Type 1 diabetic for 23 years here. I was prescribed omnipod 5 system back last year in 2023. Due to some depression I was going through I didn’t feel like I was actually ready to start it at the time and held off. Well I finally scheduled the training and everything and have been using the system. My blood sugars have been amazing for the first time in my life. I had struggled with carb sensitivity and feeling like my insulin could never keep up. I ran a lot of highs and sometimes would panic inject then end up low. I have been in range pretty much the entire time.
Well I was finally feeling good until I went to refill the pods at the pharmacy. My cost with insurance is $1532 out of pocket. I can’t even fathom this. I’m not working currently and have just been living off of my husbands income due to other health diagnoses of autoimmune disorders as of late. I just had to take more time off than my job was willing to give. I don’t know what to do. Even if I was working…How can anyone afford this??? Does anyone have any recommendations? I truly appreciate it.
Courtney- Have you called the Insurer to question this? Ask them to explain the best (cheapest) way for you to get diabetes supplies. It may cost much less if you get the pods via mail order. With my plan I pay much less if I use the preferred mail order pharmacy (Express Scripts) rather than my local drug store. I hope you can find a solution as this cost seems ridiculously high.
-Joanne
Yes I did. Unfortunately it was only $100 difference. I have BCBS of Ohio but it’s a new high deductible plan we didn’t have a choice with. It was either have something or nothing
Hi Courtney, Those high deductible plans are a huge challenge for T1ds. I know that all of the insulin manufacturers offer assistance (usually called copay cards) to reduce costs for those who have high out of pocket costs with insurance. I don’t know whether the pump manufacturers do, but you should definitely call them and ask. It’s usually a department called Patient Assistance or similar. You’ll have to answer a bunch of questions, but it’ll be worth it if it saves you money. I hope they can help you !
Since you have lost your job your household’s reduced income may make you eligible for your state’s Medicaid program.
Were you previously on a different pump, or taking injections? If you were taking injections before (and not switching from another pump) your needs may have changed since. It may not be ideal and definitely not as convenient, One challenge of managing highs (on either a pump or injections) is the roller coaster that happens if you stack insulin in a panic, resulting in going low later. Years ago my doctor told me that assuming I had calculated correctly I should not take any additional insulin for ### hours to allow the insulin to do its work. Only take more of I are more or realized I had under-counted my carbs. That has been very helpful.
I have great news diabuddies! I applied for financial assistance with omnipod and reduced my 30 day supply to $50. I am over the moon. Thank you all for your concern and help
