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In memory of "Pumper Paul"
who's dedication and drive brought us the first insulin pump bill in
Canada
The fight for
insulin pump coverage in all provinces across Canada has been going on
for too many years! We are finally seeing the results of
dedication and drive by people throughout this country. Ontario has
rolled out its new insulin pump coverage for children under 18.
Saskatchewan announced in its March 2007 budget that it will also be
covering insulin pumps for children. Newfoundland has also joined those
provinces will offer assistance to children with diabetes.
Let's continue to
fight to ensure that all provinces cover insulin pumps. Children are our
first step but not the last. We will all continue to push to see that
EVERYONE who wishes to use an insulin pump in Canada will be able to do
so.
Provinces offering pump
coverage
Newfoundland:
The Newfoundland and Labrador Pump program is open to children living in
the province who have not yet turned 18 years of age. Those who are
prescribed an insulin pump by their physician, have no private pump
coverage and comply with guidelines provided by their diabetes care team
are eligible to receive their insulin pump, infusion sets, and
cartridges under this provincial program. Diabetes care centers
will help you to complete the application process. Ontario:
Details as of January 2007
We are pleased to inform you of an
initiative of the Ontario provincial government to fully fund insulin
pumps and provide a grant to help pay for insulin pump supplies for
children and youth with type 1 diabetes that live in the Province of
Ontario.
This exciting initiative, announced by the Ministry of Health and Long
–Term Care, will ensure that cost is not a barrier to the initiation of
insulin pump therapy in children and youth. This program is administered
by the Assistive Devices Program (ADP) and became effective December
1st, 2006. If you have purchased a pump and ongoing pump supplies
between April1 and November 30, 2006 and do not have 100% third party
coverage, then you may apply for the portion of the costs incurred
directly by you (eg. 20% not covered by insurance).
We have identified that you/your child is presently on an insulin pump
and you may be eligible for reimbursement of expenses under this
program. In order to do so you must submit an application and the
following items:
~Original receipts of the pump purchase and pump supplies indicating
the portion of costs incurred by you.
~If you started pump therapy prior to April 1st, 2006, you are also
eligible for reimbursement for the portion of costs related to supplies
incurred by you from April 1st to November 30th. You must submit
receipts of the supplies indicating portion paid.
To receive this grant for future insulin pump supplies, an application
must be made by our center on your behalf. In order for us to complete
this application, we must do an assessment to ensure you/your child
meets the established criteria outlined by this program. To be eligible
for the program, you/your child must have:
~ Completed an insulin pump education program
~Demonstrated a commitment to blood glucose monitoring before each
meal and before bedtime
~Commitment to ongoing recording of blood glucose results
~Demonstrated appropriate site rotation
~Demonstrated appropriate sick day knowledge and management
~No more than one DKA in last 6 months
~Maintained regular clinic visits (at least 3 visits in previous year)
~HbA1c less that 10
For applications and further information visit the ADP website at:
http://www.health.gov.on.ca/english/providers/program/adp/adp_mn.html
or contact your diabetes center for further information.
FAQ:
Although the MOH has indicated this
program is retroactive to April 1, 2006 is there an actual start date
to begin the process?
This new insulin pump and supplies program is scheduled to begin early
December. Please contact your Pediatric Diabetes Centre after December
1st, for details.
We understand the program is retroactive to April 1, 2006 for both
pumps and pump supplies, who do we contact in order to start the process
for reimbursement as we had to already purchase an insulin pump and or
supplies for our children?
This reimbursement process will begin at the same time as the program
for new pumps, please watch for further details on the Ministry of
Health and Long-Term Care (MOHLTC), Assistive Devices Program (ADP)
website at the following link:
http://www.health.gov.on.ca/english/public/program/adp/adp_mn.html
You must still work with your
Diabetes Pediatric Centre who will have complete details after December
1st, 2006.
We understand that insulin pumps under this program will be covered
100%, we do not have to pay a co-payment, however how do I start the
process to see if we can get coverage for an insulin pump and or
supplies for our children?
As with the first question, please contact your Pediatric Diabetes
Centre after December 1st, for complete details and process information.
You may also visit the following MOHLTC – Assistive Devices Program link
for information regarding the program. Use the link below.
http://www.health.gov.on.ca/english/public/program/adp/adp_mn.html
If I have any special
questions, whom would I contact?
Assistive Devices Program staff would be most pleased to answer
questions, phone contact information is provided below:
Contact numbers for ADP by telephone:
(416) 327-8804
Toll Free 1-800-268-6021
TDD 1-800-387-5559 or local 416-327-3282
Saskatchewan:
Government of Saskatchewan
Budget 2007-08 Making Life Better in Saskatchewan
March 22, 2007
Diabetes advocates welcomed the recent Saskatchewan
provincial budget announcement of a Children’s Insulin Pump Program. The
new program will provide children under the age of 17 who meet
eligibility requirements with one pump every five years, and coverage
for insulin pump supplies as regular benefits under the Drug Plan. This
commitment will benefit families
who pay approximately $6,000 per pump and an additional $300 per month
in supply costs.
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