Which New Pump? If you have no insurance?

I"m contemplating a new pump. Thinking about holding out for the 780g or just buying a tandem, omnipod etc. It appears omnipod is more like a subscription model where you pay monthly for pods where the others are more like one time acquisitions for the pump and then you just buy infusions sets and resvoirs as needed. I assume this is OK if you have good insurance but thinking maybe more added costs for POD therapy? Certainly being on a tube pump for the last 20 years this could be something different. The other wild card that we don’t have much control is the CGM. This cost is relatively high like DEX compared with Libre 1 or 2. I see pump companies who have made announcements to start working with Abbott to provide choice and even tidepool in the mix. I think Abbott is a game changer and keeps the cost down but is lacking integration. No real results yet just announcements. DEX will always be high until Abbott is offered as another option. Thinking about just waiting a few more months. I’m presently using a 670g and have been on the #wearenotwaiting train androidsaps until my 522 finally died. I might source another in the interim. Anyone else made any decisions yet or holding out?

I am confused. If you have no insurance, then are you footing the entire bill yourself? Including the supplies? If so, and you can afford it, then I would get a t.slimx2 with Dexcom g6. In my opinion, that is the best on the U.S. market for now.

However, if you don’t have the resources for the initial purchase and the continuing supplies, then something scaled down according to the resources you have available should be your aim. That is purely a matter that only you can assess.

Thanks. Good feedback. It really is a matter of keeping the monthly cost down. Paying for a pump is not the issue it really is the re occurring cost of sensors and supplies that make it a challenge.

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We had the same problem for a little while. I am on the Omni pod and for a number of years we were paying $3600 a year for pods. The company we got them from always included a 10% discount on our next order. Now on Medicare I don’t pay for my CGM supplies but my pods run $3oo every 10 weeks. I can’t go back to the tubed pumps because that little bit of time that I have it off just wipes out any good A1C I might have. Good Luck

I went from Medtronic 522 to a tandem tslim.
My a1 c has never been better. Initially I went from generally being in the 6.5 range with a 7.2 at the end,
After 2 months on tslim/ dexcom my a1c was 5.8
Now on sleep mode all the time because it keeps you in a lower range, my calculated a1c is 5.5 so my actual a1c will be even lower than that.
I am really happy with this new system.

MT will be the cheapest, I think there is less non-durable medical cost.
I think they are also offering supplies now to people w/o insurance.
I don’t recommend that piece of tech, but it is the cheapest.

At the end of the year the costs will be similar unless you extend equipment past it’s originally intended time frame.

Omnipod is cheaper to acquire initially, but pod refills cost more monthly than tubed pump supplies with no possibility of extending them. Last I checked there was <1K startup costs, but the pods are the recurring revenue stream for them so they start to add up.

Tubed pumps cost more upfront, with supplies costing less per month and the possibility of extending the useful duration should you choose to do so.

Tandem is ~ 5K US cash price (you will have to call Tandem and explain you are self -funding to get a similar price. ) I purchased mine in 2017 cash for 4795.00 cash, so there is some flexibility in pricing. I spoke with 5 different people, and the local rep gave me the best price.

Medtronic last I heard was ~6500.00 cash price depending on which model you are interested in.

If you travel to Canada or Korea, the Sooil Dana RS pump is supposed to be extremely inexpensive to obtain and operate.

Alternatively, there are used pumps on the open market with no warranty which are extremely cheap to obtain.

If you are looking for CGM intergration the roadmaps are Omnipod and Tandem integrating with Dexcom and Medtronic going their own way.

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Although I’ve read where you can pull out insulin from an OmniPod and use it in another pod or as a bolus, I don’t. So, there is the cost of lost insulin from OmniPod’s which I don’t believe is lost from tubed pumps. Is this correct of tubed pumps, you don’t loose insulin?

If in US, could you sign up for Marketplace HC insurance and get it ?

Or if you could get another older MM 522 pump would you keep doing OpenAPS ?+

I am on the Tandem X2 and I lose 20 units to the cartridge and 12 units to the 23" tubing.

