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Get a Pump

Each person’s healthcare set-up is different, so we can’t tell you exactly what to do. But, we can offer guidance that may help you get the device combo that best fits your lifestyle.  

“If your highs and lows are controlling you, a pump is worth the money.” - Kelsey, 26


1. Choose a Pump

Different pumps have different features. Figure out which features matter to you, and then find a pump that best matches your needs. Some features to look for are sizes of insulin doses (bolus increments), wireless connection to a sensor, wireless connection to a blood sugar meter, water resistance, and whether the pump is tubed or tubeless. What the pump looks like is important to think about, too!

If you're thinking about a smart system with automated insulin delivery, be aware that each system uses a specific sensor and pump and you will be choosing them together as a unit.

Questions to Consider:

1. Do I want a pump that communicates with my sensor?

2. What do I want my pump to look like?

3. Do I want to have tubing?

4. How precise do I need my insulin doses to be?

5. Do I need my pump to be water resistant?

6. What do other people say about it?

7. Do I want my pump to be part of a smart system?

Which pumps are available? Click on the following links to get more information:

Medtronic  
Omnipod
Tandem


2. Understand Your Costs

The cost of pumping goes beyond the initial cost of the insulin pump. You also have to reorder supplies such as infusion sets and insulin cartridges every few months. Check for two things:

1. Check the Durable Medical Equipment section of your insurance for how much of your device and supplies will be covered.

2. Does your plan kick in to cover Durable Medical Equipment only after the annual deductible has been met?

Usually, you can find this information by downloading your Explanation of Benefits/Explanation of Coverage or by calling your insurance company. If you call the pump company, and indicate you’re interested in their pump, they will help you confirm your level of coverage before asking you to purchase anything.


3. Get a prescription

Either during your clinic visit, or over the phone, request a prescription for an insulin pump and the accompanying supplies such as infusion sets and insulin cartridges from your doctor. If switching from injections, make sure you also get a larger prescription for your short-acting insulin, since this will replace your long-acting insulin while using the pump. See the "How to Talk to your Healthcare Provider Guide" for help with this step.
Tips for talking to your doctor

“My A1C has gone down significantly since being on a pump.” - Ashley, 28

 


4. Get Insurance Approval

To get approved by your insurance company for your first pump, you will have to prove that you qualify. Some common qualifications include hypoglycemia unawareness, dawn phenomenon, severe high and low blood sugars, hospitalizations due to diabetes, complications due to diabetes, high A1c, and more. If you want more specifics, the pump company will usually tell you exactly what your insurance requires to qualify for their device.

Many times, an insurance company will ask for a “Letter of Medical Necessity” from your healthcare provider. Most insurance companies have a template of this on their website for physicians to fill out. Request that your healthcare provider include all of your qualifications, and include any reasons that you think your blood sugar management would improve because of an insulin pump.

Sometimes insurance companies also ask for other supporting materials such as lab tests, blood sugar logs, or clinic notes. It may feel like a lot of hoops to jump through, but having these materials organized before starting the process may help things go more smoothly.

Click the links below to get information about Medicare and private insurance coverage for:
Medtronic
Omnipod
Tandem


5. Order

Once you have all the paperwork and approval, you’re ready to order! Have your healthcare provider send a prescription to the pump company of your choosing or a local supplier supported by your insurance company. You’ll pay your co-payment, and supplies can usually be shipped to your doorstep.

You can say “hi, I’m interested in getting a Pump, can you help me with that?”


6. Get Trained

Once your pump arrives, or even as it is in transit, ask your clinic if they have any trainers available to help get you started on your new device! Sometimes, the pump company also has local or virtual trainers to assist. It can be tricky learning all the features of an insulin pump or smart system so speaking to someone face-to-face can help a lot! Online videos and the user manual for your pump are great resources.