Medicare

Omnipod® is covered under Medicare Part D

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.

 
Learn if your patient is covered

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.
Frequently Asked Patient Questions
*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.