I thought this might be a good place for a Medicare discussion regarding pumps. It may have been discussed previously but most of the information on this group is pretty dated, so I thought I'd start a new one.

I am rapidly approaching Medicare age and have questions. I would like to know who is on Medicare and what pump they have covered for you. I am currently using the Omnipod and I know they don't cover that. I would also like to know if ANYONE has gotten a CGMs covered. Just trying to be proactive and get my ducks in a row.

Thanks for any information.

Linda

Views: 218

Replies to This Discussion

I have been on Medicare for 5 years and they covered an updated pump for me. It is a Medtronics and my understanding they will cover an update on your pump when it goes out of warranty. I use the Paradigm.
There has been talking of covering CGMs for the past few years and nothing has happened that I am aware of and frankly given what is going on with the politic and economic situation I do not see it happening.
Irene
So you already had your pump when you went on Medicare, and then you got a newer version of it? That's one thing I'm wondering - if it's better to get it before going on Medicare or after.
Linda

I would Get one BEFORE.. I've been thru 2 Endo's since Getting On Medicare and No Luck
And Imagine all the USED One's out there?
Why can't we at least have one of those?

Ans? $

So far as I know, the requirement is the same -- whether you have a pump or not, you have to take a C-peptide test that proves you are below 110% of the lowest normal level of insulin secretion. If you are above that, no pump. The reason is obviously to weed out Type 2's, who in some cases really could benefit from pumps.

As far as CGM's, I don't see any hope for that for decades. Maybe centuries? Our world should survive that long!
What pump do you have?
I have a Medtronic 722, but Medicare also covers Animas. But not Omnipod.
I know just my luck.

I am going to TRY and get medicare to allow me to try pumping. MY kidney function has been on a decline, would like to halt or slow the decline.

I read somewhere (??) that medicare may make an exception for T-2 diabetics with eGFR below 50. My eGFRs have been running mostly in the 40s, lowest high 30s.

My diabetes is a bit weird, had several labels over the years. I first had a BS problem at age 14, threatened with shots, but got better, happened again in the Navy at age 22, then hospitalized at age 34 after a meat-wagon ride to ER, where I was formally Dx'd as diabetic.

Gomer

Your endo should run a whole gambit of tests. I have declining kidney function too, and in the testing process they found antibodies. No wonder the type 2 approach wasn't working too well. I got my pump right away and Medicare covers it under the durable medical equipment clause in their coverage contract.

I know that Medicare covers pumps, they just don't cover the OmniPod.

I am a type 2, medicare has paid for my pump, supplies and meds under part B. If your endo. states that you need the pump and you meet the C-pep threshold you will get the pump. Been on a MM 723 for two months. My A1C went from 9.7 to 6.5 and I looking for a lower number next time.

I have been on Medicare for about 6 years and have used Medtronic Pumps since being on Medicare. Recently updated to the Revel Pump and Medicare covered that also. Looking forward to Medtronic's Tubeless Pump. Best of Luck to you Linda in your search.

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