Omnipod® is covered under Medicare Part D!
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 Medicare Part D Benefits Changes
The annual out-of-pocket maximum for covered Part D drugs is now $2,100 (versus $2,000 in 2025)
Many Medicare Part D plans are moving “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. 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 v4.0