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5.17 Insulin Pumps

Last updated on April 29, 2026

General Policy Description

PharmaCare covers insulin pumps for people who have type 1 diabetes or another form of diabetes requiring the use of regular or rapid-acting insulin, with Special Authority approval.

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Policy details

Client eligibility and plan coverage

Insulin pump coverage is available to clients who:

  • Have type 1 diabetes or another form of diabetes requiring the use of regular or rapid-acting insulin, and
  • Are covered under:
    • Fair PharmaCare – coverage is subject to deductible and family maximum requirements, or
    • Plan B (Long-term Care), Plan C (Income Assistance and Family Services), Plan F (Children in the At Home Program), or Plan W (First Nations Health Benefits) – 100% coverage of eligible costs, and
  • Meet Special Authority (SA) criteria and PharmaCare has approved a HLTH 5375 - SA Request: Continuous Subcutaneous Insulin Infusion (PDF, 473KB) submitted by an endocrinologist or specialist physician with experience in managing insulin pump therapy

Clients should register for Fair PharmaCare before applying for insulin pump coverage. This ensures that the client has income-based coverage in place when they purchase their insulin pump – coverage is not retroactive – and that they know what their Fair PharmaCare deductible is.

Coverage terms

PharmaCare coverage is limited to one insulin pump every five years (i.e., warranty period).

Only the makes and models of insulin pumps approved by PharmaCare are eligible for PharmaCare coverage, and only when the insulin pump is purchased from an approved vendor.

PharmaCare covers approved pumps up to a maximum price with no dispensing fee. The maximum prices are available at Diabetes devices and supplies PINs.

The Full Payment Policy does not apply to insulin pumps (or supplies) as per Section 5.10: Full Payment Policy.

Special Authority

Every pump, including replacements, requires Special Authority (SA) approval. Pumps should be purchased within six months of SA approval.

SA approval must be in place before the pump is purchased and cannot be provided retroactively. Claims for clients who do not have SA approval will not be paid by PharmaCare.

Refer to SA for Insulin Pumps for coverage criteria.

SA approval letter

If the SA request is approved, the physician receives a letter with details about the pump approved for coverage.

The physician must provide a copy of the SA approval letter to the client.

The client must provide a copy of the SA approval letter to the insulin pump vendor before or at the time of purchase.

Clients with insulin pumps not covered by PharmaCare

Clients with an insulin pump that was not covered by PharmaCare may be eligible for PharmaCare coverage if the client is covered by an eligible PharmaCare plan, meets SA criteria, and:

  • Their current pump is four or more years old, and
  • The manufacturer's warranty for their current pump has expired. The physician must include a copy of the letter from the supplier confirming purchase date of the previous insulin pump.

Insulin pump repairs and replacement

PharmaCare does not cover insulin pump repairs. Manufacturers warranty their pumps for the five-year term.

PharmaCare does not cover insulin pump replacement prior to the end of the five-year coverage period.

Insulin pump repairs and replacements of broken pumps are subject to the terms of the manufacturer’s warranty period. The client should refer all enquiries about pump repair and replacement to the vendor.

Replacement costs for stolen or lost insulin pumps are not covered by PharmaCare.

Insulin pump vendor responsibilities

Vendors must obtain and maintain on file a copy of the PharmaCare letter confirming SA approval for insulin pump coverage.

Claims submitted in PharmaNet must use the Product Identification Number (PIN) for the approved insulin pump. Find these PINs at Diabetes devices and supplies PINs.

To process a claim in PharmaNet:

  • Enter intervention code:
    • MO for all claims between $500.00 and $999.99
    • MP for all claims between $1000.00 and $9999.99
  • In the Prescriber ID field, enter the prescribing physician’s Practitioner ID (assigned by the College of Physicians and Surgeons of BC), which is on the SA approval letter

If a client and their specialist determine the client cannot continue using a pump, and they return the pump within the vendor’s allowable returns period, the vender should reverse the PharmaCare claim in PharmaNet and refund the client the portion of the cost they paid.

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