Option 1: Private Health Insurance

Under the Private Health Insurance Act 2007, private health insurers can cover the cost of insulin pumps under their Hospital or General Treatment policies. If an insulin pump is provided as part of an episode of hospital treatment and the patient has an appropriate hospital policy, private health insurers are required to pay benefits towards the cost of the pump, as well as the hospital accommodation fees and the doctor’s fee.

In many instances, the provision of an insulin pump does not require the patient to be admitted to hospital. Some insurers choose to cover the cost of insulin pumps in cases where hospitalisation is not required. The benefits available and the terms and conditions for the provision of benefits for insulin pumps where hospitalisation is not required will vary between insurers and benefits may be restricted for a specified period of time.

Insulin pumps are included on Part C of the Prostheses List. The full list and further information can be viewed here.

Please note: The required level of cover may depend on different private health insurers, with insulin pumps only required to be covered on the top tier ‘Gold’ level of hospital cover.

Option 3: Self-funded by patient

Insulin pumps can be purchased outright by a patient (a prescription is still required for insulin).