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Omnipod and Cigna

Discussion in 'Parents of Children with Type 1' started by LoriAnn, Jul 30, 2010.

  1. LoriAnn

    LoriAnn Approved members

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    We are starting to look into getting Safi on a pump. The one I really think I want is the Omnipod. Mainly because of the self insertion and no tubing. I'm going to be contacting Omnipod and Cigna both to see what is covered and how much everything is going to cost, but wanted to ask here first. We have Cigna Open Access Plus.

    1. How do you like Omnipod?
    2. If you have Cigna, was the Omnipod covered under DME?
    3. Are the pods for the insulin covered under your prescription benefit or your DME benefit? (this one is most important since I have a $1,000 cap on DME)
    4. Any difficulties in getting the Omnipod covered?
    5. Any tips or hints that will make this easier for us?

    Thanks!
    Lori
     
  2. MadeleinesMom

    MadeleinesMom Approved members

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    Lori,
    We started Omnipod in January and would never go back. I don't think my daughter would do well with tubing and having the insertion method of some of those other pumps. I do not have cigna, but we have Healthnet and diabetes equipment is different than DME. They covered 100% of the pump and the cost of the pods. There were no questions and they sent it to us right away.
    Tips--Dont know how old your daughter is, but we got emla cream to alleviate some of the pain/anxiety of pod changes. Some ppl don't agree with using a numbing cream, but whatever helps my daughter's anxiety level to be lowered with this terrible condition, I am all for it! :)
     
  3. LoriAnn

    LoriAnn Approved members

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    Safi will actually be 8 tomorrow, and she wouldn't even consider a pump because of the insertion and tubing. But after talking to her about the Omnipod, she seems very excited.
     
  4. Marie4Julia

    Marie4Julia Approved members

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    Hi Lori,

    My daughter is on the Omnipod, and we have Cigna open access plus as well. When she first started on the pump, we had Oxford insurance, so they covered it under DME. Now the pods are covered under the pharmacy benefit through a third party called CareCentrix. I have a copay of $30 for a 3 month supply of pods (changing every 3 days). With Omnipod, the PDM is not the large expense. The list price for the pods is about $800 for the 3 month supply, so I feel that it's pretty good coverage and i've never had a problem with them. Let me know if you have any other questions.
    Marie
     
  5. caspi

    caspi Approved members

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    We have Cigna as well. The process couldn't have been any smoother! The pods are covered under DME and we ordered them directly through Insulet - they took care of the billing, etc. :cwds:
     
  6. Jen_in_NH

    Jen_in_NH Approved members

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    We don't have Cigna, but we use Omnipod with my son. It is under DME for us, which stinks. We had a bit of trouble getting it covered, but they did finally cover it after 1 appeal.

    We love it for my son. Having no tubing is awesome for a 3 year old (out of sight, out of mind). The insertion is easy, and he doesn't mind it in the least.

    Jen
     

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