Actually - Here is the written policy. It only covers what is a "necessity on your trip." For instance, if you were gone for a year, it would not cover a year's worth of supplies. It seems clear that they don't generate the need for a third item and at IND where they can be sticklers, this isn't a good fight to pick. The ACA also would only cover what's necessary for the trip itself.

I also wouldn't make a big deal of the insulin pump issue at the checkpoint. There are thousands of medical device clearances every day. Most pumps don't even alert a standard mag. When going through advanced technology, any pax can opt out for any reason (or no reason). TSA is used to it and there's no need for you or your daughter to sweat this detail.

On the return, your daughter will presumably have used up the bulk of her supplies, but still ought to have enough with her to handle the trip and any possible diversions (I always travel with an extra 3 days of all medications). Practically speaking, she's traveling in and between countries which have excellent medical systems, so emergencies can be handled, but the nuisance can be extreme.

A letter explaining what the supplies are and that they are medically necessary and which includes a 24-hour phone # (remember, time difference with Japan means not much overlap with doc's office hours & daytime travel) may be helpful.

Lastly, it's not necessary, but if your daughter has specialized needs which would not be evident to a treating physician, a letter describing those needs will be helpful in case of an emergency, along with 24-hour contact info.

Medical Supplies & Equipment
We realize that medical supplies or equipment may be a necessity on your trip; therefore these items are allowed on board as additional items at no extra charge. Some medical items can be carried on the plane, along with the regular carry-on allowance, as long as they meet the standard size and weight limits.

Breathing Apparatus
Delta will accept a self-contained breathing apparatus used by emergency rescue units as checked baggage as long as the unit's weight does not exceed 150 lbs. (68kgs). Please contact Reservations 24 hours in advance to let us know that you will need to bring a breathing apparatus along with you on your trip. Information about onboard medical oxygen is found in our section on Services for Travelers with Disabilities.

Needles/Syringes
If your medication must be administered with a needle or syringe, it will be permitted in carry-on baggage as long as it is accompanied with medication that has a professionally printed label identifying the medication, a manufacturer’s name, or pharmaceutical label.