What happens is the pharamcy plans sign deals for discounts with one particular pump manufacturer and one particular test strip manufacturer... those are the "preferred" ones. Anything else they will charge more for.
In this case, I believe my plan "prefers" Medtronic tubed pumps. The infusion sets are cheaper than the pods for them. I had to get my doctor to write a letter to get them to cover the Freestyle strips for the PDM, as again, it is not a "preferred" brand. The problem is, these things change from year to year based on the plans negotiations with the manufacturers....
So even if , for example, Insulet changes to another strip manufacturer (as they seem to be doing) the problem won't go away.
I believe the issue of treating pods as prescription/pharmacy items will stop pretty rapidly. I'm not so sure about test strips though. What I did for test strips was to make sure my insurer "preferred" them, but then I have a choice of insurer.
I'm pretty sure pods will be billed consistently because I can't imagine insurers wanting to fight the CMS and I can't imagine the suppliers putting up with having to divine the correct billing code based on not just the insurer but the exact insurance policy.
It's not like test strips where the correct billing code actually depends on whether the person doing the blood test takes the result and uses it on a pump or for an injection!
Still, we won't know until some time into 2016 with all the delays in employer implementation.
I suspect the reason is that someone, probably a care provider, bolused the wrong person and claimed that it was because the PDMs are indistinguishable.
If I were to actually believe the "multi-pod family" explanation then I would have to wonder why on earth the ID is not displayed on the home screen and the place were you confirm the bolus. I can't imagine a family meal where two people aren't bolusing at once and where both of them don't put their PDMs down on the table halfway through the process, probably while arguing over the correct carb count for the meal.
My daughter used to use Humalog in her Omnipod; she has been using Apidra for the past several months. She also never has any issues with Apidra towards the end of the 3 days.
Thanks for the tip, I think most of the problem is that my insulin dosage is higher then most people due to the fact I lost my pancreas in surgery. Most people have at least some normal production of insulin, I have none produced by the body.
I can't imagine a family meal where two people aren't bolusing at once and where both of them don't put their PDMs down on the table halfway through the process, probably while arguing over the correct carb count for the meal.
ROFL! I generally agree with you, John, but I have a much easier time envisioning non-synchronized bolusing :-)
I have a Dexcom Platinum BG monitor that uses similar tech (skin pierce with small cannala) that is good for 7 days, and often kept on for as much as 21 days with no problem. I am sure some bean counter at the FDA made up this rule based on his fantasy world view. It should be users who decide these things.