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Pods--run through as DME or prescription plan?

Discussion in 'Parents of Children with Type 1' started by Traci, Mar 7, 2011.

  1. Traci

    Traci Approved members

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    Our pump supplies have always been filed as durable medical expense under our medical insurance. This year, that plan has changed and will result in a huge out of pocket hit for us. Does anyone get their pods through a prescription plan? Our prescription plan has not changed that much, and would be a less expensive option for us if it's possible. For the record, our medical is with a different company than our prescription plan.

    Thanks for any help!
     
  2. manda81

    manda81 Approved members

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    DME for us.
     
  3. PatriciaMidwest

    PatriciaMidwest Approved members

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    DME.

    I read a post about someone getting them as pharmacy through Medco. I checked on it because we use Medco and sure enough the Omnipod comes up when I check on drug cost --- but then it says not available for your plan.

    Anyway, some plans are allowing this.
     
  4. sarahspins

    sarahspins Approved members

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    Yep, it's the same with Humana... most pump supplies come up when you check pharmacy benefits, but mine shows "not covered" for the pods - I would expect that this is the case for MOST insurance plans.

    I find it odd, honestly, that my insurance will happily pay $400 for my insulin, and $300 for my strips, with me paying just a co-pay, yet the $125 my pump supplies cost is not covered until I hit my deductible.
     
  5. Traci

    Traci Approved members

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    Yeah, that's pretty much what I thought. I called Omnipod and my insurance company to verify, too, and they both said the same thing. Anyway, just trying to make sure I've thought of this from every angle before we shell out $1500 for a 90 day supply of pods. :cwds: Thanks!!!
     

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