Are Omnipod Dash Pods Covered by Medicare for Type 1 and Type 2 Diabetes: Medicare Part B Omnipod Medicare Coverage
Medicare has a long list of covered benefits and services which only makes finding a Medicare plan all the more complicated.
Many people are looking for new ways to treat their type 1 and type 2 diabetes and thankfully Medicare does cover the Omnipod Dash System along with a few other devices.
Being able to manage your diabetes with ease is crucial in maintaining health and avoiding potentially life-threatening complications. In order to take advantage of these benefits, it’s important you understand what Medicare covers first.
Continue reading this article to learn how your diabetes sensor device is covered by Medicare which tracks the flow rate of your insulin medication.
Table of Contents
Does Medicare cover the Omnipod Dash System Insulin Pump?
The Omnipod Dash system is a new insulin pump that is worn on the body and delivers insulin through a small, discreet tube. It is important to know the Medicare plans where Omnipod DASH may be covered and contact them for more information.
Yes, Medicare will cover the Omnipod Dash Pods. However, we have found that many pharmacies do not have this product on hand. This is because many Medicare Part D plans do not provide Part D coverage but rather it is covered by your Medicare Part B plan.
If your Medicare company provides the needed Part D coverage, you may need to fill your prescription online versus in your local store. As not all prescription drug plans are the same, it is critical to review your coverage annually.
The Omnipod system is considered durable medical equipment (DME) which is why it’s not typically included in your drug plan formulary. Many diabetes testing supplies that are provided by insulin delivery systems are available online and at some retail stores.
Are the Omnipod Dash Pods Covered by Medicare Part B?
Yes, the Omnipod Dash system is covered by Part B of Medicare durable medical equipment coverage for those eligible for Medicare. You may also have coverage through your Medicare Part D prescription drug plan.
If you have coverage under both Medicare Parts, you will want to see which option would provide a greater benefit.
Medicare Beneficiaries covered by a Medicare Supplement Insurance policy may have zero out-of-pocket costs to obtain their Omnipod Dash Pods depending on which Medigap plan they are covered by.
The Centers for Medicare and Medicaid Services state insulin management systems are covered by Medicare Part B. Medicare Beneficiaries may have a deductible, copay, or coinsurance costs related to insulin pump therapy that monitors glucose levels.
How does Medicare Coverage work for the Omnipod Insulin Pump System?
The Omnipod insulin management system is a medical device used to treat diabetes. Medicare covers the cost of the device under certain circumstances when prescribed by your treating physician.
Omnipod insulin pump is covered under Medicare Part B in most instances. It is a personal diabetes manager that is a glucose monitor.
The Omnipod wasn’t covered under Medicare Part B because of a Medicare guideline that said tubeless insulin delivery devices, like the Omnipod, couldn’t be counted as insulin pumps. Since the insulin-delivering pod is disposable, it didn’t technically qualify as “durable medical equipment” under Part B.
However, Medicare now covers the Omnipod DASH® device.
How Much Will I Pay for a Diabetes Sensor Device with Medicare Plan G?
The Omnipod Dash System is a wearable insulin pump that helps manage diabetes. Medicare Supplement Plan G will cover the full cost of your Omnipod Insulin Pump minus your annual Medicare Part B deductible.
Once you have met your annual Part B deductible 100 percent of the cost of the Omnipod system will be covered by your Medigap plan.
How Much Will I Pay for the Omnipod System with a Medicare Advantage Plan?
The Omnipod Dash System is a new, innovative system that helps people with Type 1 and Type 2 diabetes manage their condition. There is still some uncertainty about whether this system will be covered by most insurers, but the potential for it to be used by more people is great news.
How do I order the Omnipod Dash Pods Covered by Medicare?
EdgePart Medical Supply Online Store
If you are a Medicare patient in need of an Omnipod Dash Pod, you can order one easily from EdgePart Medical Supply.
Simply go to our website and select the Omnipod Dash Pod from the list of products. You will then be prompted to enter your Medicare information.
Once your information has been entered, your order will be placed. It may be easier to pick up the phone and call them.
