Who said that?
I don’t think that’s the case. Certainly nothing Insulet has announced, right?
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oh gosh another tricare person, goodness bless you! my providers have managed to get me DENIED for a CGM and DENIED for tresiba!!! sounds like i was right when i thought they effed that up somehow? but i am seriously so lost: i have never needed doctors before unless i had broken myself falling off something, it was all emergency rooms and orthopedists 
so i am a total insurance newbie.
i finger stick 6+ times a day and inject insulin 6+ a day (long acting 2x, then food bolus and corrections), and i still get daily lows AND highs, so i should be a candidate for sure it sounds like. i was thinking to reach out to the company for omnipod and see if they can get me spun up before i have an endo: a “dumb pump” as you call it (by the way, thank you @TomH and @bkh - your explanations combined made so many things snap into place for me!!! 
) seems much the same as MDI just with fewer needles. omnipod dash without any fancy settings sounds like a great, relatively low-upfront-cost way to see if a pump works for me! i can always iterate from there: disposables sound like a good way to “try before i buy” to some extent. (or decide i love disposables and stick with it: but it seems like it’s the minimal commit way to get into the pump game.)
guys thank you so much: i literally got told “yup diabetes good luck! sorry insurance won’t pay for your stuff”, and that’s… clearly not correct 
(for that matter, rather than trying to get me approved for a cgm, my first provider was pushing ozempic when i was still 20 pounds underweight!!! 
)
FUD is the absolute best. heaven bless you all!!!
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I can actually send you some to try if you want.
I also have some of their PDM’s (Personal Diabetes Managers) too, which I can send you. That’s the dumbed-down phone you use to control the pods. It is not really a phone, you can’t make calls from it. 
But they were at one time phones, which Insulet turned into PDM’s.
(The Omnipod company is Insulet, in case you did not know that. Sorry, I know it gets confusing.)
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i figured the naming stuff out on the phone with them about 5 minutes ago 
i don’t know if my crack team 
of providers will make this go or not yet, so i would happily take any extras anyone doesn’t want!!! i am always happy to pay costs/shipping/donate to a cause in your name etc! and on the pdm: i will likely need the pdm because i dont have a second person to use their phone as backup, so if you don’t want them…
they are also really trying to route me toward the 5. i may have to start there, since everyone with sign off power seems to be pushing me that direction.
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That’s a good approach, in that Insulet already knows how to work the insurance. But they will need your physician to write the Rx for the Omnipod Dash — actually, they’ll request the prescription from the doctor plus medical necessity info. In my experience, they send a request for Omnipod 5 even if you told them you want a Dash, so be sure your doctor knows about that ahead of time, and won’t prescribe Omnipod 5, it has to be Omnipod Dash if you want to run diy Loop.
The Omnipod 5 has it’s own closed loop software that some people like ok, but I’m recommending the do-it-yourself open source Loop, as is also used by Eric and TomH, I think. The Loop documentation site at LoopDocs has no prerequisite of any particular software expertise or anything. They lead you through a complex process in a relatively understandable way.
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truthfully i am so exhausted with insurance fights that if they do the 5, i will probably just go with it and ask for a change if i want later. i’m so tired of battling for this stuff and my doctor is really putting up some resistance and i’m just tired and sad about it. tbh seems like almost any pump would be better than what i’m doing 
so whatever path gets me pumping fastest is probably my route.
my team is really not very helpful and they are disinclined to listen to me: they don’t think i know what i’m talking about because of how recent my diagnosis is. so i get treated like an idiot a lot and they don’t listen to me. if a 5 is the route of least resistance, well… 
not sure i’m up for fighting for the dash. it will also probably be easier to make the case to switch if i can specify why not the 5 after using it; again, my doctor tends to ignore me and obstruct requests that don’t match her notion of “normal”.
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Don’t tell Insulet that you intend to run diy Loop on the Dash, because that’s not FDA-approved software. I use Loop rather than Omnipod 5 because Loop gives me much more control, whereas Omnipod 5 is stubborn about doing whatever it wants.
I’d fire them and get someone who will cooperate. It’s your body, and you’re the one that has to live with the outcome.
I consider that a firing offense.
Unfortunately, they’re in a serious bind. Unlike almost everything else in medicine, here the patient is making the treatment decisions multiple times per day, with a really powerful medicine that can make you unconscious or worse if overdosed. They feel responsible for keeping you safe, but they can’t ensure your safety, so they are prone to stay away from anything scary unless they really know you and you have a track record of doing well with your self-treatment.
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this is the third team: i fired the first two. first one told me she wasn’t going to do autoantibody or c peptide because i was an adult so i was t2, that i should be getting off insulin, and was absolutely insistent on this. she reluctantly prescribed lantus after i fought for it and she refused to give me bolus at all, and she was pitching me ozempic when my BMI was 16. second guy told me he would do c peptide test, but the reality was i “probably did this to myself” and was “going to have to get off the couch and stop eating french fries”. DIRECT FVCKING QUOTES YALL. so he got sh*tcanned next.
team #3 has been better: she ordered autoantibodies, but she seems to feel like she’s a little out of her depth with detailed diabetes management. so she’s still reluctant to take me seriously or approve my requests. she suggested i book with a colleague of hers (who has t1 herself) so my next appointment is with the t1 primary provider (she may take over the spot altogether actually if we get on).
