Sarah Howard
Sarah Howard has worked in the diabetes research field ever since she was diagnosed with T1D while in college in May 2013. Since then, she has worked for various diabetes organizations, focusing on research, advocacy, and community-building efforts for people with T1D and their loved ones. Sarah is currently the Senior Marketing Manager at T1D Exchange.
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For insulin pump users: When you were ordering your current insulin pump, at what point during the ordering process did you learn how much of the device costs your insurance plan would cover? Cancel reply
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I was pleasantly surprised when I ordered my Tandem pump last month. Insurance had told me I’d have to meet my deductible ($2,000) and co-insurance (30%) after that but the supplies would be covered by a $30 “diabetes management” co-pay. Instead, both the supplies and the pump were covered by the $30 co-pay so my total cost for the t:slim X2, 90 days of set and 90 days of cartridges was $90.
I have found that I have to place the order for the provider to then check insurance coverage. Then once I have the coverage amount I can cancel – or proceed with shipping seems to be a backwards system.
I work for a company who supplies pumps and CGMs and diabetic supplies. We check insurance coverage before we give a number for cost. If you get a out of pocket cost and it changed, check the company you work with!
I used an upgrade offer from Medtronic that was not covered by insurance. Total was $400. Now that I think about it, I should have answered “I knew my coverage and cost before I ordered” instead of “other”.
I had researched the cost for the T:slim X2 and I knew medicare would cover 100% after deductable. The pump supplier did not know that I had all ready met my deductible. So that was the only variable.
I learned my out of pocket costs during the orer process phone call.
A related story: I ordered the pump through a supply company, which I also used for CGM supplies. I was promised that I didn’t need to pay for the pump for 90 days, which I planned to take advantage of until I went to reorder CGM sensors and couldn’t place an order with an outstanding balance! 🙃 It was not resolved after several phone calls and emails, so I eventually had to pay rather than run out of supplies.
I was perplexed to find the insurance company had “leased” the insulin pump from a third party supplier and when I changed insurance I owed the difference as the new insurance company would not assume the lease agreement. I was angry.
I carefully checked before starting the ordering process because I was aware that Medicare, my secondary insurance, would not pay a penny and I’d be responsible for that portion in addition to my copay. My Animus Vibe pump was 2 years old at the time Animus shut down. I wanted a Tandem pump to replace it. My primary insurance was willing but Medicare wouldn’t waver from their 5 year rule, leaving me with a $940 bill. I made the decision to purchase the Tandem pump knowing that the cost would drain my small savings account.
I began Pumping in 1998 and was aware of the “4 Year Warranty” but not with the Medicare rules I was subject to when I chose the Tandem. There was just a small balance to pay as I had well over 4 years on my current Animas when they went out of business.
After trying to figure out how to get dash pods covered by insurance for awhile, the nurse at endo did something and I got a notice it was ready at my pharmacy, so didn’t find the price till I went and picked up.
I’m due for a new pump but cannot get a cost before I order it. I don’t understand why. So frustrating and annoying and it makes me not want to give these multi-billionaires my money in protest—even if my diabetes management suffers.
I knew my cost and it is zero! I live in a country, Italy, where the National Health System provides free cures to all citizens that need it. I think this is better than the insurance system that holds in other countries, including US.
I don’t remember the details, but I do remember thinking that everyone was keeping a secret – the cost!
There was nothing for me to pay. I live in the UK (United Kingdom of Great Britain and Northern Ireland) where ALL of my diabetes consumables are paid for by our NHS (National Health Service), which is funded via direct taxation of all working people.
I was totally ignorant and didn’t think to investigate the costs, after a year discontinued the CGM because of the costs. In a way I’m glad, I’d have never opted to pump/CGM had I known although still unsure if there were options. Kept thinking my deductible threshold would be reached but no.
I really don’t remember, but I am pretty sure I would have looked into the price before ordering so as not to be hit with a large bill. Luckily, all of my CGM and pump supplies are paid by my insurance. The only thing I pay is $35 for my insulin per prescription.
Edgepark does a good job of showing my out-of-pocket costs before I add the items to the cart. This applies even to the first order of the year where the deductible applies.
I haven’t used an insulin pump b/c I’m concerned about the costs.