Does anyone else have problems getting their Omnipod through a mail order company like CVS Caremark or is it just me?? There have been all kinds of problems with them!!! I had problems with them getting my Dexcom’s back in the day before my Medicare/durable medical equipment covered it. Last month was my first script, so it was for the kit that had the receiver. So the doctor had to do a new script for this month and they have gotten all confused over that and tried to fill the kit script again. I hate this people so much but I don’t have a choice. My doctor also didn’t give me refills after this month’s script so I will go through hell next month as well. I have been on the phone since Friday trying to straighten it all out and each day they tell me all is good. Then, the next morning, I get a text or recorded phone call from CVS telling me there has been a delay. Today, they said it will take them 5 days to process the order. What kind of pharmacy takes 5 freaking days to process an order??? I started the process when I had 10 days worth of pods left. Also, my pods only seem to be lasting 48 hours, not 72. Anybody else have issues like this??
Here’s the info on how to prescribe the Omnipod so you’ll know what you should be seeing when you check your Caremark website prescriptions list. More often than not I find the pharmacy will ask the doctor for a change to the script that causes problems. The second number one cause of problems is someone in the office picking the wrong item from a dropdown or otherwise failing to use the e-script system correctly.
Regarding the 5 day thing… Does your Medicare or MA prescription plan require a Prior Authorization for Omnipods? Caremark is dodgy as hell but they can’t speed up PA’s.
Thanks for the reply. The PA has been done. They did tell me that.
I have private insurance and it seems to be ok. The initial order is completely different than the refills. The initial order has the controller with it. So you should get 2 scripts. One that is initial with no refills and another one just for refills.
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As far as your pods lasting 48 hours, why ? Are you running out of insulin, are they falling off or failing in some way.
When I first started on omnipod, I would change it when I got down to 50 units which is a waste, but that was something I got used to on a tubed pump.
Now I just let it run till I’m under 10 units. That usually is more than the 3 days and the grace period together.
And if I feel like my pump is low and I might run out, I just bring a pod and insulin with me and change it after it runs out.
They are so much easier to change and fill than tubed pumps. Takes 2 min to change.
So you have 200 units max. Thst means if you are using more than 65 units a day, you will run out before 3 days.
There are other things you can do, like ask your doctor to prescribe pods for 2 days, instead of 3. And U could also augment your pod with taking small a dose of long acting insulin every morning.
I use about 45 per day, but sometimes it stops absorbing or something and I just start a new one. Every time I use the grace period, I get that in reserve and I don’t seem to be running low on pods that way
Check to see if you are getting sites that are irritated that could mean an allergy and you will stop absorbing from that.
Yes, I am getting sites that are irritating. Will that cause the pod to suggest changing? I use flonase and skin tac before I place the pod. I can notice the difference in blood sugars if something has gone wrong with the pod, like a cannula leak.
Are you happier with the pod than with tubed pumps??
What happens when they fail? There’s an error code, or an error report. It’s very important to be clear about that because there are lots of different reasons and lots of different solutions! So what are you seeing?
It is hard to say because you haven’t told us why your pods are failing.
I actually started on pods because of a crazy situation.
I had bought. tandem Mobi. And had it for 6 months and I really liked it.
I traveled to Canada and I use one of the sleeves they give you to attach to me so it was out of the way. It’s the same size as an Omni pod but it is tubed.
Anyway it fell off but I didn’t know because the sleeve was attacked to my skin.
It fell off on the plane and was not found.
Tandem won’t replace it and my homeowners won’t cover it so my doctor ordered me omnipods which pay through pharmacy instead of durable med equip. Until I could figure out what I was going to do.
Turns out I really love them. Except for 1 little thing, the tandem mobi has a better algorithm. Otherwise it’s pods hands down
“Last month was my first script, so it was for the kit that had the receiver. So the doctor had to do a new script for this month and they have gotten all confused over that and tried to fill the kit script again.”
QUESTION #1. Is the Doc that is trying to write the script a primary care doc or an endocrinologist?
QUESTION #2. Is the doc writing an initial script for an OMNIPOD DASH or for OMNIPOD 5?
FACT 1. You might need to call Insulet directly for the initial script (the receiver)
QUESTION #3. How are you currently delivering insulin?
I have an End doing the script writing.
He is writing for the Omnipod 5
I still have some pods left for now.
My pods aren’t failing, they are giving me a “change Pod” message. I think I’ll call Omnipod today. It might be because there isn’t enough insulin to last me for a day. I think I am using 40-50 units a day.
Thanks for all of your replies and information.
