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Insulin Pump Subsidy Australia

Diabetic Insulin Pumps

Diabetic Insulin Pumps

Making a complaintInformation regarding how we consider and investigate complaints, our complaints process, and how you can review our decisions. Commonwealth Ombudsman > Publications > Brochures and Fact Sheets > Private Health Insurance Fact Sheets > Diabetic Insulin Pumps If you have diabetes, your doctor, endocrinologist or diabetes educator may recommend the use of an insulin pump. An insulin pump is a small portable medical device used by people with diabetes that delivers insulin constantly and is worn 24 hours a day. The insulin pump helps to reduce fluctuations in blood glucose levels. Does private health insurance cover insulin pumps? Under the Private Health Insurance Act 2007, private health insurers can cover the cost of insulin pumps under their Hospital or General Treatment policies. If an insulin pump is provided as part of an episode of hospital treatment and you have an appropriate Hospital policy, private health insurers are required to pay benefits towards the cost of the pump, as well as the hospital accommodation fees and the doctors fee. In many instances, however, the provision of an insulin pump does not require the patient to be admitted to hospital. Some insurers choose to cover the cost of insulin pumps in cases where hospitalisation is not required. The benefits available and the terms and conditions for the provision of benefits for insulin pumps where hospitalisation is not required will vary between insurers and benefits may be restricted for a specified period of time. What do private health insurers cover if I need an insulin pump? If you already have private health insurance and have served your waiting periods, contact your insurer as soon as possible to confirm whether you are covered for an insulin pump, what benefits will be paid, Continue reading >>

Diabetes Your Health

Diabetes Your Health

Diabetes is a disease in which the body does not produce or use insulin properly. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. The exact cause of diabetes is unknown, although both genetic and environmental factors, as well as lifestyle issues (for example, obesity and lack of exercise) appear to play roles. There are two major types of diabetes, known as Type 1 and Type 2. Type 1 diabetes is often diagnosed in children and teenagers, and for this reason was once called juvenile onset diabetes. However, people of all ages can be diagnosed with Type 1 diabetes. The cause is unknown, though there seems to be a strong family link that can be triggered by environmental factors such as viruses. Type 1 diabetes does not appear to be related to lifestyle or obesity. Type 1 diabetes occurs most often in children and young adults and accounts for 10-15% of diabetes cases in Australia.1 Type 2 diabetes affects over 1 million people in Australia, making it the most common form of diabetes.2While it was once called adult onset diabetes, children and teenagers can develop Type 2 diabetes as well. Continue reading >>

Forms

Forms

This section contains all the forms necessary for managing registration with the NDSS. Registration with the NDSS is free and only needs to be done once. To find out more about the registration process, including eligibility requirements, please visit the Registration page Address Update or Request New Card Online Form If you would like your patients to be able to purchase IPCs from the NDSS, you will need to complete an Insulin Pump Consumables Assessment Form to show they meet all relevant criteria. This needs to be signed by an endocrinologist, specialist physician or credentialed diabetes educator. NDSS Insulin Pump Consumables Assessment Form Type 1 Diabetes Continuous Glucose Monitoring Eligibility Assessment The Australian Government is now providing access to fully subsidised continuous glucose monitoring (CGM) products through the NDSS. To be eligible, the person with diabetes will need to be assessed by an authorised health professional to determine if they meet specific criteria. The authorised health professionals for CGM assessment are endocrinologists, credentialled diabetes educators, and other health professionals specialising in diabetes (physicians, paediatricians or nurse practitioners). Continue reading >>

