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Insulin pump costs

INSULIN PUMP COSTS

INSULIN PUMP COSTS

HOW MUCH DOES
AN INSULIN PUMP COST?

Prostheses List legislation provides for increased pump accessibility through private health insurance. This means that, should patients have eligible hospital cover, they can access an insulin pump which is fully covered by their health insurer. A waiting period may apply before private health insurance benefits are payable. It is also important the patient confirms that their health insurance policy covers insulin pump therapy.

A Medtronic insulin pump currently costs $9,500.

First things first – registering with the NDSS

When a patient is diagnosed with diabetes, they should register with the Australian Government’s National Diabetes Services Scheme (NDSS), which is administered by Diabetes Australia. The NDSS provides subsidised insulin pump consumables, including reservoirs and infusion sets. 

Who is eligible for NDSS subsidies?

To be eligible, the patient must be an Australian resident, hold a current Australian Medicare card or a Department of Veteran Affairs file number and should have been diagnosed by a medical practitioner.

Several countries also have a reciprocal agreement with Australia. If the patient is visiting Australia, and comes from a country with a Reciprocal Health Care Agreement, they may be entitled to temporary NDSS registration.

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Please note, different rules apply for patients with Type 2 diabetes, and in most instances, these patients may not be able to access these subsidy programs. However, Medtronic is currently offering a grant on insulin pump consumables for patients with Type 2 insulin dependent diabetes, with the opportunity to save up to 90% on RRP30.This means that pump consumables will cost roughly the same as they do for people with Type 1 Diabetes who can access the NDSS consumable prices. See here for more information.

Getting access to insulin

The Pharmaceutical Benefits Scheme (PBS) covers a considerable proportion of drug and medication costs through Medicare. Patients can get insulin from pharmacies with a prescription (from a GP or Endocrinologist) using the PBS; one prescription is generally 3-6 months’ supply, depending on the patient’s insulin needs. 

Other subsidy options for Type 1 patients

Another option for subsidy assistance for Type 1 diabetes patients is the Type 1 Diabetes Insulin Pump Program (IPP) – an Australian Government program administered by JDRF, which provides means-tested subsidies for insulin pumps for people under 18 years of age. Find more information here: 

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Medtronic’s Bridging the Gap Program

As part of our on-going support of diabetes management, we are able to offer our Bridging the Gap Program. Through this program, successful applicants31 will have access to a Medtronic insulin pump for the remainder of their health fund waiting period, up to a maximum of 12 months. 

Bridging the Gap Program - Who is eligible?

To be eligible, patients must:

  • Have private hospital cover
  • Be in the interim 12-month waiting period for private health cover benefits
  • Have been diagnosed with Insulin Dependent diabetes
  • Meet the NDSS criteria for insulin pump consumables
  • Be under supervision from healthcare professionals, including a diabetes educator and endocrinologist or paediatrician, for insulin pump therapy

To apply for a loan pump, patients simply complete the application form which requires signed acknowledgement from a physician and a diabetes educator prior to submission.

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What are the ongoing costs?

Medtronic infusion sets and reservoirs are available from the NDSS through Diabetes Australia for $25-$30 per month, for patients who meet the criteria. Applications must also be signed and completed by you before being sent to Diabetes Australia. You should also advise patients of the appropriate infusion set and reservoir for the pump, so that they can order consumables through your state Diabetes Australia office.

REGISTER WITH THE NDSS

Allowances for carers

The Australian Government, Department of Human Services, also provides a carer allowance for those who take up the carer’s responsibility for Type 1 diabetes patients. This provides support for childcare payments for parents with children under 16. A fortnightly payment of $121.70 and a Health Care Card for the child can make it possible for parents to afford PHI, consumables and insulin.  The application form can be found here:

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30. Terms and Conditions apply. If the patient is an Australian Resident who has insulin dependent Type 2 diabetes and private health insurance, the cost of the pumps is generally covered by their insurance provider depending on their level of hospital cover. They can apply for this grant to access pump consumables at a reduced cost. Pump consumables are an essential part of insulin pump therapy.

31. Successful applicants will receive a Medtronic insulin pump. Pump model and colour are subject to availability.