How to access an insulin pump
Currently funded by 4 avenues in Australia
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 2: Self-funded by patient
Insulin pumps can be purchased outright by a patient (a prescription is still required for insulin).
Option 3: Bridging The Gap Program
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 applicants 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