ANNOUNCED TODAY: The Centers for Medicare and Medicaid Services (CMS) has issued guidance clarifying that Medicare Part D Plan Sponsors may provide coverage for products such as the Omnipod System under the Medicare Part D (prescription drug) program.
FINALLY!!! I’ve endured 2 lengthy claims appeals for Omnipod coverage … once with the great support of Insulet and their attorneys, only to be denied.
“We are incredibly excited about CMS’ confirmation that Omnipod is eligible for coverage under Medicare Part D, which allows many additional people living with diabetes to benefit from Omnipod’s freedom and ease of use,” said Patrick Sullivan, Chairman and Chief Executive Officer. “Gaining Medicare coverage of our Omnipod System was one of our top priorities, since individuals living with diabetes deserve the right to choose the product that will best help them manage their diabetes. We are thrilled more people will be able to choose our innovative and differentiated Omnipod technology, which delivers continuous insulin without the use of tubes and eliminates the stress and anxiety of multiple daily injections.”
Read more: Medicare Part D (Prescription Drug) Plans May Now Cover Omnipod®
The Insulet Corp is celebrating the approval of Omnipod Pods under Medicare Part D. This is great for the people who will be entering Medicare any time soon, or for those who enrolled in Part D coverage when they attained age 65. If one wants to enroll in Medicare Part D now in order to receive the benefit of Pods now being covered as diabetic supplies we are hosed again. Why because Medicare states you have to pay a penalty to join now to enroll in Part D coverage if you are over age 65. What about the folks that had good medical supply private insurance coverage that’s not under Part D, those folks get no benefit from this announcement?
Can anyone tell me why Omnipod Pods that are disposed of after three days can not be classified as Durable Medical Equipment-DME? Dexcom sensors are disposed of after one week’s usage, yet they are classified as DME. What’s the difference between three days, and seven days that disposable sensors can be classified as DME, and Pods cannot but rather are called supplies?
This is a bit unfair if you ask me! Once again, Insulet and CMS dropped the ball on this subject. The individuals that have been using the OmniPod Insulin Delivery System over the past ten years are screwed over once again if you did not enroll in Medicare Part D. This SUCKS, and I am greatly disappointed in Insuet’s management in particular CEO Sullivan by not fighting for this argument with CMS more vigorously.
I’m so sorry James … how very stressful. I know that there is an issue with Part D and when you sign up. I wish I had better answers for you.
I don’t see having to use Part D is an advantage. Every $ being spend via Part D is going against the Drug cap that is set by Medicare. What level of drug classification is this set at??? I don’t see this being mentioned.
Oh my, this is from a post over a year ago. Folks had been struggling to get Medicare to cover Omnipod … so this was good news!