Insulin Pumps & Insulin Pump Supplies
PharmaCare covers insulin pumps for patients with Type 1 diabetes or other forms of diabetes requiring insulin. PharmaCare covers supplies for insulin pumps, regardless of whether or not the pump was covered by PharmaCare.
Insulin pump coverage is available to patients who:
- are covered under Fair PharmaCare, Plan C (B.C. Income Assistance Recipients), Plan F (Children in the At Home Program), or Plan W (First Nations Health Benefits), and
- have Type 1 diabetes or another form of diabetes requiring insulin, and
- have confirmation from their endocrinologist/diabetes physician specialist that they meet the medical criteria, and
- have Special Authority approval for coverage.
Speak to your endocrinologist/diabetes physician specialist. If you meet the criteria for coverage of a pump, your specialist will submit a Special Authority request to PharmaCare.
If the request is approved, PharmaCare will send an approval letter to your specialist's office. Your specialist will give you a copy of this letter to take to the insulin pump manufacturer when purchasing your pump.
Be sure to wait for the approval letter before purchasing your insulin pump. PharmaCare cannot provide retroactive coverage for purchases made before your approval is confirmed.
PharmaCare provides coverage for the Omnipod Insulin Management System manufactured by Insulet. If your endocrinologist/diabetes physician specialist determines that this system is clinically unsuitable for you, exceptional coverage may be provided for a MiniMed Insulin Pump System manufactured by Medtronic.
The Omnipod system is available to you at no cost, regardless of the PharmaCare plan you are covered under or any deductible you may have.
For those approved for exceptional coverage of the MiniMed pump, PharmaCare coverage is dependent on your PharmaCare plan and any associated deductible and family maximum:
- If you are covered under Plan C (B.C. Income Assistance), Plan F (Children in the At Home Program), or Plan W (First Nations Health Benefits), PharmaCare covers 100% of the cost.
- If you are covered under the Fair PharmaCare plan, PharmaCare covers 70% of costs above your deductible and 100% of costs above your family maximum.
Insulin Pump Supplies
PharmaCare covers certain insulin pump supplies if you are covered under:
- Fair PharmaCare
- Plan C (B.C. Income Assistance)
- Plan F (Children in the At Home Program)
- Plan W (First Nations Health Benefits)
This coverage is available whether or not your pump was covered by PharmaCare.
PharmaCare pre-approval is not required for insulin pump supplies.
PharmaCare covers pods, infusion sets/kits, and insulin pump reservoirs/cartridges.
PharmaCare does not cover batteries, battery caps, adhesive pads, skin wipes, continuous glucose monitoring systems, etc.
PharmaCare covers eligible insulin pump supplies purchased from pharmacies and approved insulin pump vendors who submit claims on PharmaNet. PharmaCare cannot accept manual/paper claims for insulin pump supplies.