Hi all,

It's been 6 months or so since I have posted. I was diagnosed with type 1 in February at the age of 25. I was on MDI for the first few months, then was approved of the Omnipod by BCBS mid-summer. It all has been great. I started out being extra strict about everything, like many of you did, then just like may of you said, I realized that I had to give myself a break and stop treating my body as a math problem. I really found that happy medium of being a healthy diabetic while still enjoying some foods every now and again.

I wanted on the pump because I felt it would allow me to live life more like I was before being diagnosed. As many other threads that pointed out the pros and cons of pumps, it does allow for some things closer to "normal." But nothing will ever be like normal. I knocked a few extra pods off this month from different things like exercising and one time I forgot it was on my arm and ripped it off taking my shirt off. I haven't knocked too many off, but this all happened at once, which made me throw insulin away. Long story short, I ended up being about 2 1/2 weeks short on my next 90 day insulin refill. I'm sure I could call and get them to advance my refill, but I had a couple of extra Flex Pens left, and since they have a due date, I decided to take a pump vacation until my refill comes around.

Who knew, but even given the positives and ease of use the pump gives, after 5 months on the pod, I got a sense of relief not having something stuck on me. Not having to remember where I put my pod when I change clothes, or make sure my timing was right and where I would be when I needed a pod change. Crazy enough, I kind of feel......free, even though traditionally the pump is SUPPOSED to be the treatment that makes you feel free.

I know I know, after a month or so on MDI, I am sure (maybe) that I like the pumps pros more than MDI's, but what happens if I don't? Would I need to notify my insurance to let them know that I won't be getting any more pods? There is a program called Living Well Louisiana, where I talk to a health coach one a quarter and in turn I get my insulin, as much as I need, for $15 a month. Whether or not they would charge me 15 for the Novolog and 15 for the Levemir, I don't know, but still, I would be very fortunate for getting insulin for $30 a month. My insurance also pays for things such as back up syringes, alcohol wipes, pen needles (I have prescriptions for all of them on file since I used to get those) through Liberty. I told Liberty I wouldn't be needing the full supply of pen needles anymore because of the pump. Could I call them and tell them now that I am back on MDI and to start sending the needles again? I may be missing something, but I think if I don't call my 3rd party supplier about a refill, then insurance won't get charged for the pods. And if I just tell liberty to start sending the needles, they will, just like they used too, and my insurance will cover them too. I don't want to call BCBS because I don't want to "screw" anything up and lose anything that I am getting on that insurance.

Sorry for this long post, figured I would make up for my absence! Anyone have an experience like this that you could give me some advice about the insurance? Anyone feel the same way and switched back to MDI for the reasons I was talking about?

Ben

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Assuming your supplier (Liberty) is doing 'auto-ship', then yes, it makes sense that you would call Liberty to tell them you want to stop the Omnipods, and go back to MDI/pens. They may need to contact your Dr for new/changes to Rx, so plan that into the lead time for making your changes.

I'm sorry, I should have specified. I get my pump/cgm supplies through a 3rd party that is in network for my insurance. I get my test strips, pen needles, lancelets, etc., through Liberty. I just don't want to be punished if I made a change to MDI long term when the insurance company are the ones that paid for the pump. It's a little different with the Omnipod, since up front cost is not much, it's the ongoing costs that are expensive. But I doubt the insurance company would see it that way. They just see they bought a pump, and now I am not using it. I don't want to be permanently denied further access to pumps if I decided to go back to the pump years down the road. This is all hypothetical of course, I just don't want to do anything fraudulent.

When you get your pump supplies - do you initiate the order, or does it come automatically ? If automatically, you need to know who controls that process. If you initiate the request, then no problem. Everyones plan is different. Generally who ever handles the billing to the insurance company is where the order originates, and they choose if 3rd party providers are used.

Pumps are usually approved by insurance companies based on medical necessity. I can see where if they approved your pump, and then you stopped using it, and then you wanted to use it again, you should be still covered for supplies as long as you have the original pump. But if you stop using it, and later order a new pump, you may have to explain more regarding it being medically necessary, when you chose to not use it for some periods of time. That's where the Living Well plan/health coach may be relevant, if that involves details on how you manage your diabetes. If using your current pump did not provide the expected medical benefits, then they might want to know how the next pump would.

I have generally found that as long as you're not getting MDI stuff and pump stuff all in the same order, it will be OK. People switch back and forth fairly routinely. It's not uncommon.

I am a firm believer that when managing T1, we all have to find the treatment methods that work for us. And by "work," I don't just mean a good A1C. There is more to life than that! If, when pumping, you have a great A1c, but are otherwise miserable and your quality of life is suffering, then pumping isn't a good method of treatment for YOU. If I use a CGM, I can probably get my A1C down further, but I found that CGMs made me obsessive and detracted from my quality of life. It was a trade off for me.

We all have different lives with different needs, schedules, and attitudes. If MDI makes you feel better, then go for it.

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