Insulin Pump Program

The Insulin Pump Program assists with the costs associated with approved insulin pumps and supplies for children, youth and young adults up to age 25 who are living with type 1 diabetes.

Am I eligible?

You may be eligible for the program if you are diagnosed with type 1 diabetes and:

• are under the age of 25 years,
• have a valid PEI Health Card,
• have been referred to the Provincial Diabetes Program, and
• meet certain medical criteria.

 

How do I apply?

Your diabetes care team will help you with the registration process.

If you have private health insurance, contact your provider to determine what and how much they cover and request written confirmation of this. This will be used to calculate how much you will pay out-of-pocket for your insulin pumps and supplies.

Complete the Insulin Pump Program or Insulin Pump Plus Glucose Sensor Program Initial Application Form. Your doctor, nurse practitioner, or diabetes educator will need to fill out and sign a portion of this form.

Mail your completed form to:

Insulin Pump Program Administrator
Four Neighborhoods Health Center
152 St Peter’s Rd., Charlottetown, PE, C1A 5P8

Faxes and emailed copies will not be accepted.

 

How much of the cost will be covered?

Depending on your household income and private medical insurance, you may be eligible for up to 100 per cent coverage to assist with the cost of the pump and monthly pump supplies.

The information listed below is based on estimated costs for example purposes only.           

Estimated eligible coverage if you do not have private medical insurance:

• Annual household income: $0 to $20,000
  • Eligible coverage:100%
  • Pump every 5 years: $0
  • Pump supplies per year: $0
     
• Annual household income: $20,001 to $40,000
  • Eligible coverage: 95%
  • Pump every 5 years: $315
  • Pump supplies per year: $150
     
• Annual household income: $40,001 to $50,000
  • Eligible coverage: 90%
  • Pump every 5 years: $630
  • Pump supplies per year: $300
     
• Annual household income: $50,001 to $100,000
  • Eligible coverage: 70%
  • Pump every 5 years: $1,890
  • Pump supplies per year: $900
    ​
• Annual household income: Greater than $100,001
  • Eligible coverage: 60%
  • Pump every 5 years: $2,520
  • Pump supplies per year: $1,200

Estimated eligible coverage if you do have private medical insurance with 80% coverage:

• Annual household income: $0 to $20,000
  • Eligible coverage: 100%
  • Pump every 5 years: $0
  • Pump supplies per year: $0
     
• Annual household income: $20,001 to $40,000
  • Eligible coverage: 95%
  • Pump every 5 years: $63
  • Pump supplies per year: $30
     
• Annual household income: $40,001 to $50,000
  • Eligible coverage: 90%
  • Pump every 5 years: $126
  • Pump supplies per year: $60
     
• Annual household income: $50,001 to $100,000
  • Eligible coverage: 70%
  • Pump every 5 years: $378
  • Pump supplies per year: $180
    ​
• Annual household income: Greater than $100,001
  • Eligible coverage: 60%
  • Pump every 5 years: $504
  • Pump supplies per year: $240

 

What insulin pump supplies are eligible for coverage?

The following supplies from a government-approved vendor are eligible for coverage:

• insulin pump from a government-approved vendor (one pump every five years),
• infusion sets (maximum 140 sets per year),
• reservoirs (maximum 140 per year),
• site inserts (maximum one replacement device per year),
• skin adhesive wipes (maximum 150 per year), and
• sterile transparent dressings (maximum 200 per year).

See the list of government-approved vendors and products for the PEI Insulin Program.

 

Can I get a refund for the insulin pump I already purchased?

No. You will not be reimbursed for an insulin pump or insulin pump supplies you purchased before you enrolled in the program.

 

When do my benefits for the Insulin Pump Program end?

You are eligible for benefits until June 30 each year. You must reapply by July 1 each year to keep your coverage. Program benefits end when you turn 25. See the Renew your Insulin Pump and or Glucose Sensor program benefits web page to reapply. 

 

What if I move away from PEI?

Your eligibility for this program ends three months after you leave PEI to live elsewhere.

 

Additional questions?  

Please refer to the Insulin Pump Program Questions and Answers .

 

How can I contact the Insulin Pump Program?

Insulin Pump Program Administrator

Four Neighborhoods Health Centre
152 St. Peter's Road
Charlottetown, PE   C1A 7N8

Telephone: 1-833-335-0538
Email: diabetesadminofficer@ihis.org