Does Medicare Cover a T Slim Insulin Pump?

As technology in the medical field continually advances, diabetics who are dependent on insulin continue to have more options available to meet their unique needs. Insulin delivery systems such as the T Slim Insulin Pump allows patients to have the proper amount of insulin throughout the course of each day, without needing any manual injections. But is it covered for Medicare recipients? 

Medicare Benefits Solutions

Mar 31, 2021

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What Is the difference between insulin injections and insulin pumps?

Using injections or pumps often boils down to the preference of the individual. Either method is used to provide accurate, timely doses of insulin for patients who are maintaining their overall health requirements.The main difference between the majority of insulin pumps and insulin that’s injected, however, is the type of insulin that each of them use.

Most pumps use bolus, or rapid-acting, insulin. Manual injections allow patients to use long-lasting (basal) insulin. Of course, this always depends on the patient’s individual needs and circumstances.

There are some critics of pump systems. These critics point out that using rapid-acting insulin may put patients at risk of diabetic ketoacidosis if there is ever a pump failure and the patient doesn’t immediately notice the problem. On the contrary, individuals that prefer using an insulin pump tend to praise how easy they are to use. They also enjoy the flexibility that using an insulin pump has when adjusting the rapid-acting doses to response to food consumption and daily activity levels.

With all of that said, the main deciding factor for diabetics who are considering a pump is whether they believe they’ll be able to appropriately use the pump in accordance with the manufacturer’s instructions. In other words, insulin-dependent people who doubt that they’ll understand or comprehend how to properly navigate the settings of a pump often feel a lot more comfortable taking insulin via manual injections.

How does the T Slim Insulin Pump work?

The T Slim Insulin Pump is currently one of the smallest insulin pumps that you’ll find on the market. In fact, it’s very easy to wear, comfortable, and is highly discreet. The T Slim unit works the same way most other insulin pumps do. It provides regular doses of insulin through a thin plastic tube, or cannula, which is attached with a medical-grade adhesive to the injection site.

It has a rechargeable battery and a touchscreen, as well as sophisticated software that will help integrate it with a Dexcom G6 continuous glucose monitor, or CGM. When the T Slim unit is paired with Dexcom CGM, it can predict all low blood sugar levels. It then automatically adjusts the insulin amounts it releases in response to the fluctuations. Then, a patient can download daily reports to their computer. Or, they can use the pump’s controls with a smartphone app. T Slim users are able to share their data with up to 10 contacts. This helps them screen for issues with the pump or glucose levels.

What Is the Medicare coverage for a T Slim Insulin Pump?

If you receive Medicare benefits and are a diagnosed diabetic requiring insulin to help manage your blood sugar levels, you may qualify for Medicare coverage of the T Slim Insulin Pump under Medicare Part B. For a pump to be eligible DME, or durable medical equipment, a diabetic person could be required to provide proof that more than three insulin injects are needed each day.

Medicare benefits may cover only specified brands of pumps. However, the T Slim Insulin Pump is eligible for coverage under Part B if the recipient’s requirements qualify a pump as DME. Unlike the insulin that’s used in manual injections, insulin used by pumps is also covered under the same DME rules. However, coverage options do change throughout the course of the year.
Medicare recipients that are interested in getting a T Slim Insulin Pump should first verify if eligibility for DME use before they get a device. Talk to your physician and contact your Medicare plan directly for specific details. 

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