OmniPOD Insulin Pump Coverage

I will be a new participant with BCBS of TX this new coming year, 2015.
I have been trying very hard to get an answer to a question that is very specific to insulin pumps. I see where they are covered and that a portion, the pump, falls under Durable Medical Equipment for initial set up and that the supplies such as tubing, reservoirs, etc. are covered under the prescription coverage. I use a pump called the OmiPOD, made by Insulet Corporation. This pump is tubeless and the insulin is held in a pod that is attached to you body and includes the cannula. A remote piece, about the size of a cell phone or pager operates the pod to dispense insulin. This piece is also my glucose meter to help aid the amount of insulin necessary to dispense. My current coverage has all this equipment under DME. The new BCBS plan is not clear on this particular type of pump, only the older ones with tubing. Can someone tell me how BCBS processes the supplies end of this type of pump? Thank you very much!

Parents
  • Good Morning! We would love to look into this for you. All we need to get started is for you to private message your contact and policy information so that our team can do a thorough review of your coverage.
    Thanks!Jeri
  • Could someone reach out to me?  I have tried for days via phone and keep getting transferred around.  My employer offers the Bronze HMO (B660ADT) plan.  I am trying to figure out what my omni pod and dexcom charges are going to be monthly.  Its very important to find out because if they are 500.00 on top of my premium I am not going to be able to continue the therapy which is the worst thing a Type 1 diabetic can face.

Reply
  • Could someone reach out to me?  I have tried for days via phone and keep getting transferred around.  My employer offers the Bronze HMO (B660ADT) plan.  I am trying to figure out what my omni pod and dexcom charges are going to be monthly.  Its very important to find out because if they are 500.00 on top of my premium I am not going to be able to continue the therapy which is the worst thing a Type 1 diabetic can face.

Children