The Insulin Pump Access Program refunds you for the purchase of an insulin pump and supplies needed.
This program has been in effect since April 16, 2011. To be eligible, individuals must be under 18 years of age and meet a set of clinical criteria.
Insulin pump
An insulin pump is a portable device to inject insulin directly into the body without using a needle in diabetic patients. About the size of a pager, it is programmed to inject insulin as needed by the person wearing it.
As it operates continuously, the pump allows you to:
Control unstable diabetes
Reduce frequency of hypoglycemia
Reduce frequency of insulin injections
Make eating schedule and organisation of daily activities more flexible
Eligibility
People under 18 years of age covered by Québec’s public health insurance plan (RAMQ) must meet a set of clinical criteria to qualify for the program. Eligibility for the program must be re-evaluated annually.
Persons admitted to the program may continue to participate in it after age 18 if they still meet the clinical eligibility criteria.
See your doctor to learn about the clinical eligibility criteria.
Commitments
To ensure the effectiveness of diabetes treatment using an insulin pump, parents and their child, if necessary, must commit to:
Monitoring capillary blood glucose, at least before each meal and at bedtime
Regularly logging capillary blood glucose results
Mastering concepts of advanced carbohydrate counting and applying them to the child’s food plan
Providing the child with the assistance, supervision and guidance necessary to ensure safe and proper usage of the insulin pump
Participating in a training program on the use of the pump designed according to the child’s age
Attending at least 3 follow-up meetings with a diabetes care multidisciplinary team
Staying informed on matters regarding care for diabetic people. Your doctor will guide you in updating your knowledge.
Cost reimbursement
Only the cost of insulin pumps purchased under the program may be reimbursed.
The program provides a maximum refund of $6,300 per insulin pump. The pump can be replaced every 5 years, subject to certain conditions.
The program also provides a maximum of $4,000 per year for supplies (insulin reservoirs or catheters, for instance).
Procedure
Program registration
Please contact your child's paediatrician, an endocrinologist or family doctor to obtain information on the program.
If the doctor deems that your child can wear a pump, they will direct you to a designated institution where your child’s eligibility will be assessed.
The annual eligibility assessment for people over 18 years of age registered in the program can be conducted by a doctor recognized by the program throughout the province.
Eligibility certificate
If your child meets the eligibility criteria, the designated institution’s authorised doctor will give you an eligibility form.
A section of the eligibility form concerns your insurance coverage. This section must be completed with the doctor and the following information indicated:
The name of your insurance company
The name of the insurance holder
The number of your policy or insurance contract
The doctor will then send the form to the CHU de Québec – Université Laval, which is the program’s paying agent, for a file to be opened.
Training program
Before choosing a pump, you must attend an information session on type 1 diabetes with your child.
The information session is given by the designated institution’s multidisciplinary team. It covers the following subjects:
Diet and advanced carbohydrate counting
Keeping a rigorous blood sugar log
Basic knowledge on insulin pump therapy
Choosing a pump
Along with your child, you will then choose the most suitable pump model. The doctor or a member of the medical staff will help you in this process.
Getting the pump and reimbursement
For the insulin pump
You must procure the insulin pump selected through the company that manufactures or distributes it. To receive your reimbursement, you must submit a copy of your child’s eligibility form to the company.
For supplies
Required supplies must be purchased according to the pump model selected. To receive your refund, send the original receipts or insurance statements to the CHU de Québec – Université Laval.
The CHU de Québec – Université Laval must receive the original documents in order to refund you.
For supplies delivered at home
With some companies, you will not have to pay for supplies as they are directly refunded by the CHU de Québec – Université Laval.
Installing and setting up the pump
The pump will be installed and set up at the designated institution.
A member of the medical staff will give you the necessary training before the insulin pump is put to use. You must undergo this training with your child.
The medical team will then follow-up to verify the settings of your child’s insulin pump.
