let all know the results.
The letter is for ABN advanced beneficiary notification and it states that an Onmipod box of 10 would cost $299 and that Medicare will only cover BG monitors and insulin for pumpers only. Medicare does not cover omnipod medical supplies and the reimbursement rate is zero. I have 3 options 1Pay now and have medicare billed for official decision,2- don’t bill Medicare and opt to pay now but this can’t be appealed to Mdeicare- this may help for private insurance to cover.
I misquoted estimated pod cost in a previous post: estimated cost:$45/pod.
Thanks to Bradford, Dee and Denise and all others that posted.
Nancy
I just had to pay for a 3 month’s supply out of pocket and it was about $840. And I think you can get a discount if you don’t have insurance.
I will post after my insurance is reviewed.