The Cost Of Insulin Pump Therapy

The Cost Of Insulin Pump Therapy

With eligible hospital insurance you could get coverage for an insulin pump The cost of If you’re living in Australia - the cost of an insulin pump is generally fully covered by your insurance provider depending on your level of hospital cover (assuming the appropriate waiting period has been served). In choosing the health fund that’s best for you, it doesn’t necessarily have to be the most expensive level of cover. If in doubt, check with your private health insurer for what is covered. For the price of a coffee per day, you could get coverage for an insulin pump1 Are you in the interim waiting period for private health cover? NOW YOU MAY BE ELIGIBLE FOR A LOAN PUMP FOR PEOPLE UNDER 18 YEARS OF AGE YOU MAY BE ELIGIBLE FOR A T2 GRANT, OFFERING UP TO 90% OFF RRP5 FOR INSULIN PUMP CONSUMABLES. More Details More Details More Details Continue reading >>

Type 1 Diabetes Insulin Pump Program

Type 1 Diabetes Insulin Pump Program

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. The Australian Government's Insulin Pump Program provides subsidies to very 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 $107,548. This amount is subject to annual changes made by Centrelink. Applicants with an annual family income of more than $107,548 are not eligible to receive the subsidy unless they are caring for more than one child with type 1 diabetes. In Continue reading >>

Insulin Pump Therapy In Australia

Insulin Pump Therapy In Australia

The Case for Action Insulin pump therapy can be life-changing and together with new technologies such as continuous glucose monitors, potentially life-saving for people with type 1 diabetes. Insulin pump therapy can reduce the frequency of severe hypoglycaemia1 (low blood sugar), enable better blood glucose management to reduce risk of complications, and reduce costs associated with ambulance use, emergency department presentations and hospital admissions. Insulin pump therapy can reduce fear of hypoglycaemia1, diabetes-related distress and depressive symptoms and can improve health status and quality of life. Australia has one of the highest rates of type 1 diabetes in the world. In the past year alone over 3021 new cases of type 1 diabetes were registered (8 new cases every day). There are over 25,000 young people with type 1 diabetes under age 30 and there are 118,000 Australians with type 1 diabetes. Due to cost and poor access only 14,990 (12%) Australians with type 1 diabetes have accessed insulin pump therapy, comparing poorly to the USA which has twice the level of access, estimated at 25%. Australia has an unfair funding model for insulin pumps with around 80% of all pumps in Australia provided to people with private health insurance. Australians without private insurance do not have affordable access to insulin pumps. The Insulin Pump Program introduced by the Australian Government in 2008 to improve access has to date only provided 611 pumps and has not been available to high-needs groups including young adults over age 18 years. High and/or urgent clinical needs, people over 18 years, and women planning for and during pregnancy should be eligible for access to the Insulin Pump Program. Currently, some people with type 1 diabetes with a clear clinical need ar Continue reading >>

Insulin Pumps, Diabetes And Health Insurance

Insulin Pumps, Diabetes And Health Insurance

Are insulin pumps covered by private health insurance? Compare the benefits offered to people living with diabetes from Australian health funds. If you suffer from diabetes, your doctor or other medical specialist may recommend that you use an insulin pump. Worn 24 hours a day, an insulin pump delivers a constant supply of insulin and helps blood glucose levels remain stable. Happily, if you have an appropriate level of hospital or extras cover in place, the cost of your insulin pump may be covered by your private health fund. Consult your health fund to find out what level of cover is available to you. In many situations you will not need to be hospitalised in order to receive an insulin pump, so you’ll need to check whether your fund covers the cost of an insulin pump where hospitalisation is not required. This guide will explore the conditions of when insulin pumps will and will not be covered. Compare health funds and enquire for cover for insulin pumps About You Tell us about yourself for your quote. How will my private health fund cover me if I need an insulin pump? The Private Health Insurance Act 2007 stipulates that private health funds can cover the cost of insulin pumps under either their hospital cover or general treatment cover policies. However, the level of cover provided varies depending on whether you receive the pump is provided as part of hospital treatment or not. For example, if you are hospitalised due to diabetes and receive an insulin pump, and if you have an adequate level of hospital cover in place, your health fund is required to provide cover for: The cost of the insulin pump Your hospital accommodation fees Your doctor’s fees However, in many situations you will not need to be hospitalised in order to receive an insulin pump, so you’ll Continue reading >>

