Insulin Pump Program

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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 under the age of 25 years,
  • have a valid PEI Health Card,
  • have been referred to the Provincial Diabetes Program, and
  • are diagnosed with type 1 diabetes.

Your diabetes care team with the Provincial Diabetes Program will use a number of medical criteria to evaluate your eligibility [PDF | 99 KB] for the program.

How do I apply?

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

  1. If you have private medical insurance, contact your provider to determine the level of coverage available and request written confirmation of your coverage which will be used to calculate your co-payment.
  2. Submit a completed Family Contribution and Release of Information form [PDF | 873 KB]. 

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 estimate costs for example purposes only.           

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

  • Annual household income: Under $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: Under $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 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).

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

Coverage is not retroactive. If you are a new applicant to the Insulin Pump Program you will not be reimbursed for an insulin pump or any insulin pump supplies you purchased prior to your program registration date. 

What if I move away from PEI?

Your eligibility for this program will end the day you leave PEI to take up residency elsewhere.

How can I contact the Insulin Pump Program?

Health PEI Insulin Pump Program
Montague Health Centre
407 MacIntyre Avenue
Montague, PE   C0A 1R0

Telephone: (902) 838-0787
 

Date de publication : 
le 8 Janvier 2021
Santé Î.-P.-É.

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healthpei@gov.pe.ca

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