Hello everyone! New here and already found this group very useful. I am new to Medicare ( my first “learning” year). I was used to being self insured for the past 20 years of my life and this has been quite of experience. I have purchased all the options/supplemental that are available with Medicare and found out that my Ozempic took me to the doughnut hole within 3 months… I finally got Medicare to pay for my Free Style Libre. My question to you all is: Does Medicare covers Omnipod? I have been paying for it out of my pocket all year because I have tried Edgepark and got no where with them to get me covered. Any help with my question would be greatly appreciated. thank you and have a Happy New Year!
Hi and welcome! Glad you found our site!
Medicare does not cover OmniPod because it is not considered DME (durable medical equipment). My coverage is through our supplement although I still have a co-pay of about 20 percent. I am grateful we can afford it because I like the convenience of going tubeless.
ETA: Some Part D plans cover Omnipod.
Thank you so much for your help. I am in process of getting this thing resolved. Edgepark is trying to get it approved for me. They requested a script from my Dr. and hopefully that will be it. Again, when I was self insured I didn’t need any thing except a script. Unfortunately, when I turned 65 this year I was forced against my will to switch from private insurance to Medicare. Not to get political here but thank you to our government that was OK taking taxes out of my business every month and now abounding to pay for my needs as promised…
Hi! New member here. Transitioning to the Dash. My supplemental carrier wants to charge me $30 a pod. If the pods can truly last up to 5 days, 2 days longer than the old school pods, the cost will be comparable to me. Seems crazy high, though. Do I need a new provider?
Welcome to FUD!
The Dash pods last 3 days, same as the old ones.
The cash-pay cost of the new pods is a little more than the old pods. About $47 per pod versus $30 per pod for the old ones. (This price changes all the time though,so this is just the general ballpark.)
Are you on Medicare? If not, since it’s February, it’s possible that the price you are seeing is before you hit your deductible. Like after you buy a few boxes it may become much cheaper for you. That is the way it is for me at the beginning of every year.
They last 3 days + 8 hours, for a total of 80 hours.
Thanks for the welcome and the responses!
Yes, on Medicare. I guess I was confused about the 5 days. Shoot. I thought $20 for the old school pods was high. I’ll have to think about that extra $10. I’ll look into the copay factor. That would make a difference.