I am switching to UMR Insurance with the UnitedHealthcare Choice Plus Network as of September 1. UMR seems to not know what end is up, and they could not tell me how to get Pods. Insulet said that UMR contracts with EdgePark, but Medco told me that Pods were "durable medical equipment" that would have to go through Liberty. When I looked up UMR's definition of "durable medical equipment" it covered wheelchairs and crutches, but nothing like the disposable Pod.

What I need to know is this: for those of you with UMR and UnitedHealthcare Choice Plus, from where do you send for your Pods? I know each plan is slightly different, but I cannot believe that Insulet is contracted with too many different suppliers. I am working by phone to try to figure this all out with the various suppliers, but no one can give me a straight answer. What have the rest of you who deal with UMR found?

Views: 348

Replies to This Discussion

I don't know about UMR, but what I worked out is that it comes down to money:

Some insurance companies class them as durable and some as medical supplies (like insulin). It all seems to depend on which causes us to pay most; Blue Cross Blue Shield of Oregon requires the distributor to bill them as durable, they pay 100% of diabetic supplies but only 70% after the deductible of durable medical equipment. Meanwhile apparently Medicare requires them to be billed as supplies and Medicare doesn't cover supplies.

Since it's the insurance company that chooses how to bill them, not you nor Insulet nor the distributor, they have to tell you which distributor to use (if they are different). Likewise Insulet has to supply through different distributors according to how the insurance company want the pods billed.

John Bowler jbowler@acm.org

Thanks for the reply. I know you are right that it all comes down to money, and all insurance companies are out to get as much as they can. I finally learned that Edgepark is "in network" for my plan, so UMR should at least pay for SOME of the bill. Medicare, for me, is still a few years off, so I hope by that time they get their head together and will cover the Pods. I do not want to go to a tubed pump just because Minimed is OK with Medicare but other pumps like the Omnipod are not. Time will tell.

I have UMR and UnitedHealthcare PPO, and use Edgepark for my pod re-orders. My plan considers the pods as supplies, and charges me 20% after deductible. Hope this helps.




From the Diabetes Hands Foundation blog...

DHF receives $200,000 grant from Novo Nordisk

Grant given to support programs aimed at bringing together people touched by diabetes for positive change BERKELEY, CA: December 4, 2014 – Diabetes Hands Foundation (DHF) has received a grant of US$200,000 from Novo Nordisk to support programs aimed at Read on! →

Guest Post: World Diabetes Day 2014 on Twitter… sifting through the data

At Symplur we track hashtags, keywords, user accounts, and pretty much anything else on Twitter that has to do with healthcare. We collect the data and then build countless ways to slice it up so that we’re able to better Read on! →

Diabetes Hands Foundation Team


Manny Hernandez
(Co-Founder, Editor, has LADA)

Emily Coles
(Head of Communities, has type 1)

Mila Ferrer
(EsTuDiabetes Community Manager, mother of a child with type 1)

Mike Lawson
(Head of Experience, has type 1)

Corinna Cornejo
(Development Manager, has type 2)

Desiree Johnson  (Administrative and Programs Assistant, has type 1)


Lead Administrator

Brian (bsc) (has type 2)


Lorraine (mother of type 1)
Marie B (has type 1)

DanP (has Type 1)

Gary (has type 2)

David (has type 2)


LIKE us on Facebook

Spread the word


This website is certified by Health On the Net Foundation. Click to verify. This site complies with the HONcode standard for trustworthy health information: verify here.

© 2014   A community of people touched by diabetes, run by the Diabetes Hands Foundation.

Badges  |  Contact Us  |  Terms of Service