My husband is T1D and has a prescription for the omnipod 5, absolutely wonderful.
What is not wonderful is the fact that UHC keeps telling me it's covered under DME yet when I sent it to the place they tell me to send it, I'm told it can only be covered under the pharmacy plan. This has happened 4 times now and I am fed up.
It is now with Byram Healthcare and it is gonna take another 3-4 weeks (!!) before it arrives on our doorstep.
My question is, with a Silver-C advantage plan (through the marketplace) and a prior authorization already in place for the omnipod 5, how big are the chances that Byram Healthcare can actually send this out and it's covered under DME instead of the pharmacy plan?
The difference between DME and pharmacy plan is 5% vs 40% respectively, that's a big difference.
I'm tired of calling 5-6 times a day to different places to try to sort this mess out, I'm tired of having to repeat myself 4-5 times and to explain the same issue in a million different ways and still not get my point across.
I want my husband to start using the omnipod to get his sugar under control by using it in combination with the dexcom, but it's like they simply don't wanna work with me to get him all the stuff he needs!
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