Updates on Medicare Coverage of OmniPod?

Hello, I have been unable to use the OmniPod since I went on Medicare approximately 3 years ago. As of January 2016 they were still recycling the Pods. When did this change?

I was told by an Insulet technician at least two years ago that Insulet would no longer support the recycling program, and that I should not ask for recycling supplies anymoreā€¦ so I stopped. Was I misinformed?

You should ask ā€œhow much do I have to donateā€ for an interview. The lobbyists donā€™t seem to have a problem accessing our ā€œrepresentatives?ā€ do they?
Just sayingā€¦

I was turned down by BC/BS for a DMD pump because I didnā€™t fit THEIR model/mold. I was able to finally get the omnipods through my prescription medicine (RX) provider instead of as a DMD. Perhaps you could find a part B coverage where they might cover the Omnipods as a prescribed item. I hope that I will remain covered when my BC/BS becomes my part B providers in a few years. I also love my pods. My prescription provider considers them as a syringe instead of a pump device. This also means that my copay is lower than the ā€œdurable medical deviceā€ of 20% would be. They actually ended up helping me by turning me down, in the long run. I use better living now because they know how to code it. I found out about this by reading this board on an earlier post. :astonished: The omnipod people (Insulet) were oblivious to this and said they knew nothing about this, but it worked for me just as it did for that earlier poster. Good luck guys.

Are you currently on Medicare,or is that what you referred to when you said
Blue Cross would be your Part B provider Ā³in a few yearsĀ²? My current
insurance pays for my Pods right now, too, but once I lose that insurance, I
am out of luck. All of the other supplemental insurances I have found just
tell me, Ā³If Medicare does not pay for it, we do not pay for it.Ā² End of
discussion. The key, thus, is to get Medicare to recognize that a pump is a
pump is a pump, no matter how the infusion sets or Pods are connected to it.
I believe that Medicare WILL pay for a new PDM if I need one, but they will
not pay for the Pods which are simply the Ā³infusion setĀ² for the OmniPod
pump. This is very, very frustrating.

tudiabetes+299017151f030fc1e08c2dff348606e9@discoursemail.com

I agree, the system is really bad. I have not started medicare but donā€™t look forward to it. When I start, my BC/BS becomes my part B provider with no drop in cost. I am hoping that I can still get my pods through its prescription provider, which is how I get them now. If they would rather I go to a higher priced pump system I would still rather keep the pods. Cross that bridge when I get to it in a few years. Maybe by then Medi(donā€™t)care will wake up.

Good luck. I would not hold my breath if I were you. For most companies,
if Medicare does not pay, they will not pay, no matter WHAT your former
coverage was all about. I am just trying to figure out how to pay for the
Pods myself so I do not have to go to a tubed pump. I also understand why
some people keep their Pods on until the total 8-hour grace period runs out.
If I get eight extra hours out of each Pod, then for every three days I have
saved a a full day of use from another Pod. Thus, if I do this for nine
Pods, I actually get a whole three-day Pod use ā€œfreeā€. It is a sad way to
live, but in the end if it stretches out how many Pods I use and must pay
for, it may be worth it. I still fail to understand why our government can
regulate so many things, yet they cannot regulate how much companies charge
for medical devices and for live-saving drugs. Sad, sad world.

Sherryann
tudiabetes+48f866a1875aaca23c2232f6e30e2e57@discoursemail.com

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