Omnipod® is covered under Medicare Part D.
Insurance can be complicated - let us help!
The information below includes tips and strategies to find a Medicare Part D Plan that best covers your prescription(s) in a way that fits your individual budget and needs.
The first step to getting started, is filling out our online form to help us determine your coverage and benefits in your current plan.
Did you know…
- Omnipod is available on Medicare Part D plans thru the pharmacy – removing the barriers and limited access posed by Medicare Part B
- You could pay less for your Omnipod prescription – choose a Medicare Part D plan with preferred coverage during open enrollment
- Don’t miss out – Medicare Part D open enrollment is 10/15-12/7
Most Omnipod DASH® and Omnipod® 5 users on Medicare pay less than $50/mo. through the pharmacy.
Omnipod 5 calculation is based on a consumption of ten (10) Pods per month. Majority defined as at least 70% of patient co-pays $50 or less per month . Among All Paid Omnipod 5 G6 Pods Commercial and Medicare Claims from August 2022 through July 2023. Includes benefits and offerings available through Insulet, such as the copay card program. Actual co-pay amount depends on patient’s health plan and coverage, they may fluctuate and be higher or lower than the advertised amount on a monthly basis. Source: IQVIA OPC Library
Here are a few ways to check which plan is best
for you:
(Note: Unlike pharmaceutical products, Omnipod will not appear on Medicare’s plan finder site since it is a medical device.)
Have Medicare do the legwork for you
- Call 1-800-MEDICARE (1-800-633-4227) and speak with a representative
- Search the Medicare.gov plan finder site, using the following instructions:
- Make a list of your current medications other than Omnipod.
- You can create an account or just enter your zip code and select the plan type (e.g. Medicare Advantage).
- Follow the prompts to add all medications. Once all prescriptions are added other than Omnipod, click “done adding drugs”.
- Add pharmacy and click “done” - a list of plans will populate.
- Find a plan that looks most suitable, click “plan details” to get contact information for further questions regarding Omnipod coverage.
The Part D plans below cover Omnipod and may be the most cost-effective options for your Omnipod prescription:
Covered products include the Omnipod® 5 Automated Insulin Delivery System and the Omnipod DASH® Insulin Management System.
| Plan Name | Coverage Level |
|---|---|
| Aetna SilverScript Plus & Platinum 3 Tier | Covered, Tier 3 |
| AARP Medicare Rx Preferred (PDP) | Preferred, Tier 3 |
| AARP Medicare Advantage Plans: - Choice - Choice Plan 1 & 2 - Advantage & Advantage Plan 1, 2 & 3 - Walgreens - Secure Horizons, Secure Horizons Plan 1 & 2, Secure Horizons Focus | Preferred, Tier 3 |
| Cigna – all PDP & Advantage Plan Offerings | Preferred, Tier 3 |
| Express Scripts Employer Retiree Medicare Advantage Plans: - Premier Access 4 Tier Standard - High Performance 3 Tier - Premier Performance 4 Tier Standard | Preferred, Tier 2 |
| Humana Advantage Plans: - Gold Plus & Gold Plus SNP - Choice PPO - Community | Preferred, Tier 3 |
| Wellcare Medicare Advantage Plans | Preferred, Tier 4 |
| Wellcare Medicare Part D (PDP) | Covered, Tier 4 |
Looking to get started on Omnipod now with your current Medicare Part D plan?
To check your coverage, click the link below and fill out the online form. Our team will be in touch to review your benefits.
Ready to experience tubeless freedom?
Omnipod 5 and Omnipod DASH can simplify life with
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