Get Your Patient Started on the Omnipod® Insulin Management System
Once you determine that the Omnipod® System is the right insulin therapy option for your patient, our Customer Care team will work with you, your patient, and your patient’s insurance provider to get him or her started as quickly as possible.
Due to the unique disposable nature of the Pods, the Omnipod® System may be covered either through your patients’ pharmacy benefit or their medical benefit. The Omnipod® System may also be covered by your patients’ Medicare Part D insurance provider. Our expanded coverage options improve access to Pod therapy and offer many patients the flexibility to choose how they prefer to receive their Pods.
Omnipod® System Patient Profile
The Omnipod® System is intended for individuals with insulin-dependent diabetes including Type 1 Diabetes, Type 2 Diabetes, Gestational Diabetes, and Latent Autoimmune Diabetes. It can be used by people of all ages and is ranked the #1 prescribed pump1 for children.
Insulin pump therapy is not recommended for individuals who are:
- Unable to perform at least four blood glucose tests per day
- Unable to maintain contact with their healthcare provider
- Unable to use the Omnipod® System according to instructions
Prescribe the Omnipod® System through the Medical Benefit
Please work with your patient to complete the following:
- Patient Information Form
- Certificate of Medical Necessity
- Photocopy of the front and back of your patient’s medical insurance card
Send these three completed documents as a single fax to our confidential fax line at 877-467-8538. After our Customer Care team contacts your patient’s insurance provider(s) to confirm his or her insurance coverage, we will then follow up with your patient directly to discuss coverage options, confirm the prescription, and arrange for shipment of the Omnipod® Insulin Management System.
Prescribe the Omnipod® System as a Pharmacy Prescription
The Omnipod® System is the only full-featured insulin pump in the United States that is available through the pharmacy channel. We currently have access through the two largest Pharmacy Benefit Managers in the nation, and are continuing to expand pharmacy access across the United States. To get your patient started, all that a pharmacy benefit manager requires is an electronic prescription (eRx), which enables your patient to order Pods in the same way that he or she would order other prescriptions. Please view our sample prescription to see how to write an eRx for the Omnipod® System.
For patients with Medicare coverage, the Omnipod® System may also be available as a Medicare Part D benefit.
Request a Demo Kit to Try the Pod at Home
If your patient is unsure about which insulin pump is the right choice, our Demo Kit allows patients to get a feel for the Omnipod® System prior to ordering. The Demo Kit features a non-functioning Pod that your patient can wear for up to three days to get a feel for the Pod at home. Your patient can request a free demo kit on our website, and we will follow up with them directly to arrange for shipment of the kit.
How Much Will the Omnipod® System Cost?
The actual cost of the Omnipod® System will vary based on your patients’ insurance coverage. If your patients are able to get the Omnipod® System through their pharmacy benefit, they will pay a co-payment. If they are receiving it through their medical benefit, they will pay a pre-determined co-insurance percentage.
The Omnipod® System Financial Assistance Program
Our mission is to make diabetes management as accessible as possible. Should any Omnipod® System users change or lose insurance coverage, Insulet’s Financial Assistance Program provides eligible users with a financing plan that allows them to continue to benefit from the Omnipod® System, regardless of insurance provider.
- According to dQ&A Q1 2018 Patient Panel Survey. Share of parents of children with Type 1 Diabetes on an insulin pump who had been prescribed the Omnipod® System was higher than for other pumps. Statistical significance of results calculated at the 95% confidence level.