Insulin Pump & Cgm Services

Insulin Pump & Cgm Services

There are a variety of product services available to patients from the Diabetes Service, a public, specialist health service located within the Garvan Institute of Medical Research. The Diabetes Service is staffed by Diabetes Specialists, Registrars, Diabetes Educators, Dietitians, and a Psychologist. The aim of the Diabetes Service’s multidisciplinary approach is to equip patients to manage their diabetes on a day-to-day basis and to facilitate access to resources and support. The time patients spend with the Diabetes Centres Medical, Nursing and Allied Health staff supports, complements the care and education provided by General Practitioners. Please note: From 1 July 2016, the Government is introducing changes to the National Diabetes Services Scheme (NDSS) – an Australian Government-funded scheme that provides subsidised products for people with diabetes, along with self-management information and support services. Under the new arrangements, people with diabetes will pick up their Government-subsidised diabetes related products – such as needles, syringes, blood glucose test strips, urine test strips, and insulin pump consumables – at the pharmacy, as these will no longer be available via Diabetes Australia. There will be no change to the range of products available, or to the co-payment for people with diabetes. Diabetes Australia will continue to provide self-management information and support services to people with diabetes. There may be delays in processing orders during and immediately after the handover period so please stock up on your diabetes supplies to avoid inconvenience. For more information: Continuous Glucose Monitoring (CGM) There have been significant advances in the development of continuous glucose monitoring systems (CGMS) in recent tim Continue reading >>

Insulin Pump Program

Insulin Pump Program

The Australian Government's Insulin Pump Program provides subsidies to very low income families who have children with type 1 diabetes. The Program aims to improve access and 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. Since its inception in 2008, the Program has provided over 800 subsidised pumps to children with type 1 diabetes. Program activities for the 2017-18 financial year have commenced and JDRF Australia will be contacting families who are on the expression of interest list to advise of the next steps in progressing their applications. To improve access to the Program, the Government has introduced a number of changes to the Program arrangements, effective from 1 July 2017: The Government has established a panel of suppliers to supply pumps to the recipients under this Program. The following pumps will be available under the Insulin Pump Program: Accu-Check Spirit Combo (Roche), Paradigm Real Time (Medtronic) and Paradigm Veo (Medtronic). These pumps will be supplied with approximately three months' initial supply of pump consumables. The requirement for patient co-payment has been removed and recipients will be receiving their pumps fully subsidised by the Program. The expected number of pumps subsidised under the Program, in each financial year, is expected to increase from up to 68 pumps per year to approximately 90 pumps per year. Subject to meeting with the Program criteria, families with a combined annual income of up to $107,548 will be able to apply for a pump subsidy under the Program. Eligible families will be required to discuss with their Healthcare Professionals which of the abo Continue reading >>

Insulin Pumps

Insulin Pumps

What is an insulin pump? An insulin pump is a small battery-operated electronic device that holds a reservoir of insulin. It is about the size of a mobile phone and is worn 24 hours a day. The pump is programmed to deliver insulin into the body through thin plastic tubing known as the infusion set or giving set. The pump is worn outside the body, in a pouch or on your belt. The infusion set has a fine needle or flexible cannula that is inserted just below the skin where it stays in place for two to three days. Only fast acting insulin is used in the pump. Whenever food is eaten the pump is programmed to deliver a surge of insulin into the body similar to the way the pancreas does in people without diabetes. Between meals a small and steady rate of insulin is delivered. The insulin pump is not suitable for everyone. If you’re considering using one, you must discuss it first with your doctor or Credentialled Diabetes Educator. How does it help me manage my diabetes? Research has shown that insulin pump therapy can reduce the frequency of severe hypoglycaemia as well as improve quality of life. Using a pump may also improve suboptimal blood glucose control. It is important that you have realistic expectations about pump therapy. It is not a cure for people who require insulin to manage their diabetes but a way of delivering insulin that may offer increased flexibility, improved glucose levels and improved quality of life. Pump therapy requires motivation, regular blood glucose checking, the ability to learn pump technology and the willingness to keep in regular contact with your diabetes educator or endocrinologist for review and adjustment of pump rates. Resources - Blog post- What I've Learned From 12 Years Pumping What insulin pumps are available to me? You can see av Continue reading >>

