Anthem Insurance and Tandem pump


(Bill) #1

I’m on Anthem BlueCross BlueShield (Blue Preferred Plan (POS)) and was looking to get on the Tandem pump system. It’s really difficult to find out what the yearly costs will end up being. I was wondering if anyone would be willing to share what their cost have ended up as… Thanks!


(Dennis J. Dacey, PWD) #2

Hi @Bill,
There are so many differences in insurance plans - deductibles, coinsurance, etc., I suggest that you speak directly with YOUR insurance company representative. Also call in the Tandem pump representative to direct your approach. First question is, “Is Tandem a provider to BC / BS of Wisconsin”; for example I use a Medtronic pump which links to the Contour BG meter for wireless transmission of BG values. United Health / Medicare supplies all my pump needs at total annual cost to me of $0.00 yet will not provide even one penny toward the cost of BG strips for the meter.

It is not a matter of cost that determines which brands are covered and at what cost.


(hopekyra) #3

I agree with Dennis–you’ll have to talk to a representative about your specific plan. It’s worth noting, though, that the purchase of the pump and the supplies might not fall under your standard deductible (at least with Anthem BCBS–that’s what I have also). It will fall under “durable medical equipment,” which might have its own separate listing under your plan. With my Anthem plan, they cover all of my test strips, lancets, and Dexcom CGM supplies at no cost to me because it falls under preventive care. However, when I purchased my pump, I believe I paid my durable medical equipment deductible + my 20% copay for costs after I hit that mark. I think I paid around $1000 out of pocket for the pump itself. Now that the pump cost is out of the way, I have to pay for the pump supplies (reservoirs and insets). I believe it’s around $300 every three months (for enough supplies to change sets every 2-3 days), and once I hit my durable medical equipment deductible each year then I only pay a portion of that. Hope that helps! Definitely talk to Anthem and medical equipment supplier (like Edgepark) for specific cost info though!