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Yes. Marketplace is a option but the deductibles are high depending on monthly payment. If I pay 850mo they will pay 60 percent after 5K deductible for pharmacy and DME for example.

I have acquired a older 522 pump but there seems to be one of the buttons is sticking. The problem with older pumps is that not all features work. Medtronic will certainly not help. On the hunt for another. Sad that the technology has been here for years but no action by companies.

I think you can reuse part of the tubing a few times but it is not recommended by the pump companies. This helps save some of the insulin. This is true for Medtronic.

@Flynn_Simon I re-use cartridges and infusion sets regularly with limited trouble. I say limited because I use steel sets and move them after 2.5 days to a new location. Re-securing them is the challenge.

@Firenza - I routinely siphon off and reuse the insulin in the cartridge. I have yet to find a reliable way to harvest the insulin from the old tubing though.

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I know some people that reuse the tubing for several weeks at a time. Not the physical infusion set that is but just the tubing. When I asked Medtronic they say it needs to be replaced the same time as the reservoir.

It can be done, but there is a higher chance of occlusions IMHO. The longest I have gone is a week on the tubing and set (over 3 sites). Tandem will gladly sell anything they offer for cash price if you ask. Their prices are obviously much cheaper than using a distributor. Also when I would go somewhere a local rep was showing, they would always give me free equipment.

I have tried to recover insulin from a defective OmniPod and if the pod failure is right away I find I can usually get half of it back but if the pod has been in use for a while any recovery is very limited and insignificant. When I had a lot of defective pods I complained to Insulet about the cost of losing the insulin which was worth more than the pod and learned they had a token reimbursement for lost insulin. They would prorate the lost insulin at $10 for a full pod which was nowhere near the worth of the lost insulin. It seemed like most of my pod failures were usually happening right away with a full pod so I usually got the full $10 but I also learned they had a cap on how much they would reimburse you for the year and soon ran into that so then they stopped offering even their token reimbursement.

It seems like a lot of the "pod failures"were due to a malfunction of the PDM. When your PDM tells you your pod is empty after three hours of usage and you’re still walking around, you know it’s not working. But that is a very scary experience because if it had actually emptied in a couple of hours I would’ve had a very serious overdose.

Since I started using my iPhone to control my pods I’ve only had one pod failure and that was a reading of being obstructed when it was almost empty. I find the phone is much easier to use than the OmniPod PDM plus it gives me a lot more detailed information and options. For instance on the PDM I could choose between a carb ratio of three or four but on my iPhone I can use 3.1 or 3.6 for a carb ratio or anything between 3 and 4.

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Thank you for your reply! None of us like to lose insulin to waste, but it happens. Those using pens are told (or I was when I used pens) to prime it by injecting 2 units into the air. That adds up and for the cost of insulin, it just adds to it.

I had read where Insulet would reimburse you for lost insulin and when I called in a pod failure I asked about it. I told them about how many units I lost and they calculated that many units times $0.05. This happened three times over the course of two years. I have never seen one check from Insulet for any lost insulin. I thought it was a nice gesture, but now I think differently, that it’s a perpetuated lie they tell to get customers off of the phone. Heck, I’ve called in several failed pods. They replaced the pod and all was well with the world, but don’t tell me you will send a check for the lost insulin when you have no intention of doing so. That is just wrong on so many counts.

Medtronic is offering options for people without insurance. I use Medtronic and really like the technology.

Note: I am a Medtronic ambassador. My opinions are my own. They did not pay me to say nice things. OK, they sent me a shirt and a cup but even I am more expensive than that.

This again is one of those strange variations in the different experiences we all have with our vendors. For a couple years OmniPod never mentioned any reimbursement for lost insulin but then one customer service rep told me about it and they did send me a $10 check. After that I got several more checks that year until they told me I had maxed out their limit of reimbursement.

It might be just luck or chance coincident or improvement in the quality of their pods but since I switched to the looping system and run the OmniPods off my iPhone, I have not had any pod failures. Of course now most likely the next one will fail and they won’t send me a free one because I’m not using their PDM equipment.

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That is really interesting. Which loop are you running and sensor? Closed loop on the pod right? dash or other?