Medicare

Omnipod® is covered under Medicare Part D

Open Enrollment is Now! Oct 15-Dec 7 2022

Help your patients get preferred coverage for medications through Medicare Part D

The Omnipod® System is currently the only CSII therapy available on some of the largest Medicare Part D plans. This option for your patients eliminates the hurdles posed by the Medicare Part B process.

Understanding Medicare Part D

 

Part D Pharmacy Benefit
Part B Medical Benefit
  • Coverage for your patients with both Type 1 and Type 2 diabetes
    • No C-peptide tests required
  • Typically longer turnaround times and Certificate of Medical Necessity paperwork required
  • Streamlined electronic fulfillment process, which may reduce paperwork and expedite the Pod initiation process
  • Typically longer turnaround times and Certificate of Medical Necessity paperwork required
  • Your patients pay a co-pay as they go
  • Your patients may pay high up-front costs to get started
  • Typically no switching restrictions, so if your patients don’t love it, they may be able to switch at any time
  • Your patients are locked into a 4-5 year pump upgrade cycle
  • Send prescriptions to your patients’ pharmacy of choice
 
*Patients with Type 2 diabetes with qualifying C-peptide results may have coverage.
What it Means for Your Patients
What it Means for You

Flexibility and choice

  • The Omnipod DASH® System is available through mail order or retail, which means patients have the opportunity to get their system at the same pharmacy where they get their insulin.

Less paperwork

  • Simple prescribing through your EHR system.
  • More time with your patients.

Reduced up-front and ongoing costs

  • The Omnipod DASH® Personal Diabetes Manager is provided at no charge with first box of Pods.**
  • No Commitment, Pay as you go monthly co-pay

Coverage for all patient types

  • Both Type 1 and Type 2 diabetes.
  • Typically, no c-peptide test required.
  • As easy as prescribing insulin.

Reduced risk to get started

  • There are typically no switching restrictions, so if your patients don’t love the Omnipod DASH® System, they may be able to switch at any time. And patients with tubing frustration may be able to give Omnipod DASH® System a try with no obligation at any time.

 

For more information on coverage and how to sign up, please call our Medicare Access team at 877-939-4384.

**Omnipod DASH® System customers will be eligible to receive 1 no charge PDM every 4 years with the purchase of Pods subject to certain conditions including, but not limited to, verification of insurance.
*Omnipod DASH® System customers will be eligible to receive 1 no charge PDM every 4 years with the purchase of Pods subject to certain conditions including, but not limited to, verification of insurance.

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