Omnipod and insurance companies

Hi everyone,

I'm in the middle of trying to get health insurance, however I am due for an upgrade on my pump and very interested in the Omnipod. The problem is I have heard a lot of people have had problems getting it. I was hoping without being too personal or nosy if anyone that does have the pod and is covered for it and supplies, could share what insurance company they go through???? I really appreciate it and hope everyone has a wonderful holiday season!!!

I have BCBS through the State of Maryland. They have great coverage for the omnipod system. No issues with getting it at all. Once my app was in, the system was at my door within a week! You may wish to contact your local rep who can assist you with all the insurance details. Good luck!

I live in VA, but my insurace in BCBS of Maryland too. Like you said Kate I had no problems either with getting my pump and CGM. I use MM, but absolutely no hang up and within 3 days they had got my records from my Endo and got approval from BC/BS and was shipping my pump to me.

When you get your insurance situation straightened out, I'd definately contract a rep too, let them deal with the hassels of health insurance and getting approval, its what they get paid to do.

I should also probably state that they cover the omnipod in a weird way. The entire system is a durable medical good (not weird, that's usual for the pod). But since it uses test strips in the pdm, they are now considered a durable medical good. That means I have to go to a durable medical good provider and not a pharmacy (read: I can't get my test strips at CVS or Walgreens, I have to go to a local store). It works well for me, but you might want to check about it as well.

Kate, thanks for mentioning this. I'm going to an omnipod in the next couple of weeks. I also have BCBS in my state but the Omnipod rep told me after checking with my insurance that the pdm is considered durable medical equipment and the pods themselves are considered supplies. They never mentioned test strips so I will need to check on how this works.

I really appreciate all the help guys!!! It's hard enough to try and find coverage that won't cost a fortune but still allow me to get quality stuff. I really don't want to be too personal or be rude, but if you don't mind me asking. I know BCBS has a lot of plans, could you recommend any???

I have Aetna and have been told that they are one of the best insurances to deal with. No problem with the Omnipod or my Dexcom. Yea!

We have BCBS through General Motors and the Pod wasn't covered at all, neither was my Dexcom. It all depends on your individual insurance provider AND the specific policy. I was very lucky, we had to switch from HAP (covered everything) to BCBS (covered nothing) and several of us complained and worked with the BC rep at GM and they actually changed the policy. Now both are covered, couldn't believe it. Hopefully it will continue, you never know.
The best way is to call Omnipod with all the insurance information and they will actually do the work for you and check on the coverage.
Good luck, I love my pod.

I think we have the State PPO.

My HMO considers every package of pods as DME and told me the cost would be far too high to warrant getting the system.
So be very careful, and do lots of checking before you make plans!

We have the State HMO (for state employees).

I am on oxford and they covered it surprisingly with no problems at all

Mine considers them DME as well. However, DME is fully covered and therefore makes pumping less expensive than MDI for me (because the PDM is a meter, test strips are also considered a DME under my plan). I agree, one must carefully review and compare insurance plans to determine the actual cost of any insulin therapy.

My BCBS is a PPO too. They have been really great.

Thanks again everyone! It's just been really hard trying to find good or at least decent coverage that won't cost an arm and a leg. I would really love to get the pod but right now any upgrade would do since my current pump is falling apart. Any information anyone can give is greatly appreciated.