traditional Omnipod (runs off Euo pods) → Omnipod Dash (dash pods) → Omnipod 5 (APS system)
They stopped manufacturing mine on Jan 1st. I was on the old Euro pod, traditional omnipod model because of my stubborn resistance to EVER upgrading anything.
A nurse told me that all the specialty pharmacies in town closed down - either during covid or during the civil unrest. But, there’s something worse than that going on behind the scenes. A diabetic at the medical distributor said she’s been having a hell of a time because they changed the medical codes dictating how its billed (as part of an effort to get distribution thru traditional pharmacies).
She says they changed it from “durable medical” to “nondurable medical,” and it broke the whole system. She says the worst thing will be pushing it through insurance (although this should be a free upgrade since they stopped manufacturing this model), somehow everything breaks because of the billing code changes.
I’m still trying to get the RX pushed through a distributor who can supply me with a dash omnipod insulin pump. I’m trying to go directly through Insulet cooperation because their the only ones I know can distribute them. They contact a distributor. There’s some new hiccup there that I’m resolving on the Doctor’s side.
My Doctor is so fed up with this process. I scheduled with a new endo in 6 weeks incase all other processes fail, but I’m running low on equipment.
Anybody have any secret sauce or experience about how to pull this off? I casually started this process 6 months ago, but have been drumming on it hard for the last 2 months. No progress yet. I am remaining calm and haven’t started freaking out (much) yet. You know how I hate these medical catch 22 business process where there is no known way to push the paperwork through the meat grinder. Eventually this ends with me entering a hysterical rage.
Adapt Health told me they will still carry Erospods till they run out, but I just went on Medicare so I have to let them go through the pharmacy side. The good part is, it was the same copay for a thirty day or 90 day order. I have a nice bunch of Omnipod five boxes and a stash of Eros to use up. Medicare is complicated enough but this worked out well.
The reason they changed from DME to Pharmacy is that it typically is easier to get at a pharmacy and most people don’t have a deductible at the pharmacy. it also doesn’t trigger the 4-6 year warranty issue like DME does.
PM or give me a call/text sometime @mohe0001 and we can go over things privately if you want. I think you should still hae my phone #?
I’m still LOOPing btw using Omnipod Dash and the Dexcom G7 on an iPhone and loving it. Will never switch.
I can’t believe your still looping. I was wondering if all you got kicked off or not. How did they unlock the dash pods? When did they get access to those?
BTW, they called me today. Insulet caught the ball and passed it to the insurer. We will see if they catch it. If they do, its the best football play ever (and because I wrote to both companies publicly on LinkedIn. 4,000 views in a couple days). Its a nail biter because I drive really far for work and I’m scared to drop down onto MI. I gotta be in peak seasonal driving condition. This storm kinda missed us and hit Chicago.
That will buy me some time if the insurer drops the ball. https://www.youtube.com/watch?v=ssvWIQBVse8
Sorry I broke my shoulder and I’m not thinking very well. and didn’t explain. i.think I could have continued buying Eros pods there but had to switch to drug coverage, so Im stashing 5s.
They pushed the device Rx through within days. Other people around town were stuck in appeals with the insurer because they they changed the billing codes from Durable Medical to Non-Durable Medical (or something). Insurance has been denying coverage for everyone and it turns into a big fight.
I had the most successful prescription renewal of anyone. But, its good to know these options exist for anyone who simply tried to file the paperwork and does not make veiled threats on social media (and tag the companies involved). That really got business done fast and effectively. It was a highly effective strategy. I can’t believe that worked.
They didn’t successfully fill the pod piece. I got the PDM. Time to start all over from the beginning with the Docs office. God help me. At least I didn’t end up in the great insurance denial bugs that trapped other people in town for months. I gotta keep my cool, but I am seething inside.
Are you over thinking this? Call Insulet and ask them to do a new benefits check. They’ll hook you up with the company your insurance likes, who will fax your doctor a script request and they’ll handle the paperwork necessary.
I fell in that same boat when my insurance finally started covering CGM. I made things way more complicated than they had to be, trying to get the authorizations and track down suppliers and figure out how my non-Endo doc with little DME schedule was supposed to initiate this. Turned out it’s stupid simple to just call the manufacturer and let them do their thing. They’ve already worked the kinks out if the system.
I made the first call to Insulet in June of last year on this matter.
I have the PDM in my possession, so we are half way there.
I have an RX at Walgreens for both traditional and Omnipod 5 pods (which is REALLY confusing the pharmacy techs. They look like they are 12 and its clear they haven’t been doing this long. Huge pharmacy staffing problems here. Sometimes they just shut down because there are no staff).
I need the Rx for the Dash pods. I’ll start making phone calls again tomorrow.
It’s possible that I can resolve all of this by the end of the month. Emergency stockpiles of pods will be exhausted…maybe in 6 weeks, so everything is OK. I’m just mad.
I can’t believe that worked.