How Long Does it take Receive Omnipod When Ordered Online from EdgePark?
It generally takes around one week to receive Omnipod when ordered online from EdgePark. However, this may vary depending on a number of factors such as the availability of the product and the shipping method used.
Existing customers may receive their product in as short as 2 to 5 days.
Does Medicare Part D Prescription Drug Coverage Provide Omnipod Coverage?
Yes, Medicare Part D coverage may cover the Omnipod patch pump system. If your Part D prescription drug plan includes Medicare coverage for Omnipod we have found it to be covered and include a Tier 3 and Tier 4 co-pay.
If your Part D drug plan provides prescription drug insurance coverage options for your Omnipod Dash System please compare pricing between the different parts of Medicare to ensure you are paying the lower amount.
How much does the Omnipod Dash system cost?
The Omnipod Dash system is a wearable insulin pump that helps manage diabetes. It is covered on some Medicare plans under a Tier 3 or Tier 4 co-pay benefit. It is most often covered by Medicare Part B and for those Beneficiaries covered by a Medigap plan, this is the most cost-effective option.
When filling your tubeless Omnipod insulin pump covered under Medicare Part B, you will need to obtain the system through a medical supply store and not your local pharmacy.
Medicare Beneficiaries covered by a Medigap Plan G will be responsible for their Medicare Part B deductible if it has not already been met.
Maximum out-of-pocket costs for Medicare Advantage plans can be a few hundred dollars to several thousand dollars. Review your plan documents for coverage details.
Are there any Alternatives to the Omnipod Dash System that Medicare Covers?
Yes, there are a few alternative insulin pump systems that Medicare covers. These include the Medtronic 640G system, the Tandem Diabetes Care t:slim X2 system, and the Insulet OmniPod U-200 system.
As Medicare benefits may be different under your plan, you may find your Medicare plan does not cover the specific device you are wanting but may include one of the alternative devices.
We recommend checking out reviews online to see which tubeless insulin pump system would be your best option.
What else do I need to know about the Omnipod Dash Patch Pump System and Medicare coverage?
If you’re on a Medicare Advantage plan, you may be able to get coverage for the Omnipod Dash system through your plan. However, not all plans cover the Omnipod Dash system, so it’s important to check with your insurer to see if it’s an option for you.
One of our Medicare insurance agents can also review what cost-effective options for your Omnipod are available.
There are many parts of Medicare and it is vital to review each part for the best option for Medicare benefits. Omnipod could be more affordable on your Part D coverage or Medicare Part B. It is vital to review the list of covered drugs in your Part D plan.
How do I find Medicare Plans where Omnipod Dash May be Covered?
Daily insulin injections are not fun which makes a system like Omnipod a perfect solution for the delivery of insulin.
To find Medicare plans that may cover Omnipod Dash, you can visit the Centers for Medicare & Medicaid Services website and use the “Find a Plan” tool. You will need to enter your zip code and select “Medicare Health Plans” as your plan type.
On the next page, you can select “Yes” next to “I have diabetes” under the “Special Needs Plans” section. This will filter the plans shown to only those that may cover Omnipod Dash.
This tool will specifically look at Medicare Advantage plans that include Part D coverage for Medicare Beneficiaries who have diabetes. It may not provide specific coverage for this device.
It is vital to remember that these types of devices typically fall under Medicare Part B durable medical equipment coverage.
Do you have Questions about a Medicare Plan: Call for More Information about Your Medicare Enrollment
No matter if you are looking for tubed insulin pumps that regulate the amount of insulin into the body or simply need help navigating Medicare plans. Integrity Now Insurance Brokers has a team of Medicare agents ready to provide the help you need.
As licensed Medicare agents we certify in Medicare annually to keep track of all the changes that happen each year. This way you can sit back and relax and let us take care of your health insurance coverage.
Reach out to one of our Medicare experts and we will explain the differences between a Medigap plan and a Medicare Advantage plan. This will allow you to make an informed decision about which Medicare plan provides the needed insurance coverage.
You can fill out one of our online Medicare Quote Forms or call us at 562-735-3553.