Simplified insulin delivery deserves simplified access.
Omnipod® is available through the pharmacy. And while all of our systems require a prescription, they are covered under private insurance companies, Medicare, select State Medicaid and Managed Medicaid Programs. When you submit your health insurance information, we’ll contact your insurance provider(s) to determine your benefits. We will then contact you to review your benefits before getting started. For more information, call 1-800-591-3455.
Omnipod DASH® users pay on average less than $50/mo. co-pay* through the pharmacy.
The only tubeless, full-feature insulin pumps available through the pharmacy
The pharmacy channel makes it convenient to pick up your Pods where you’d normally pick up your insulin. Omnipod® products are available nationwide through retail and mail-order suppliers. Click here for a list of available pharmacies.
Benefits of the pharmacy channel include:
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Convenience of picking up your Pods and insulin supplies in one place
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Alleviates high start-up costs by providing the Omnipod 5 Controller or DASH Personal Diabetes Manager (PDM) at no charge with your first prescription*
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Simplifying payments with a monthly, pay-as-you-go cost structure†
To receive Omnipod through your pharmacy benefit, your health care provider will need to submit a prescription, which allows you to receive your Pods just like you receive your insulin.
†Seagrove Partners syndicated services; 2020. The diabetes forum: 2020 insulin pump market primer
How much will Omnipod cost?
While on average, most Omnipod DASH® users pay less than $50 per month through the pharmacy, your actual cost will differ based on your insurance coverage. To get a sense of your out-of-pocket cost for Omnipod, give us a call at 1-800-591-3455 or get started online with a no-commitment benefits check.
*Average calculated based on a consumption of ten (10) Pods per month. Majority defined as at least 70% of patient co-pays under $50 per month. Based on 325,741 paid pharmacy claims between January 1st, 2022 and December 31st, 2022, both for commercial plans and Medicare, and includes benefits and offerings through available Insulet programs, such as the DASH co-pay card. 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.
How to get started with your pharmacy benefit
- Once you and your doctor have determined that Omnipod is the best choice for you, complete our form to get started. This will allow our Omnipod Specialists to contact your insurance plan to determine if you have coverage.*
- After reviewing your insurance information, you will receive an email or phone call from an Insulet Customer Care representative to discuss your insurance results.
- Once you're ready to get started, our team will connect you with a serviceable pharmacy. We will also follow up with your health care provider directly to request a prescription.
- Once your health care provider sends the prescription to the specified pharmacy, your Omnipod product will be processed and ready for pick up or shipped.
Covered by Medicare? So are we
Omnipod is covered under Medicare Part D. But unlike pharmaceutical products, Omnipod does not appear on Medicare’s plan finder site since it is a medical device. Still, there are access options for some Part D plans under a Tier 3 and Tier 4 co-pay benefit.
Curious what Medicare coverage options may be available for you?
Omnipod not covered by your insurance?
If Omnipod is not covered by your health insurance click below for steps on how to advocate for yourself or a loved one living with type 1 diabetes.
Don’t let cost get in the way - financial help is available
We’re constantly assessing our financial assistance program. Eligibility will depend on product and insurance coverage. Call us to discuss the details*.
*Omnipod® Copay Card
Financial Assistance Program Terms
1. Program Eligibility
Eligibility criteria: Subject to program limitations and terms and conditions, the Omnipod® Financial Assistance Program (the “Program”) is open to patients who have a valid Omnipod DASH® or Omnipod® 5 prescription who demonstrate a financial need for assistance based on criteria established by Insulet, and who fill their prescription through the Pharmacy channel.
This offer is not valid for participants whose prescription is paid for in whole or in part by Medicare, Medicaid, or any other federal or state program. This offer is only valid in the United States, Puerto Rico, and the U.S. territories. Participants receiving their products through the Durable Medical Equipment or Pharmacy Durable Medical Equipment channel are not eligible to participate in the copay card program. Participants on certain commercial insurance plans may not be eligible. Please contact Insulet Customer Support at 1-800-591-3455 for details.
2. Program Details
With the Program, an approved participant who meets eligibility criteria may receive a copay card to reduce their monthly out-of-pocket expenses when filling their Omnipod® prescription. The program is described as follows:
• A program benefit that covers the participant’s eligible out-of-pocket prescription costs for Omnipod DASH® and Omnipod® 5 Pods (copay, deductible, or co-insurance) on behalf of the participant, in accordance with criteria determined by Insulet.
• In order to participate in the Program, a person shall complete Insulet’s Financial Assistance Program Application Form, as provided by Insulet and as may be updated from time to time.
• The form shall be filled out with true and correct information by the applicant and provided to Insulet.
• In addition, the applicant shall provide evidence of income, as directed by Insulet.
• Insulet shall evaluate the application in accordance with its policies and make a determination as to the eligibility of the applicant.
• If the application is accepted by Insulet, Insulet shall communicate to the participant the level of assistance that they will receive as part of the Program.
• The assistance shall be provided through a copay card delivered electronically by Insulet to Participant.
• The copay card shall be valid for one (1) year and covers a thirty (30) days’ fill of Pods, every month.
• Participants are solely responsible for updating Insulet with changes to their prescription, financial situation or health insurance, including but not limited to, initiation of insurance provided by the government, in addition to any change in coverage terms or other offers such as accumulator adjustment benefit design or copay maximization programs. Participants shall further inform Insulet of any change or lapse in coverage for their Omnipod ® prescription.
• Participants are responsible to provide Insulet with accurate information on their copay.
Insulet reserves the right to change, amend or rescind this Program, in whole or in part, at any time.
3. Limitations
The Program may not be combined with any other offer, rebate or coupon. If at any point a participant begins receiving coverage under any state or government program, the participant will no longer be able to use this card and they must contact Insulet Customer care at 1-800-591-3455 to stop their participation. Participant shall also update Insulet if their financial situation changes in a way that would make them non-eligible to participate in the Financial Assistance Program. Participating in this Program means that you are ensuring you comply with any required disclosure regarding your participation in the Program. Other restrictions may apply. Health plans, specialty pharmacies and Pharmacy Benefits Managers not specifically authorized by Insulet are prohibited from enrolling participants in the Program. The copay card shall last for a maximum of twelve (12) months per participant.
This Program is not health insurance. Insulet reserves the right to rescind, revoke or amend this offer, as well as any eligibility criterion without further notice.