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That sounds very promising. If it’s not too far off, maybe deal with the official Omnipod prescription at that time?
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i super appreciated the willingness to say “hey i am not an expert in this, i can keep seeing you if you like but my colleague has insight that may get you better care”. i actually really like this doctor!!! she just isn’t maybe the right fit for me now that i have diabetes: i think we would have been a great match before, but as you say… she is sort of between a rock and a hard place. the t1 doc probably will feel better about working with my needs and have a better idea of what all the options out there are, and there’s no expertise like first hand experience!
edit to add: if i can’t get omnipod approved by next week with current situation, i will book an extra telehealth with t1doc and see if we can’t push this right along… i literally am in awe of you all, doing this for so long… less than a year of this and i have already had it up to here and then some with needles and pokes!
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Please don’t do that!
It will make it much harder to get the Dash later.
Plus, it’s important to learn this now - YOU manage your 'betes, not them. YOU decide what you want and what you will use, not them.
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Have you ever seen The Shining?
I’ll do it like Jack from the movie.
donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5donotgetthe5
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i am doing the best i can. i am tired and i keep getting told no.
get a different endo
being told no for a pump you request is unacceptable.
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don’t have one. all i have is a GP. on waiting list for endo: it’s months. i got told i couldn’t have bolus insulin, i got told i can’t have a cgm, i got told only an endocrinologist can prescribe me a pump. no no no and it makes a person want to quit 
(edit to add: i am not quitting, but i am definitely griping, sorry for any confusion)
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I’ve been lurking on this thread for a bit and thought I would bring up something that happened with my insurance three years ago. I know that Tricare covers pump therapy but have you checked the requirements for 1st time pump users?
My insurance covered pumps but I was denied because my A1C was under 7 and I hadn’t been experiencing hypo or hyperglycemia that required hospitalization. The Omnipod rep wasn’t aware of this rule because so few people starting pump therapy have A1Cs under 7.
My endo had 30 days to do a peer on peer review in order to get Omnipods covered. They also had a rule that once you were denied you couldn’t reapply for the denied item for 365 days. I don’t think a primary care provider would have been able to be successful in that review. Endo practices are used to this and know what to say. Honestly I have no idea what he said to get me a pump because I clearly didn’t qualify. He told me once your on pump therapy it’s a much easier process to get covered and it’s been no problem since then.
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criteria as i understand for tricare are: t1, multiple sticks a day, and the keywords are “poor glycemic control” which i got entered into my chart verbatim on purpose last appointment. i also suggested she write down “brittle diabetic” which i believe is an informal term but conveys the right info. my january a1c was 5.2, but that’s actually not a good thing: in my case i was having so many bad lows (it’s better now but shhhh i want them thinking it’s worse) that it drags that down. 5.2 indicates “poor glycemic control” due to frequent and serious lows. the phrasing is in my chart for that now but it’s… i dunno maybe i’ll just give up system mostly seems to hope i’ll do it a favor and just kick the bucket so they can stop bothering about me:rofl:
(edited to add: i am not serious about giving up. but it sure feels like the universe is rooting for that sometimes!)
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Ohh no ! I didn’t mean to cause any more stress! The insurance stuff will get better once you get to a endo I promise! They really are use to denials and getting all of our crap covered.
Don’t give up! You’ve been doing all of this yourself without any help from the Diabetic Educators that most of us newbies see soon after starting insulin. That’s gotta be insanely stressful! You’re doing a really 
job from the looks of it. Most folks just follow that stupid sliding chart for insulin until they get to a endo. You are actually learning to do it yourself. I think your soon to be endo provider will be quite impressed and surprised. Their first question will be - where did you learn all this ? Lol
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my answer will be “webmd” just for the comedy value
i want to watch their face when i say that
and you’re correct: i got zero training. none. nobody even gave me a sliding scale, actually nobody told me such a thing was out there. i googled “how do i know how much insulin to take”, found a sliding scale, and printed it off and laminated copies for my purse and bathroom as a starting guideline. and one pharmacist asked if i knew where to inject to hit subcu. that’s it otherwise they kicked me out of the er and said good luck. i have a friend with t2 and he told me about cgms and helped me start using coupons for the libre (what he wears, so he steered me there vs dexcom) when insurance denied me: that’s how i got that in my toolkit, otherwise i was finger sticking constantly. kind of a cobbled together setup over here!
you guys all keep me going when i feel like throwing in the towel. here’s a little mara love to say thanks
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@eric sorry for the duplication
as far as the shining…
fun fact: in high school i did ski club every winter. we went night skiing after school on fridays. my junior year our bus broke down in a blizzard on highway 2/stevens pass, at 11pm.
it was one of those charter-style buses with TVs. the boys on the bus had put on the shining.
that was the first time i ever saw that movie: around midnight trapped in a broken-down bus on a mountain pass in a blizzard with several dozen other teenagers.
it has a whole ‘nother level of impact in that setting half the bus was hysterical before the chaperones intervened
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