Here in New Zealand we don’t have access to Omnipod. The only pumps funded by the health system are Ypse and Tandem. But that also streamlines things
For example you just have to have your GP send a Rx to any pharmacy in New Zealand and they order your pump/supplies from one of two national suppliers. Usually I get my supplies the next day and it costs me $0 out of pocket. Our tax bracket is 35% instead of 33% in the US so I don’t buy the idea that higher taxes are a barrier, especially when you factor in deductibles, premiums, copays etc as a defacto tax (which mostly do not exist in New Zealand, but always seems to be left out of the American calculation when publicly funded health systems are criticized for being too much of a tax burden). We don’t have any of those “hidden” expenses in our system. The only thing you pay for is a visit to your GP which can range from $20 to $80 NZD. Also, if you call in for a prescription refill you have to pay for those as well if you’re not already seeing the GP and that can cost anywhere from $10 to $30 NZD. Areas with wealthier residents have lower subsidies so GPs tend to cost more there. Any public services your GP refers you out to are $0 out of pocket and that includes things like routine diabetes care all the way to major surgery. Technically prescriptions cost $5 for 90 days but many pharmacies wave this fee. Insulin pumps and supplies are considered prescriptions just like insulin would be so they are subsidized at the same rate.
I definitely don’t miss the bad old days of arguing with DME providers. The longer I live in NZ (3 years now) the more absurd and obscene the whole process seems to me. It’s amazing that Canada is right next door with an example of how things can be done much better and yet somehow that message is almost entirely blocked from mainstream conversations.
That sounds like a nice system there in NZ.
Now, I am having problems with the Omnipod coming off every day after I swim. I think I am going to have to get some tegaderm and cover the pod.
The over patch doesn’t work.
Working with Caremark takes bulldog followup. I get my DASH pods through them. Don’t use the mobile app. Talk to them directly. The online RX record does not show the number of boxes you will get so you can’t be sure it’s correct in your order. If the quantity of boxes is wrong (my Dr screwed up on my first Rx) Caremark will not correct it so you end up getting hosed on your copay. So be sure to ask “how many boxes?” in the order. The main record online will show 5 pods per box but no number if boxes. Useless to us and customer service people!
The 5 business days processing before it gets shipped is their normal. Once you get the first Rx through, plan to call as soon as your insurance will let you renew. This will let you build up a bank of pods. Only a 10 day supply on hand would make me nervous.
You will need annual pre-authorization from your Dr. Caremark will do this but you need to keep track of your annual date because this step is slow. You will not get a not get an advance notice only a “can’t fill the Rx now” when you refill. If you forget the annual, it will take 2-3 weeks to turn that around then they will fill the Rx. But… Call them back as they often don’t automatically fill the pending Rx when they do get the authorization.
Never trust them to prefill your Rx on a certain date. For whatever reason, it just doesn’t work and you’ll be waiting thinking it’s on the way and it’s not even in the hopper.
I find it worth the trouble to use the CVS mobile app to track my dates and refills.
Initially your Dr writes an Rx for the starter kit that gets filled once and an Rx for pods with refills. Keep track of the latest Rx number on the box. It will help in working with Customer Service.
IDK if Omnipod 5 has any additional rules at Caremark. I don’t swim so no help on the coming off early. My Rx is one pod every two days so I get 9 boxes a whack.
Grit your teeth and just plan for the extra time for follow ups to them. Good luck and best wishes!
One other thought… Is your pod in a location where your bathing suit might be moving it slightly as you swim? If mine are in a place where repetitive motion moves the pod ever so slightly I get a red welt at the site.
This is great advice for anyone placing mail order pharmacy orders. OptumRx has the same problem, doesn’t show qty, and I call in my orders. Instead of asking the rep I specify the quantity e.g. Omnipod 5 Dexcom G7 and G6 Pods 9 boxes. Novolog (or whatever) U100 10ml vial quantity 5. Doing that on a recorded phone call takes away all the opportunities for the usual shenanigans like sending a 30 day supply instead of 90 or shorting you a vial of insulin.
For pharmacy benefits that require a PA, a new PA is required for each new prescription. So just getting started with Omnipod 5 requires 2 PAs. Every time your doc sends in a new script they’ll have to do a new PA.
Thank you for the very detailed advice on CVS Caremark. I know you meant well, but they just suck. Nothing that you said could explain the miscommunications that I received from them. I’ve already experienced the things you mentioned when I had my Dexcom prescription with them. I cringed when I found out that my pods would have to go to CVS Caremark. I love my local CVS pharmacy. It’s sad they even have the same name.
I’ve found while swimming that repeatedly diving and resurfacing even with depths much less than the 25ft maximum will kill the 'pod.
I’ve certainly found that tight clothing can cause major problems particularly if it causes or exacerbates perspiration. I do wear my 'pod under my [lifting] weight belt and that’s fine, though often somewhat uncomfortable, as the weather gets hot though it stops working. I’ve had two 'pods fail in the last couple of weeks with adhesive detachment and a bent canula under the weight belt.