Omnipod® is covered under Medicare Part D.

Insurance can be complicated - let us help! 

The information below includes tips and strategies to find a Medicare Part D Plan that best covers your prescription(s) in a way that fits your individual budget and needs.

Did you know…

  • Omnipod is available on Medicare Part D plans thru the pharmacy – removing the barriers and limited access posed by Medicare Part B
  • You could pay less for your Omnipod prescription – choose a Medicare Part D plan with preferred coverage during open enrollment
  • Don’t miss out – Medicare Part D open enrollment is 10/15-12/7

Omnipod DASH® users pay on average less than $50/mo. co pay through the pharmacy.

Average calculated based on a consumption of ten (10) Pods per month. 131,049 paid claims between January 1st, 2020, and December 31st, 2020, both for commercial plans and Medicare, were analyzed Actual co pay amount depends on patient’s health plan and coverage, they may fluctuate and be higher or lower than the advertised amount on a monthly basis. Source: Data on file.

Here are a few ways to check which plan is best
for you: 

(Note: Unlike pharmaceutical products, Omnipod will not appear on Medicare’s plan finder site since it is a medical device.) 

Have Medicare do the legwork for you

  • Call 1-800-MEDICARE (1-800-633-4227) and speak with a representative 
  • Search the Medicare.gov plan finder site, using the following instructions:
    1. Make a list of your current medications other than Omnipod.
    2. You can create an account or just enter your zip code and select the plan type (e.g. Medicare Advantage).
    3. Follow the prompts to add all medications. Once all prescriptions are added other than Omnipod, click “done adding drugs”.
    4. Add pharmacy and click “done” - a list of plans will populate. 
    5. Find a plan that looks most suitable, click “plan details” to get contact information for further questions regarding Omnipod coverage.

The Part D plans below cover Omnipod and may be the most cost-effective options for your Omnipod prescription:

Omnipod® 5 Automated Insulin Delivery System

 

Plan Name Coverage Level Phone Number
Cigna – All PDP and Advantage plan offerings Preferred
Tier 3
855-391-2556
Humana Gold, Community, and Choice Advantage Plans Preferred
Tier 3
888-347-0092
Aetna SilverScriptPlus Preferred
Tier 3
855-335-1407
Elixir – All plan offerings Tier 4 866-250-2005
Wellcare – All PDP and Advantage plan offerings Tier 4 866-527-0056
MedImpact Medicare Tier 4 877-403-6032

Omnipod DASH® Insulin Management System

 

Plan Name Coverage Level Phone Number
AARP MedicareRx Preferred (PDP) and MedicareAdvantage Preferred
Tier 3
800-850-6807
AARP Medicare Advantage Plans 1, 2, 3 Preferred
Tier 3
800-850-6807
AARP Medicare Advantage Choice Preferred
Tier 3
800-850-6807
Cigna – All PDP and Advantage plan offerings Preferred
Tier 3
855-391-2556
Humana Gold, Community, and Choice Advantage Plans Preferred
Tier 3
888-347-0092
Aetna SilverScriptPlus Preferred
Tier 3
855-335-1407
Elixir – All plan offerings Tier 4 866-250-2005
Wellcare – All PDP and Advantage plan offerings Tier 4 866-527-0056
MedImpact Medicare Tier 4 877-403-6032

Looking to get started on Omnipod now with your current Medicare Part D plan?

To check your coverage, have your doctor send a prescription to your local retail pharmacy OR click the link below.

Ready to experience tubeless freedom?

Omnipod 5 and Omnipod DASH can simplify life with
3 days (up to 72 hours) of continuous, tubeless insulin delivery with no multiple daily injections. 

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