United Healthcare to Begin Covering Tandem Insulin Pumps
On July 1, 2020, United Healthcare (UHC) announced they will begin covering the Tandem t:slim X2 insulin pump for members on Medicare Advantage, Medicaid, individual and group market plans, a departure from UHC’s four-year policy to only provide health insurance coverage for Medtronic insulin pumps.
Actual dollar coverage amount will vary from plan to plan, but the decision to provide coverage for more insulin pump options is a major step for people who require insulin to survive and prefer an insulin pump, shown to improve quality of life, as an insulin delivery system.
UHC previously only provided coverage for Medtronic insulin pumps, a policy that was criticized as limiting choice for people with type 1 diabetes and insulin-dependent type 2 diabetes, particularly because UHC is the largest health insurance company in the US. The Medtronic-only coverage policy previously applied to adults, then expanded to children on February 1, 2019, a move condemned by the the diabetes community.
JDRF’s Coverage 2 Control campaign put heavy pressure on UHC, calling on members of the diabetes community to voice their concerns not only to UHC, but to all insurance companies with policies that limit choices of care for people with diabetes.
Different insulin pumps have different features, usage methods and dosing capabilities. This makes choosing an insulin pump system extremely personal. Each insulin pump company—currently Medtronic, Tandem and Insulet (makers of Omnipod) in the United States—utilizes different types of infusion sets, has different delivery and setting capabilities and unique customer support. Medtronic and Tandem both have closed-loop systems available (Omnipod’s closed loop system is coming soon) with different continuous glucose monitor (CGM) integrations and different algorithms to manage blood sugar levels.
For many users, the ability to choose between types of insulin pumps is not only one of personal preference, but of true safety. For example, in 2017 the Porter family had to fight for coverage for a tubeless Omnipod insulin pump for their son Colton, who lives with autism and required a non-tubed insulin pump for sensory reasons.
While Beyond Type 1 applauds the decision to include the Tandem t:slim X2 insulin pump as part of UHC’s coverage, as a matter of safety and health, further reliable and affordable treatment choice is required for all people living with diabetes.
Editor’s Note: For help navigating insurance coverage of diabetes supplies and medication, check out our Health Insurance Hurdles 101 or our T1D health insurance guide.