Glucose Sensor Program
Under the Glucose Sensor Program, eligible Islanders can buy glucose sensors at a reduced cost at pharmacies on PEI.
What is a glucose sensor?
Glucose sensors, often referred to as Continuous Glucose Monitoring (CGM) track glucose (i.e., sugar) levels throughout the day and night. Unlike a blood glucose meter which provides just a single glucose reading, glucose sensors can provide glucose information up to every five minutes.
People living with diabetes can gain valuable insight into their glucose levels, including rate and direction of change, allowing them to better manage their diabetes. Studies have shown that glucose sensor systems may help reduce A1C levels and reduce hypoglycemia (low blood sugar) events.
Users insert a tiny sensor wire just underneath the skin with an applicator. An adhesive patch holds the sensor in place so it can measure glucose levels in the interstitial fluid. A transmitter sends readings wirelessly to a device (i.e., a receiver, compatible smartphone / smartwatch, or insulin pump), so users can view the information. Depending on the product, the user will change the sensor every seven to 14 days.
What if I don’t have a smart phone or internet access?
If you don’t have access to the internet or a smart phone please contact your diabetes nurse educator or the Glucose Sensor administrator at 1-833-335-0538 to request a G7 reader.
Am I eligible for benefits under the Glucose Sensor Program?
You are eligible if you have been diagnosed with diabetes and you:
- are a PEI resident as defined by the Drug Cost Assistance Act,
- have a valid PEI Health Card,
- filed your most recent income tax return for the most recent year, and
- rely on an insulin pump or three or more daily injections of insulin to manage your diabetes.
How do I apply?
Complete the Glucose Sensor Program Initial Application Form.
- Your doctor, nurse practitioner or diabetes educator will need to complete and sign a portion of this form.
If you are under 25 and enrolled in the Insulin Pump Program:
- complete the Insulin Pump Program or Insulin Pump Program plus Glucose Sensor Program Initial Application Form instead.
- Your doctor, nurse practitioner or diabetes educator will need to complete and sign a portion of this form.
Mail your completed form to:
Glucose Sensor Program Administrator
PEI Pharmacare
PO Box #2000
Charlottetown, PE C1N 7N8
Faxes and electronic copies will not be accepted.
You can also get a printed copy of this form at your local Health PEI Diabetes Education Centre.
When do my benefits for the Glucose Sensor Program end?
You are eligible for benefits up to a maximum of one year or the portion of the year after your approval until June 30.
To keep your benefits, you must reapply by June 30 each year. You can submit your renewal anytime between April 1 and June 30. Before you apply, you will need to have filed your income tax statement for the preceding year with the Canada Revenue Agency.
See the Renew your Insulin Pump and or Glucose Sensor program benefits web page for information on how to reapply.
What is covered?
The following glucose sensor supplies are eligible for coverage under the PEI Glucose Sensor Program:
Abbott Libre or Libre 2 sensors:
- Wear time is 14 days.
- Two sensors can be dispensed from your pharmacy every 28 days.
- Maximum number of sensors per year is 26 sensors. Free reader (where required) is available by contacting Libre customer service.
Dexcom G6 sensor:
- Wear time is 10 days.
- Three sensors (i.e. one box) can be dispensed from your pharmacy every 30 days.
- Maximum number of sensors per year is 39 sensors.
- The Dexcom transmitter (one transmitter every three months) is available at no cost from your pharmacy. A receiver (where required) is available at no cost by contacting Dexcom Customer Service.
Medtronic Integrated (CGM) Guardian Sensor (3) or Guardian Connect CGM:
- Wear time is 7 days.
- Five sensors (i.e. one box) can be dispensed from your pharmacy every 35 days.
- The maximum of sensors per year is 55 sensors.
- Free transmitter (one per year) is available at your pharmacy.
How do I know which sensor is right for me?
View the sensors’ features on their websites and discuss your options with your health care team:
What will it cost?
How much you pay depends on your household income and whether you have private health insurance.
Scenario 1: You do not have private health insurance.
If your household income is:
- $0 to $20,000, you pay $0 per dispense.
- $20,001 to $40,000, you pay $10 per dispense.
- $40,001 to $50,000, you pay $20 per dispense.
- $50,001 to $100,000, you pay $60 per dispense.
- $100,001 or greater, you pay $80 per dispense.
Scenario 2: You have private health insurance that covers part of the cost of glucose sensors.
Your co-payment will be the amount listed below or the amount remaining after payment by your private insurance, whichever is less.
If your household income is:
- $0 to $20,000, you pay $0 per dispense
- $20,001 to $40,000, you pay $2 per dispense or the cost remaining after payment by your private health insurance.
- $40,001 to $50,000, you pay $4 per dispense or the cost remaining after payment by your private health insurance.
- $50,001 to $100,000, you pay $12 per dispense or the cost remaining after payment by your private health insurance.
- $100,001 or greater, you pay $16 per dispense or the cost remaining after payment by your private health insurance.
What happens if my sensor falls out or stops working? Can I get a replacement sensor at my pharmacy?
If your sensor has to be replaced early for whatever reason (falls out, stops working etc.) you can get a replacement sensor by calling your sensor company’s Customer Service line. They will ship your sensor directly to you at no cost.
Under the Glucose Sensor Program, replacement sensors are not available through your local pharmacy.
Will I get a refund for sensors I already purchased prior to being eligible for benefits under the Glucose Sensor Program?
No. You will not be reimbursed for sensors you have already purchased.
On the application, how do you define household?
A household is a person, the person’s spouse (if the person has a spouse) and any dependants
- No person may be considered to be part of more than one household
- Spouses shall be considered part of the same household unless otherwise confirmed
How do you define dependant?
A dependant is a child of a person or the person’s spouse who is
- Under 19 years of age and does not have a spouse or
- Is 19 years of age or over but under 25 years of age, is a full-time student and does not have a spouse
- A dependant may only be a member of one household
How do you calculate household income?
Household income is the total income of the persons in a household, other than any dependants, calculated on the amounts reported on the person’s income tax return for the preceding tax year as filed with and verified by the Canada Revenue Agency, calculated as follows:
- Line 15000 (total income) less
- Line 21000 (split income)
- Line 21400 (child care expenses)
- Line 22000 (support payments made)
Can I apply my payments to the household cap for the PEI Catastrophic Drug Program?
No, out of pocket expenses paid for the glucose sensors cannot be applied to the Catastrophic Drug Program “household cap”.
Who can I contact if I have further questions?
Glucose Sensor Program / Insulin Pump Program
PEI Pharmacare
16 Fitzroy Street
Sullivan Building
Charlottetown, PE C1N 7N8
Telephone: 902-213-4825 or 1-833-335-0538 (toll-free)
Email: diabetesadminofficer@ihis.org