Omnipod® is covered under Medicare Part D!
Access matters. We're committed to helping keep Omnipod® 5 covered, accessible, and affordable. Omnipod 5 is the #1 most prescribed AID system through Medicare part D,1 and it is broadly available through retail pharmacies. This means there are fewer barriers between your patients and the benefits of tubeless, automated insulin delivery with a system that users agree is easy to use.2
What Medicare Part D means for your type 1 and type 2 Medicare patients
Unlike other insulin pumps covered under Medicare Part B, Omnipod 5 is covered by Part D. This means:
No more qualifying c-peptide tests to get an insulin pump
Pod therapy can start as soon as tomorrow at your patient’s preferred pharmacy
Understanding 2027 Medicare Part D Benefits Changes
The annual out-of-pocket maximum for covered Part D drugs is now $2,400 (versus $2,100 in 2026)
Many Medicare Part D plans have moved to “preferred brands,” like Omnipod, from a flat co-pay (a fixed dollar amount per month) to co-insurance (a percentage of drug or pharmacy-based device costs).
Optional Medicare Prescription Payment Plan (MPPP) enables Medicare beneficiaries to pick up their prescription with no payment at the pharmacy counter and spread the out-of-pocket cost over the year
Additional resources for you and support for your patients
Omnipod is committed to helping you support your patients’ Pod therapy treatment.
1) Omnipod offers a free coverage check and support with the coverage determination process.
- Send prescription to ASPN Pharmacies in Livingston, New Jersey location today to start the coverage check and support process for your patient
- Our dedicated team at ASPN Pharmacy can eliminate the uncertainty around formulary exceptions, prior authorization form selection and submission processes
2) Through CoverMyMeds
- Initiate electronic PA (ePA) as would for any medication that needs Prior Authorization
- Once approved, send prescription to patient’s preferred retail pharmacy
3) Use our coverage lookup tool to find Medicare Part D plans in your area that cover Omnipod
If you’d like more information about Medicare, please visit:
Medicare.gov or call 1-800-MEDICARE
Ready to prescribe?
2. Insulet Data on File. OP5-003 Clinical Study Report. 2024.13-week randomized, parallel-group clinical trial conducted among 194 adults (age 18-70) with type 1 diabetes in France and the U.S., comparing the safety and effectiveness of the Omnipod 5 System versus pump therapy with CGM.
The Omnipod 5 Automated Insulin Delivery System is indicated for use by individuals with type 1 diabetes mellitus in persons 2 years of age and older and type 2 diabetes mellitus in persons 18 years of age and older. Refer to the Omnipod® 5 Automated Insulin Delivery System User Guide and www.omnipod.com/safety for complete safety information including indications, contraindications, warnings, cautions, and instructions.
INS-ODS-10-2020-00115 V5