I fought heaven and earth to get my insurance to process DASH pods as a pharmacy benefit. Now I’m locked out of a pump upgrade for 3 years.
Will the Omnipod 5 system utilize the DASH pods? That was my understanding when it was called Horizon. If I have to get a new Rx for “Omnipod 5 pods” I’ll likely be locked out.
i am going to take a guess that maybe you are not locked out, especially if the item is under pharmacy benefits. Here is why. Suppose you went on a a medication for something. Lets say stinky feet. Now that medication works for a few months but your docotr says hey those shoes still smell. So here is another medication we can try.
Would your pharmacy benefit manger say oh no, you must take the first medicament for 3 years? I dont think so.
If you wish to test this out, call omnipod, or tandem or medtronic and ask for insurance verification. They will test what your options are. Hardware and pharmacy rarely mix, but the pod is different. remember these companies want to sell their devices so they will be delighted to call your insurance.
My guess is you have the world open to you for making a choice.
I think the pods are treated differently.
I got 3 pods from my pharmacy, but then decided to go with a tandem pump.
I was told that since there is no pump involved, there is not a 5 year rule to consider.
And well in my case they were correct.
I could probably refill my pods script if I were so inclined.
Perhaps a good back up to my pump, I had not considered
Seems to me like it uses the same pods…Source here: New Diabetes Technology: What to Expect in 2021