Insulin Pumps

Insulin pumps are small computerised devices that monitor and deliver insulin continuously throughout the day and night. This greatly improves the quality of life of certain people with type 1 diabetes. The machine sits outside the body, connected to a small tube that rests just under the skin. 

How do I apply to be covered for an insulin pump?

Firstly, you should check that your policy covers insulin pumps. If you’re covered and you’ve served your relevant waiting period, then here’s what you need to know.

Is this your first pump?

If so, complete the initial application form attached. Your endocrinologist and diabetes educator will need to complete their section, as well and attach a letter detailing the need for your insulin pump. (They should be very familiar with this requirement, so you might have this already.)

Once we have the information we need, approval can take between 2 and 10 business days. Make sure to allow this time before proceeding with the delivery of your pump.

Please note: hospital admissions for a fitting of your new insulin pump attract an excess inline with your specific hospital cover. 

Is this an upgrade or replacement pump?

Upgrade/replacement pumps can be approved on eligible policies in two circumstances:

 Your existing pump is no longer meeting your insulin requirements due to a change in medical circumstances
OR

Your existing pump has malfunctioned, and no longer meets your insulin requirements
There’s a different form to complete if you want to apply for a replacement insulin pump. Be advised that additional information might be needed, depending on the nature of the issue. See the form itself for more specifics.

Please note: hospital admissions for a fitting of your new insulin pump attract an excess inline with your specific hospital cover. 

A note on warranty periods

Please be aware that an upgrade or replacement due to the manufacturer’s warranty expiring does not meet the above criteria as a medically necessary reason for replacement. A warranty is a period of time in which the supplier of the pump is financially responsible for replacing the existing insulin pump were it to malfunction. However, there is no need to replace a working insulin pump just because the warranty has expired, or if a newer model is available. If you are not sure why your pump’s being replaced, ask your endocrinologists or diabetes educator.

 Of course, if there is a medical need to upgrade your pump, your completed application will indicate this—so please don’t worry! Once we have the information we need, approval can take between 2 and 10 business days so please allow this time before proceeding with the delivery of your pump.

A note on insulin pump consumables and blood glucose monitors

Please note that there are consumables associated with the upkeep of insulin pump therapy. These include infusion sets (cannula and tubing) and insulin cartridge reservoirs. You may also need a blood glucose monitor. These can be claimed as a health appliances if you have High Extras cover with health.com.au. Bear in mind that these are not covered under your hospital insurance.