Diabetes Australia Welcomes Additional Funding For Insulin Pumps

Diabetes Australia Welcomes Additional Funding For Insulin Pumps

Diabetes Australia welcomes additional funding for insulin pumps Up to 280 children and young people with type 1 diabetes will be able to access fully subsidised insulin pumps thanks to a significant expansion of the Insulin Pump Program announced in the 2018-19 Federal Budget. Diabetes Australia CEO Professor Greg Johnson said the funding boost was very welcome. Up to 280 Australian children with Type 1 diabetes will now be able to access fully subsidised insulin pumps, up from only 66 pumps per year previously which is good news, Professor Johnson said. There is extensive evidence demonstrating the improved health and quality of life benefits of insulin pump therapy for many people but when it comes to accessing this critical technology Australia lags behind many comparable countries so this is a step in the right direction. This is something that Diabetes Australia, in collaboration with JDRF Australia, the Australian Diabetes Society, the Australian Diabetes Educators Association and the Australian Paediatric Endocrine Group, have been advocating for over many years. Professor Johnson said Diabetes Australia welcomed several other measures announced in the budget. The Budget allocates around $14 million per year for nine years from the new Medical Research Future Fund for a Translation Research Accelerator for diabetes and heart disease which will help researchers accelerate the process of progressing research from early studies through to the human trials that are essential for the development of new medicines and technologies, he said. There is $750,000 per year over four years to improve education and develop resources to help pregnant women and their families achieve a heathy weight during pregnancy. This will help Australian mums lower their risk of developing Continue reading >>

Insulin Pump

Insulin Pump

First things first – registering with the NDSS When a patient is diagnosed with diabetes, they should register with the Australian Government’s National Diabetes Services Scheme (NDSS), which is administered by Diabetes Australia. The NDSS provides subsidised insulin pump consumables, including reservoirs and infusion sets. Who is eligible for NDSS subsidies? To be eligible, the patient must be an Australian resident, hold a current Australian Medicare card or a Department of Veteran Affairs file number and should have been diagnosed by a medical practitioner. Several countries also have a reciprocal agreement with Australia. If the patient is visiting Australia, and comes from a country with a Reciprocal Health Care Agreement, they may be entitled to temporary NDSS registration. Please note, different rules apply for patients with Type 2 diabetes, and in most instances, these patients may not be able to access these subsidy programs. However, Medtronic is currently offering a grant on insulin pump consumables for patients with Type 2 insulin dependent diabetes, with the opportunity to save up to 90% on RRP30.This means that pump consumables will cost roughly the same as they do for people with Type 1 Diabetes who can access the NDSS consumable prices. See here for more information. Getting access to insulin The Pharmaceutical Benefits Scheme (PBS) covers a considerable proportion of drug and medication costs through Medicare. Patients can get insulin from pharmacies with a prescription (from a GP or Endocrinologist) using the PBS; one prescription is generally 3-6 months’ supply, depending on the patient’s insulin needs. Other subsidy options for Type 1 patients Another option for subsidy assistance for Type 1 diabetes patients is the Type 1 Diabetes Insulin Pu Continue reading >>

