Hi…I am now an Animas user and it’s fine, but I used to be an Omnipod user and loved it. I don’t think it is generally known, and it really should be, that Medicare does not cover Omnipod at all. Anyone near retirement needs to know this. I wish someone would research this. It’s a BIG problem. I would go back to Omnipod if I could. Is this policy expected to change? Michou
I have mentioned this problem about medicare. I am on medicare (medicare advantage plan) and paying out of pocket for the Pods. Originally, my ins co said I was covered…8 mos later they said “they made a mistake”. I see no reason why Medicare can pay for other infusion pumps but not the Omni Pod. Doesn not make sense!
I am trying to fight this by contacting my local govt reps. Working on it!
Government is always inefficient and slow. It’s taking them a long time to learn about the insulin delivery device industry evolution. Hopefully this will change soon.
The more of us that work on it, the better! I haven’t been able to get a straight answer as to why Medicare doesn’t cover the Omnipod. Thanks…
I am in the same position as you MICHOU. I will be on Medicare July 1st this year and I already know that Medicare will not cover it. My insurance agent says I need to submit a copy of the original prescription by my doctor and then Medicare may (or may not) pay me 80%. I am not holding my breath till that happens. In the meantime I am trying to decide what traditional pump to apply for, and who knows, maybe Medicare will decide they don’t want to pay for that either.
When I called Insulet to inquire why my “auto ship” supply of pods had not arrived is when I learned that “Insulet” is not on Medicare’s list of ‘approved providers’. Supposedly Insulet has submitted paperwork every year in a timely fashion to be approved and every year Medicare ignores their application.
For now, I have 2 months left with the OmniPod and then I am SOL…
Thanks for your reply…I went on the Animas Ping, and I am ok with it. It’a a good pump, but I miss the freedom of “no tubing” Medicare did pay for the pump and is paying for the pump supplies. They pay 80% and a supplemental insurance ( I have AARP) pays the remaining 20%. I am so grateful that I’m covered, but I just can’t understand why Insulet is not an approved provider. Good luck!!! Michou
While reading the Animas Ping literature I noticed something that I don’t understand. Maybe someone here can explain it. The literature says "When new technology from Animas becomes available, the Animas exAccess Upgrade Program gives our pumpers the opportunity to upgrade to our newest technology at an affordable price*.
*Limitations apply. Patients covered by Medicare are not eligible for this program.
Why are people on Medicare not given the same opportunities as anyone else???
I don’t think they are giving Medicare the same price break. It may all come out in the wash for you. If they cover the insulin pump, you’ll have your 80% coverage most likely. Pretty much they are just taking advantage of the government. Medicare has certain replacement guidelines and it may have more to do with the process for replacing the pump.
The information presented in the brochure I received from Animas Ping hints that there is a deal in the making with incorporating the Dexcom technology into the Animas Ping. So if and when that happens, people on Medicare will not be able to upgrade unless they want to pay for a whole new system?? Are all tubed pump companies like this and prevent people on Medicare from the privilege of upgrading?