Diabetes is a common ailment among seniors, which makes diabetes management a major concern for many Medicare recipients. Doctors will routinely prescribe insulin injections as a treatment for type 2 diabetes, the most common form among seniors. Many seniors, however, are interested in insulin management systems like Omnipod. Keep reading and we’ll discuss the Omnipod system and whether Medicare benefits will cover it.
In a nutshell, diabetes occurs when your body stops making the hormone insulin, stops making enough of it, or doesn’t use the insulin it makes the right way. When the body turns carbs into glucose, the lack of insulin prevents your cells from turning it into energy you can use. Instead, you get a glucose buildup in the body. The glucose buildup is very bad for your body and can lead to heart disease, damage to your sight, and even amputation of your toes or feet.
Doctors address diabetes in several ways. The most common approach is a nutrition plan that replaces foods high in processed sugar with healthier food. Healthier foods release sugar into your bloodstream more slowly than high-sugar snacks. You can also expect your doctor to suggest more exercise to help you control your weight. Finally, for more serious cases, your doctor may prescribe insulin shots.
One of the key challenges with insulin shots is that you must remember to take them. If you still work, it’s easy to forget to take your shots on the rigid schedule they require. As people grow older, memory often becomes its own health concern as various forms of dementia become more likely. This is where Omnipod enters the equation.
Omnipod is an insulin management system. In simple terms, the system delivers insulin to your system in two ways. It delivers a base or basal rate of insulin around the clock. It also can deliver additional insulin around your mealtimes to maintain a stable blood glucose rate. This eliminates the need to remember to take your insulin several times a day. Instead, you or someone you trust only need to refill the insulin once every three days.
Does Medicare Cover Omnipod?
Your Medicare benefits may cover the Omnipod insulin management system, if you have Medicare Part D prescription drug coverage. Rather than treating Omnipod as treatment or therapy that might get coverage under Part B, like an outpatient service, Medicare considers Omnipod a prescription in the same way it would treat insulin itself.
Your doctor prescribes you the Omnipod system and you take the prescription to a pharmacy the way you would any other prescription. The pharmacy fills the order.
Part D plans each have a formulary, or list of covered drugs. You’ll need to make sure the formulary for your Part D coverage includes Omnipod. If you aren’t sure about your coverage or the formulary doesn’t make it clear, contact your Part D provider and ask for clarification.
The cost for your Omnipod prescription will depend on your Medicare Part D plan because costs and coverage can vary.