United Health Care to begin covering Tandem insulin pumps

WRITTEN BY: Lala Jackson

On July 1, 2020, United Healthcare (UHC) announced they will begin covering the Tandem t:slim X2 insulin pump for members on Medicare Advantage, Medicaid, individual and group market plans, a departure from UHC’s four-year policy to only provide health insurance coverage for Medtronic insulin pumps.

Actual dollar coverage amount will vary from plan to plan, but the decision to provide coverage for more insulin pump options is a major step for people who require insulin to survive and prefer an insulin pump, shown to improve quality of life, as an insulin delivery system.

UHC previously only provided coverage for Medtronic insulin pumps, a policy that was criticized as limiting choice for people with Type 1 diabetes and insulin-dependent Type 2 diabetes, particularly because UHC is the largest health insurance company in the US. The Medtronic-only coverage policy previously applied to adults, then expanded to children on February 1, 2019, a move condemned by the the diabetes community.

JDRF’s Coverage 2 Control campaign put heavy pressure on UHC, calling on members of the diabetes community to voice their concerns not only to UHC, but to all insurance companies with policies that limit choices of care for people with diabetes.

Different insulin pumps have different features, usage methods, and dosing capabilities. This makes choosing an insulin pump system extremely personal. Each insulin pump company – currently Medtronic, Tandem, and Insulet (makers of Omnipod) in the United States – utilizes different types of infusion sets, has different delivery and setting capabilities, and unique customer support. Medtronic and Tandem both have closed-loop systems available (Omnipod’s closed loop system is coming soon) with different continuous glucose monitor (CGM) integrations and different algorithms to manage blood sugar levels.

For many users, the ability to choose between types of insulin pumps is not only one of personal preference, but of true safety. For example, in 2017 the Porter family had to fight for coverage for a tubeless Omnipod insulin pump for their son Colton, who lives with autism and required a non-tubed insulin pump for sensory reasons.

While Beyond Type 1 applauds the decision to include the Tandem t:slim X2 insulin pump as part of UHC’s coverage, as a matter of safety and health, further reliable and affordable treatment choice is required for all people living with diabetes.

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Wow, I wonder what provoked this change in policy. Maybe all the lawsuits scared 'em.

I bet this is a preemptive effort to stay as far away from the patients VS medical system fights that are heating up. They are all filing suit and policy changes today. Strange. Seems they have all been talking to each other.

Great news, thanks for posting.

United health care was purchased by Kaiser Permanente. Generally kaiser offers 3 options. They added tandem when animas went under.
Right now it’s Medtronic, tandem, and omnipod
I’m sure they are trying to align the two systems. Soon the branding will change too.
I have been happy with Kaiser. However they change very slowly. You can petition them if something you need is not on the formulary. I haven’t tried that though.
25 years ago I was on Novo beef insulin because that’s what I was always on. Kaiser switched me to
Humulin then to Humalog with no warning. I can see where this could be a problem for some but I actually welcomed the changes.
And I could eat hamburgers again! Well maybe it was healthier before hard to say.

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I can’t find this story. UHG is the largest insurer in the nation. How could Kaiser afford that? I’m seeing a lot of interesting stuff, but can’t find their specific relationship…help!

I think you might be right, but it might be the other way around? Maybe Optum (a subsidiary of UHG) bought Kaiser? I’m not sure.

https://copehealthsolutions.com/cblog/learning-from-kaiser-and-optum/

Yup, here it is…UHG bought Kaiser. I did not know that. Thanks for the update!