Wearable disposable insulin pump covered by medicare?

[policywunk]

Client T65 8/1/23 is using a V Go wearable ( disposable ) insulin pump .She is pay 75.00 for cartridges monthly on ACA plan (and 125.00 for the vials of insulin. As far as i can google Medicare doesn't cover this device under part B DME even called the manufacture and they said they don't know.I understand the insulin used in a disposable pump has to be billed under part D even though she will be on original medicare with a supplement whereas the the insulin used in typical insulin pump can be billed under part Anybody have an knowledge on this?

 

[sshafran]

Client T65 8/1/23 is using a V Go wearable ( disposable ) insulin pump .She is pay 75.00 for cartridges monthly on ACA plan (and 125.00 for the vials of insulin. As far as i can google Medicare doesn't cover this device under part B DME even called the manufacture and they said they don't know.I understand the insulin used in a disposable pump has to be billed under part D even though she will be on original medicare with a supplement whereas the the insulin used in typical insulin pump can be billed under part Anybody have an knowledge on this?

I went into the weeds on a similar one (Omnipod) and after 15 different answers the truth was Part D - period. end of story.

Then finding Part D coverage on plan finders is impossible so they (Omnipod) helpfully listed on their site plans that had them on formulary.

Insulin Pump is very specific in Medicare and the newer options are not "pumps."

 

[somarco]

Insulin Pump is very specific in Medicare and the newer options are not "pumps."

Dexcom (some models) are covered by Part B, same for Medtronic.

I have yet to find a reliable resource that lists all brands and models covered by Medicare. This MNT article gives information about different pumps but fails to mention which are covered by Medicare.
[EXTERNAL LINK] - 6 Best Insulin Pumps for Diabetes in 2023: Products and More

This link shows brands and models covered by Medicare that are available through ADS (northcoastmed AKA Advance Diabetic Supplies)
[EXTERNAL LINK] - Products Archive | Advanced Diabetes Supply®

One of the considerations in buying a pump should be is it covered by Medicare or not? If the pump is not on the approved list insulin falls under Part D.