Insulin Pump PrOGRAM

Type 1 Diabetes Community
Insulin Pump Subsidies

The Type 1 diabetes insulin pump program, funded by the Australian Government will continue in 2018/2019.

The allocation of funding has priority access for those who applied for an insulin pump subsidy between 1 July 2017 to 30 June 2018. 

You can submit an expression of interest to join a potential funding waiting list for a subsidy towards the purchase of an insulin pump by entering your details through the link below.

Lodge an Expression of Interest

Type 1 Diabetes Insulin Pump Program

The Australian Government's Insulin Pump Program provides subsidies to low income families who have children with type 1 diabetes. Pumps supplied under the Program are fully subsidised, i.e. recipients are not required to make any co-payment.

The program aims to improve access and affordability of insulin pumps for limited income families who have children (up to 18 years of age) with type 1 diabetes and do not have access to other means of reimbursement, such as private health insurance.

how will i know if insulin pump therapy is right for my child?

You will need to discuss the suitability of insulin pump therapy for your child with your child's Healthcare Team.

Who is eligible for an insulin pump subsidy?

To be eligible to receive a subsidy under the Program, an applicant must not be in receipt of, or be eligible to receive, any other means of reimbursement, including reimbursement via private health insurance, which may be used to assist the applicant to purchase an insulin pump. The child (recipient) on whose behalf the application is made, must be under 18 years of age on the date of application, and must hold or be listed on a current Medicare card.

Before an applicant can be approved to receive a subsidy, the following criteria must be met:

A. Income Eligibility

The applicant's combined annual family income must be less than or equal to $109,610. This amount is subject to annual changes made by Centrelink.

Applicants with an annual family income of more than $109,610 are not eligible to receive the subsidy unless they are caring for more than one child with type 1 diabetes. In this circumstance, the applicant will not be eligible for a subsidy for the first child, but will be eligible to receive subsidy for subsequent children with type 1 diabetes.

Once income eligibility is assessed, JDRF Australia will progress the application and request the child's Healthcare Professional to confirm clinical eligibility.

B. Clinical Eligibility

As part of the application process, your Healthcare Team (Diabetes Educator and Paediatrician/Endocrinologist) will be required to confirm that you meet the following clinical eligibility criteria:

  • The child has type 1 diabetes
  • The child will benefit from a transition to, or continued insulin pump therapy
  • The child/carer has demonstrated willingness to check blood glucose levels four or more times per day
  • The child/carer has demonstrated competence at injecting insulin using pens/syringes
  • The insulin pump initiation will be conducted by a multidisciplinary team
  • The initiating team makes a commitment to the transition and a system to ensure follow-up and ongoing support

What income support documents will I need to submit?

Applicants, including applicants in receipt of a Carer Allowance payment from Centrelink, will be required to supply eligibility confirmation documents as described in the following table:

Eligibility Confirmation Documents Required

Medicare Eligibility

Photocopy of Medicare Card (must be current).

Age Eligibility

Photocopy of an appropriate proof-of-age document (e.g. Birth Certificate) to confirm that the child is under 18 years of age on the date of application.

Income Eligibility

Statement from Centrelink confirming that the applicant is in receipt of a full income support payment; OR
Income Assessment statement from Centrelink; OR
Copy of previous financial year's tax return or notice of assessment; OR
Other approved evidence of income.

Validity of Documents

Evidence of income provided by an applicant will remain valid for six (6) months.

 

I have private health insurance. am i able to get an insulin pump subsidy?

You are not eligible to receive an insulin pump under this Program if you have access to other means of reimbursement, such as private health insurance.

Australians with private health insurance covering insulin pumps will generally be eligible for full reimbursement of their pump by their health fund, following the relevant waiting period attached to their cover. If you have private health insurance, please contact your insurer for more information about how to receive funding through private health insurance.

Which Insulin pumps are available under the insulin pump subsidy?

As of September 2018, the following pumps are available under the Insulin Pump Program:

  • Accu-Chek Spirit Combo (Roche)
  • MiniMed 640G (Medtronic)
  • Paradigm Veo (Medtronic)

These pumps will be supplied with approximately three months' initial supply of pump consumables.

Are the pumps available under the program waterproof?

Insulin pumps available under the Program meet the minimum requirement of being water tight. We recommend that you check with the respective pump manufacturer for more information and clarification.

Are insulin pumps available under the insulin pump program compatible with continuous glucose monitoring (cgm) devices available through the national diabetes services scheme (NDSS)?

There are a range of CGM devices available through the NDSS. Pump recipients who wish to use CGM technology have the option to select a CGM device that works with their pump or, where a compatible device is not available, they are able to select a CGM device that works independently of an insulin pump.

We recommend that you discuss this with your child's Healthcare Professional who will help you make the best selection for your child.

Do i need to do anything extra to access insulin pump consumables?

The National Diabetes Services Scheme (NDSS) provides access to a large range of subsidised products to help people with diabetes manage their condition. These products include subsidised insulin pump consumables for approved persons.

Your Healthcare Team will complete the NDSS Registration Form and/or Insulin Pump Consumables Assessment Form as appropriate. Once you have registered with the NDSS, you will be able to purchase subsidised products through the NDSS. For more information, please contact the NDSS on 1300 136 588 or email: ndss@diabetesaustralia.com.au or visit the NDSS website: www.ndss.com.au.

How will I know if my application for a subsidy is successful?

You will receive an email from JDRF Australia after your clinical eligibility has been confirmed to let you know if you are eligible for a subsidy.

What happens if funding is exhausted while my application is being processed?

In the circumstance where your application has been assessed as eligible for subsidy and the funding for the Program has been exhausted, your application will be put on a waiting list for eligible applicants and you will be informed about the status of your application by JDRF Australia.

Will I receive the subsidy payment directly?

Program recipients will be receiving their pumps fully subsidised by the Program. No payments will be made to the applicants or the recipients.

Can I 'opt out' of the process once i start?

You can opt out of the process at any time up to the point where JDRF Australia has placed an order for your child's insulin pump and the respective supplier has dispatched the pump.

I have more than one child with type 1 diabetes, how will this affect me?

Applicants with a combined family income of up to $109,610 will be eligible to receive a subsidy for each of their children living with type 1 diabetes.

Applicants with a family income of more than $109,610 are not eligible to receive a subsidy unless they are caring for more than one child with type 1 diabetes. In this circumstance, the applicant will not be eligible for a subsidy for the first child, but will be eligible to receive a subsidy for a subsequent child with type 1 diabetes.

Can I apply for a replacement pump?

Subject to continuing to meet the Program criteria, previous recipients are able to apply for a new pump subsidy under the following circumstances:

  • The manufacturer's warranty (generally 4 years) on the insulin pump has expired; and
  • A replacement insulin pump has been recommended by the child's Healthcare Professional.

Recipients who received their insulin pumps under the Program between their 14th and 15th birthday (inclusive) are able to lodge an application for a new pump subsidy prior to the expiry of their pump warranty. These recipients can apply for a new pump between three (3) months prior to their 18th birthday and one (1) day prior to their 18th birthday. Subject to meeting the eligibility criteria, the place of their application in the waiting list and the availability of funds, these recipients will be eligible to receive a replacement pump when the warranty of their existing pump expires.

Any questions?

Call JDRF Australia on 02 9020 6100 or email pumps@jdrf.org.au.