Well this is a new year, so new deductible to be met. Mine is $2700 thru UHC (retirees benefit)
My deductible goes towards medical or pharmacy-so both! Ugh!
I always get it confused, because I order both Omnipods and Dexcom sensors thru ADS.
One goes thru pharmacy (I think it’s the pods) and Dexcom thru DME, I think.
Since my deductible had not been met, I paid $518 for 15 pods just now. I’m waiting a little while to order Sensors as deductible should be met soon.
I paid $60/box for sensors last year, and $128 for 15 pods last year.
Yes, to other person posting on this, I had tried Edgepark as UHC said, but their prices quoted were higher than ADS.
IMO the people at ADS are the nicest to work with.
Please keep me posted on what you find out, and I’ll post my cost after deductible gets met.
Yes, I’m still getting pods and CGM sensors thru ADS. My wonderful $2700 deductible is met! Yippee! I guess😂!
Last pods were about $86. I think that’s thru UHC pharmacy
Will order sensors soon
Hope y’all are getting yours all figured out!!
I just started the process all over again through Insulet. They are now an in network provider of the pods (as DME, which I have a deductible I have to meet before they are covered). I will update on how that goes. Appeal was denied by UHC but I am optimistic this is because of this new change and that Insulet will be able to get it approved.
Hi Sherry, I am just wondering how you are able to get your pods approved by ADS through pharmacy. I was told they needed to use DME and that it wasnt covered under my pharmacy benefits anymore. Did ADS order them through the UHC pharmacy for you? I’m restarting the process for DME through Insulet but UHC is once again dragging their feet and I am now dreading that the worst case scenario is about to occur and I’ll get denied again.
Please keep me posted. And can you let me know the copays?
I will look at my EOB’s to determine if the pods are going thru DME and let you know, ok?
Is there a reason you don’t want to go thru DME?
Other than maybe your deductible?
The reason I am now trying again to get it filled as a pharmacy benefit is that they have denied me three times as DME but it was easy breezy getting it as a pharmacy benefit (and cheaper). I may have just figured out what happened, in which case I will be extremely relieved and also a little bit pissed off that this information was not somehow relayed to me sooner. UHC automatically opted me in to getting the pods through Optum RX however I need to opt out of that for ADS to fill the order since it was being denied. According to Optum I received a notification of this, I read my mail pretty closely especially from my insurance company and I don’t recall ever getting anything. Hopefully this works though!
Geez, they never make it easy for us huh?
I ever got pods thru Optimrx so maybe that’s why, but I also never got anything to opt out either.
Good luck!
Do you purchase them as a DME benefit? Im now being told that the plan I am on stopped covering them as a pharmacy benefit in December so going through ADS at this point is not an option.
Well more great news😡
My pods are going thru pharmacy benefit with no problems, BUT my PDM is out of warranty.
Figured that would be no big deal-PDM is $500 and I pay 20%=$100!
UHC has denied the PDM saying it is not cost effective, so am getting doctor to appeal!
So they pay for pods thru pharmacy but you don’t get the PDM to use them???
You have to laugh instead of cry at what incompetent, uninformed, uneducated people that make these important decisions.
And they say you should try and have low stress!!??
Is it broken, or just out of warranty?
If it is working, you wouldn’t need to get another one.
If you want a different one, maybe waiting until the new Dash PDM comes out this summer would be worth it for you and getting that one.
Or waiting until the Dash PDM comes out, and then being able to buy the old-style PDM from eBay, because people will then be selling them off.
Ok I’m going to look that up to see what new things are in the Dash PDM.
Thank you.
It’s working but having some hiccups. I do have a spare that they sent me which was so nice, but don’t think they can do that again.