Has anyone had any luck with fighting insurance to cove Omnipod and Cgm as a pharmacy item? First the def of a DME is anything reusable. So we all know pods are not reusable. The Second problem is my DME goes up every year and it’s quite expensive. Does anyone have any experience or advice?
I suspect it will be an uphill battle. It varies between insurance companies. Here is an old thread on the topic.
Some insurance companies have insulin pump supplies and CGM supplies on both DME and pharmacy lists, but not very many. If the Omnipod is on your insurance formulary you technically should be able to get it as a pharmacy item, but you may find it difficult finding a pharmacy that will get it for you. But getting an insurance company to change their formulary? I think that would be difficult.
Appreciate your time.