Omnipod® 5 FAQs:
Availability and Access

Yes. The Omnipod 5 System is available through the pharmacy channel.

At this time, the Omnipod 5 System is available in the United States, the United Kingdom, Germany and the Netherlands. We are currently working on making the Omnipod 5 System available in additional markets, but no further information is available at this time. The Omnipod Insulin Management System and Omnipod DASH Insulin Management System continue to be available in Europe and Canada.

Insulet does not ship Omnipod 5 (Pods or Controller) directly.

Through the pharmacy channel there is no long-term commitment or 4-year lock in period enabling a user to start or switch to the Omnipod 5 System at any time.

Typically, the pharmacy channel requires less paperwork for authorizations. Thus, simplifying the process for healthcare providers and improving the patient experience to start on product with a valid prescription.

Yes, Omnipod is covered under Medicare Part D. But unlike pharmaceutical products, Omnipod does not appear on Medicare’s plan finder site since it is a medical device. Still, there are access options for some Part D plans under a Tier 3 and Tier 4 copay benefit. To learn more about Omnipod and Medicare click here.

No. Omnipod and Insulet Corporation follow federal laws that prohibit savings to be applied to government insurance programs.

We have Omnipod specialists available who will help determine not only what product may be best for you but what savings may be available.  Visit us at Request a call | Omnipod and tell us about yourself and a specialist will call you or you can call them at 1-800-591-3455, 9AM EST to 8PM EST M-F.

If you are insured but Omnipod is not covered by your plan, our Customer Advocate team can help. Please call 800-591-3455 to speak with a dedicated Customer Advocate on adding Omnipod to your coverage. To learn more about the Omnipod Financial Assistance Program^§ click here. 

If you meet specific eligibility criteria and income guidelines the Omnipod Financial Assistance Program^§ may be available to you. Click here to learn more or call us at 800-591-3455.

The out-of-pocket cost of the Omnipod will depend on the individual’s coverage and can be determined once access to Omnipod is secured through their insurance plan.  We offer a free benefits check so you can better understand your coverage. Simply connect here and fill out the form and an Omnipod specialist will take it from there.

Omnipod 5 may be covered by Veterans Health Administration for VA beneficiaries who qualify. To determine if you qualify, please consult your VA healthcare provider. You must be seen at a VA healthcare facility or a VA Community Care Network clinic to be eligible to qualify for coverage.

Omnipod 5 may be covered by DoD/Tricare for beneficiaries who meet the prior authorization criteria. To determine if you qualify, please speak with your healthcare provider to submit an initial prior authorization. Once you have received a prior authorization approval from DoD/Tricare, eligible Omnipod 5 systems may be obtained through retail or home delivery. For more information on retail pharmacy or ESI mail order, visit TRICARE Formulary Search at https://www.express-scripts.com/frontend/open-enrollment/tricare/fst/#/#/.

As with any new product, coverage will be limited, but continue to build steadily and continuously. To review your coverage and available options, call Customer Care at 800-591-3455.

Omnipod 5 may be covered by IHS or Tribal Insurance. To determine if you qualify, please consult with your healthcare provider. You must be seen at your healthcare facility to be eligible to qualify for coverage.

Omnipod DASH may be covered by Veterans Health Administration for VA beneficiaries who qualify. To determine if you qualify, please consult your VA healthcare provider. You must be seen at a VA healthcare facility or a VA Community Care Network clinic to be eligible to qualify for coverage.

Omnipod DASH may be covered by DoD/Tricare for beneficiaries who meet the prior authorization criteria. To determine if you qualify, please speak with your healthcare provider to submit an initial prior authorization. Once you have received a prior authorization approval from DoD/Tricare, eligible Omnipod 5 systems may be obtained through retail or home delivery. For more information on retail pharmacy or ESI mail order, visit TRICARE Formulary Search at https://www.express-scripts.com/frontend/open-enrollment/tricare/fst/#/#/.

Omnipod DASH may be covered by IHS or Tribal Insurance. To determine if you qualify, please consult with your healthcare provider. You must be seen at your healthcare facility to be eligible to qualify for coverage.