United Healthcare and Omnipod

[Daniel's Mom 1993]

I am appealling United Healthcare to cover our Omnipod in network. I called care coordination and they said mail an appeal - I am requesting a letter of medical necessity from the doctor, also a "clincal exception" from doctor - or is that the same as medical necessity? I also sent an email to Insulet and asked for some information on studies that might help.
Does anyone have any advise or names of anyone at UHC that might help - the rep I spoke to today was no help but I figure they may be trained that way hoping I will go away.
We should recieve our pump today and pump start is 4/17/08. :)

[Lizzy731]

I am appealling United Healthcare to cover our Omnipod in network. I called care coordination and they said mail an appeal - I am requesting a letter of medical necessity from the doctor, also a "clincal exception" from doctor - or is that the same as medical necessity? I also sent an email to Insulet and asked for some information on studies that might help.
Does anyone have any advise or names of anyone at UHC that might help - the rep I spoke to today was no help but I figure they may be trained that way hoping I will go away.
We should recieve our pump today and pump start is 4/17/08. :)

We have the Empire Plan (government plan) but UHC covers the DME, including the omnipod. We had no problems at all. I am wondering why they are giving you a hard time? Maybe because we have a government plan?

You may want to ask about this.........

[Daniel's Mom 1993]

It may be your plan is different - what I have found so far is that there is not a contract between Insulet and UHC - it is the not the pump that causes it to be out of network but the DME provider but since no one but insulet can provide Omnipod that makes no sense to me - I am hoping that others will let me know what they had to do because I know I have read a couple of posts from others that it was approved for GAP exception.