My daughter currently is using the Tandem x2 slim pump, She has been using it for a year, just seeing her with activity and other things I am wanting to switch to Omnipod…nurse at the Dr office said I have to ask Tandem first??? Why would I have to do that? What are ways to do a different pump? I am asking the Dr as well but want some input please!
We switched from Tandem to Omnipod, and no, we didn’t need Tandem’s permission. You’ll want to check your insurance, of course, but I recommend letting the Omnipod rep do that for you.
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hi @Dee314 no you don’t have to “ask”, however, depending on how your insurance covers omnipod, you may have a coverage issue. For example, my insurance covers a pump as DME, with a DME deductible, and they will only pay for a pump about every 4 years (same as the pump warranty). My insurance would cover omnipod as prescription benefit, and so I could switch no problem. If YOUR insurance covered the tslim as DME and covers omnipod as DME, they may make you pay full price for it (not cover it) for x amount of time… just a cost thing… pays to check!
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Hi @Dee314 . You said you want to switch to Omnipod - how does your daughter feel about switching? The pod may be more practical for certain sports but people do find ways to to engage even with tubed pumps.
Dee @Dee314 , carring on from what @joe said, the only reason you may need to ask Tandem is if you did not BUY the Tandem but rather entered into a pump LEASE Program.
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I’m seconding what @srozelle recommended. Pump reps are great resources - when you decide which one you want the rep checks insurance coverage, and likely has worked with individuals who have wanted to switch.
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Also echoing Joe: the reason it wasn’t a problem for us was exactly what he described. For us, Tandem was considered DME and Omnipod is pharmacy, so there’s no conflict.
Incidentally, this also made Omnipod wildly less expensive for us. That isn’t why we chose it, but it sure is nice!
Her insurance covered the Tandem, when I called and asked if there was a certain amount of time I had to keep the pump they said they didn’t see anything and we would know for sure when the Dr called to put it through. My daughter is always included in her care and her opinion always matters and she actually brought up the Omni pod because she seen a girl at the park with one and she said she would rather have that. When I looked it up I’m just not sure what is the difference between the Dash and Horizon? I’m hoping her insurance lets her switch! Thanks everyone!!
Horizon isn’t out yet, but it’s going to be Omnipod’s version of Tandem’s Control IQ, where the pod communicates directly with Dexcom. Dash is what’s available right now, where you have to enter the BG number yourself. Horizon (aka “Omnipod 5,” I think) is awaiting FDA approval, hopefully sometime soon!
You did not say how old your daughter is, but it might be smart to ask the opinion of other children her age who have used the Omnipod - what did they like, what did they not like? Or, if she is really young, ask parents of young children. When I first read about the Omnipod before going on a pump, I thought that would be a great idea. I then asked my endocrinologist for a pump and she did not deal with Omnipods, so I ended up with something else. And I am glad I did. I would have been allergic to the Omnipod, and I would have knocked it off my arm all the time if I wore one.
My daughter loves the Omnipod, and it works well for us. Everyone is different, so thank goodness there are options!