Alberta and Nova Scotia providing coverage for insulin infusion pumps through provincial programs

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New government programs may affect group benefits plans with extended health care coverage that include coverage for insulin pumps and supplies in Alberta and Nova Scotia.
 

Alberta

The Insulin Pump Therapy (IPT) program

Effective June 1, 2013, the government of Alberta offers coverage of insulin-infusion pumps and some pump supplies to patients of all ages with Type 1 diabetes. Patients must be referred to the program by their physician or nurse practitioner and must meet the eligibility and clinical criteria to be covered under the new Insulin Pump Therapy program. While a few other provinces have had insulin pump programs in place for some time now, Alberta is the first province to offer the pumps without an age restriction.

The Insulin Pump Therapy program will also cover the costs of some pump supplies for up to five years for persons already using a pump.  Existing users must be referred to the IPT program by their physician or nurse practitioner and will need to be assessed to ensure they meet the eligibility and clinical criteria for the program. 

For more information about the IPT program, you can visit the Alberta government website here: http://www.health.alberta.ca/services/insulin-pump-therapy-program.html
 

Nova Scotia


On April 4, 2013, Nova Scotia announced a new program to provide provincial funding for insulin pumps and pump supplies for children aged 18 or younger with Type 1 diabetes. Young adults between ages 19 and 25 can also apply for coverage of their insulin pump supplies. Applicants will need to meet all criteria to be eligible for funding.

Funding through the program will be based on family income, size and medical eligibility; therefore not all successful applicants will receive the same funding. This program was designed to assist low income families and provide coverage to those who would otherwise not be able to afford an insulin pump or pump supplies. Families who have purchased an insulin pump or insulin pump supplies since the announcement of the program on April 4, 2013, can still apply to the program for consideration.

The Nova Scotia Insulin Pump Program details are still being refined, but the program is scheduled to begin receiving applications for coverage on September 16, 2013. Further details on the Program were anticipated late in August.

For more information about the Nova Scotia Insulin Pump Program, you can visit their website here:  http://novascotia.ca/DHW/insulin-pump-program.asp

Insulin pumps and plan coverage for both provinces

Not all Sun Life group plans offer coverage for the expense of purchasing an insulin pump or pump supplies.  If a plan member in Alberta or Nova Scotia has coverage for insulin pumps and supplies under their Sun Life plan, they must first pursue coverage for obtaining these items through the provincial program before submitting these expenses to Sun Life for reimbursement.

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We have prepared a communication for you to share with your plan members to let them know about this development.

Questions?

Contact your Sun Life Financial group benefits representative.