Omnipod® is covered under Medicare Part D!
Open Enrollment is Oct 15-Dec 7
Omnipod 5, the #1 prescribed¹ and patient requested pump², is covered by Medicare Part D!
What to know about Medicare Open Enrollment
Your patients can choose a part D plan that provides the best coverage they need, including Omnipod 5. Selecting a plan that fits their budget and prescription needs may help lower their costs.
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 2026 Changes to Costs and the Donut Hole
Annual out-of-pocket maximum for all Part D medications will be capped at $2,100
Optional Medicare Prescription Payment Plan (M3P) 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
More predictable costs as there will be no Coverage Gap (also known as the donut hole)
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?
1. USA 2024, Data on file
2. Omnipod was the pump most frequently requested by people with type 1 and type 2 diabetes in a survey with Endocrinologists conducted by dQ&A across the United States. n=77 (T1) and n=63 (T2); H2 2024; P.25
Omnipod 5 is indicated for people with type 1 diabetes, ages 2 years and older and type 2 diabetes in persons 18 years of age and older. Rx only. WARNING: Do not use SmartAdjust™ technology for people under the age of 2 or who require less than 5 U of insulin per day. Please see Omnipod.com/safety for important safety information.
INS-ODS-10-2020-00115 V3