I know that it can vary from company to company and would depend on insurance coverage and what-not. However, does anyone know if the OmniPod PDM and Supplies are substantially more expensive than the other tubed pumps out there? i.e. Animas?
Does anyone know if there are any cost comparison charts out there that can at least give me an idea?
What do you all think??
Not sure about a comparison chart. I think out of pocket cost for omni (cash, no insurance) is $300ish for box of 10 pods, which theoretically lasts one month. You would/should confirm that by calling the customer support line to ask about it.
I haven't pumped a tubed pump in a many years but I recall the reservoir/infusion set combo maybe averaging around $15 per set (I was pumping MM with silhouette and quickset sites). So perhaps about 1/2 the cost? But this is cash value and not insurance, etc...
The PDM out of pocket was about $150.
My insurance Anthem BC/BS of California covers pods two different ways.
1 - As DME at 20% copay of the negotiated rate, which puts the pod cost at about $5.50 (about $1.83/day).
2 - As preventative supplies (like syringes) at 100% covered ($0/day).
The answer is to fully explore each of your options, go with what option makes the most sense for you. I have been on OmniPod for over 4 years and cannot imagine being tethered by a cannula. The new smaller pods are even better. Good luck!
John, How do you get them to bill as preventative and get it covered 100%?!?! I have insurance through Independence Blue Cross of PA, but I live in Connecticut, so really, it falls under Anthem BC of Connecticut.
Pod supplies (meaning, pods) are 3-4x the cost of tubed pump supplies. I have been on the pod for 4 years, and last year our insurance changed. Im now on a 80/20 plan. Pod cost me about 350-400 out of pocket for 3 months, traditional tubed pump supplies will cost about 100. I went over the detailed cost with my DME provider before deciding to switch. Although I love the pods, I dont love them 400% more.
YMMV of course.
Yeah, My insurance changed as well and where I was covered 100%, now I will be responsible for 50% under DME. Not to mention my premiums when up and when all is said and done, I will pay about $6000 more a year. :-( Also, I swear I cannot get a straight answer out of my insurance company as to what supplier is in network? Can I order directly from the manufacturer as I have for years? Do I need to get EVERYTHING from EdgePark?? I just keep getting the run around and just hate having to order supplies and 'hope' that I can afford what the insurance company does not cover.
I just found out that I am pregnant, so I am also concerned about the fact that sometimes the pods fail and can be unreliable.
Congratulations on your pregnancy!
I've had pumps and pods. The way it was explained to me was that the OmniPod is less expensive up front, but the pods make the continual use a bit more expensive along the way.
As for pod failure, I've had a few failures, but no more than with infusion sets, and pulling out the set due to getting my tubing caught on a drawer pull, or a door knob.
Initially I ordered directly through OmniPod, then they were no longer preferred by my insurance. I've just started up with Edgepark recently and they gave me the exact amounts I will owe before I ordered. They verify the insurance and tell you what you need, etc., before the order goes through.
Best of luck to you!