Department Of Health

Department Of Health

Information relating to the National Diabetes Services Scheme (NDSS) Changes to the NDSS from 1 July 2016 | Overview | Access Points | Registrants | Products User research for NDSS Online Services Portal - March 2018 The NDSS supports people to manage their diabetes through access to information, services and government subsidised products. The Department funds Diabetes Australia to deliver information and support services to people living with diabetes registered with the NDSS. Each year, Diabetes Australia undertakes registrant research to measure satisfaction levels of NDSS services. This research will commence in March 2018. It will include some questions about Registrants views on the creation of a centralised NDSS online services portal. The NDSS online services portal would: simplify NDSS registration for those newly diagnosed with diabetes; provide online access to webinars and training courses; and offer information and notifications on changes to the NDSS. This research will help build the Department's understanding of Registrants needs. If you have any questions about the NDSS online services portal or want to be involved in further user research, please email the NDSS team . Request for Proposal Process to List Selected Diabetes Products on the NDSS Product Schedule The Australian Government foreshadowed changes to the NDSS in the 2015-16 Mid-Year Economic and Fiscal Outlook, which announced that the Australian Government will achieve further efficiencies through the sourcing and purchasing of selected products on the NDSS. These efficiencies are necessary to ensure the long-term integrity and sustainability of the NDSS, while ensuring a range of clinically effective products are available for NDSS registrants to effectively self-manage their diabetes. The Continue reading >>

Australian Government Subsidy Of Continuous Glucose Monitors

Australian Government Subsidy Of Continuous Glucose Monitors

The Australian Government is aware of the significant impact that diabetes has on individuals and their families, and is committed to working towards the broad prevention of the disease, and its associated complications, in the Australian community. A National Diabetes Strategy (2016-20) has been developed which will guide national action and priorities to prevent diabetes and support Australians living with diabetes. On 1 April 2017, the Minister for Health and Minister for Sport, the Hon Greg Hunt MP, announced that the Australian Government would provide fully subsidised continuous glucose monitoring (CGM) products to eligible children and young people aged under 21 years with type 1 diabetes through the National Diabetes Services Scheme (NDSS), in line with the commitment made during the 2016 Federal Election. Throughout the implementation phase of this initiative, the Government, through the Department of Health, worked collaboratively with an expert advisory group, which included endocrinologists, credentialed diabetes educators and stakeholder organisations, to allocate the limited financial resources available for this initiative in the most clinically appropriate manner. The advisory group recommended that people with type 1 diabetes who experience significant difficulty in managing their blood glucose levels should be a high priority for access to CGM. In addition, the advisory group confirmed that people under 21 years of age are the group with the highest clinical need for assistance in managing their condition through the use of CGM technology. The outcomes of this initiative are being monitored and evaluated to inform any future consideration by the Government regarding the expansion of the CGM initiative. Any decision to expand the initiative would also n Continue reading >>

Funding Increase For Insulin Pump Program

Funding Increase For Insulin Pump Program

Funding Increase for Insulin Pump Program More children of low income families will benefit from a funding increase for Australia's Insulin Pump Program. The Federal Government has provided an additional $870,000 for the program, which will enable a further 136 families to afford an insulin pump. Insulin pumps can particularly benefit children as they may find it more difficult to regularly monitor their blood sugar levels, follow structured eating and exercise plans, and receive daily injections, Federal Minister for Health, Tanya Plibersek, said. Through the $6.1 million Type 1 Diabetes Insulin Pump Program, the Government covers up to 80 per cent of the cost of insulin pumps for eligible low income families. Subsidies to help cover the costs of insulin pumps are available to eligible families with an annual income of up to $101,653. The maximum subsidy is provided to eligible families with an annual family income of up to $71,230. Ms Plibersek said with the incidence of type 1 diabetes in Australia increasing, it was important families took the right steps to manage the chronic disease. More than 1,000 young people under the age of 18 are being diagnosed with type 1 diabetes each year. There is no cure, and unlike many cases of type 2 diabetes, it is not caused by diet or lifestyle factors, Ms Plibersek said. The small computerised device delivers a slow, continuous level of insulin throughout the day. An insulin pump can be programmed to administer more or less insulin, when and if required. The Type 1 Diabetes Insulin Pump Program was introduced in 2008 and has been administered by the Juvenile Diabetes Research Foundation. Australians living with diabetes are supported by the Government through the subsidy of essential medicines under the Pharmaceutical Benefits Continue reading >>

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