Description

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. 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 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.

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

Reimbursement of Costs

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 4 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 designated institutions for assessing the eligibility of children under 18 years of age are the following:

  • CHU de Québec – Université Laval
    • Centre hospitalier de l'Université Laval (CHUL)
  • Centre hospitalier universitaire (CHU) Sainte-Justine
  • MCGill University Health Centre (MUHC)
    • Montreal Children's Hospital
  • Centre intégré universitaire de santé et de services sociaux de l’Est-de-l’Île-de-Montréal
    • Hôpital Maisonneuve-Rosemont
  • Centre intégré universitaire de santé et de services sociaux de l’Estrie – Centre hospitalier universitaire de Sherbrooke (CHUS)
    • Hôpital Fleurimont
  • Centre intégré universitaire de santé et de services sociaux de la Mauricie-et-du-Centre-du-Québec
    • Pavillon Sainte-Marie (Trois-Rivières)
  • Centre intégré de santé et de services sociaux de l’Outaouais
    • Hôpital de Gatineau
  • Centre intégré universitaire de santé et de services sociaux du Saguenay–Lac-Saint-Jean
    • Hôpital de Chicoutimi
    • Hôpital d’Alma
  • Centre intégré de santé et de services sociaux de Chaudière-Appalaches
    • Hôpital de Saint-Georges
  • Centre intégré de santé et de services sociaux de l’Abitibi-Témiscamingue
    • Hôpital de Rouyn-Noranda
  • Centre intégré de santé et de services sociaux du Bas-Saint-Laurent
    • Hôpital Régional de Rimouski
    • Centre hospitalier régional du Grand-Portage

Other institutions may be added to the list.

The annual eligibility assessment for people over 18 years of age registered in the program can be conducted by several specialist doctors spread across 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, which is the program’s paying agent, for a file to be opened.

Choice of pump

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

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 paying agent.

The paying agent 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 paying agent.

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.