How to obtain coverage for insulin pumps in BC . . .
- The person speaks to their endocrinologist or diabetes specialist about whether an insulin pump is appropriate.
- If the person meets the eligibility criteria, the physician will complete and submit a Special Authority request to PharmaCare.
- PharmaCare Special Authority will review the request.
- If approved, Special Authority will send an approval letter (including instructions on how to obtain the approved pump model) to the requesting physician.
- The physician will provide a copy of this letter to the person.
- The person will follow the instructions provided to order their pump, and provide a copy of the approval letter to the insulin pump vendor.
- If approved, insulin pump coverage is provided for the device itself. Insulins are covered separately.
- PharmaCare covers the rapid-acting insulins used in insulin pumps, up to a maximum allowable cost.
Similar to drugs covered by PharmaCare, the government will pay first and then if there are any costs associated with the purchase then the Group Benefits plan (depending on your provider and coverage) may cover the rest.
This is the link where you can find more information about this program:
https://www2.gov.bc.ca/gov/content/health/health-drug-coverage/pharmacare-for-bc-residents/what-we-cover/medical-supplies-coverage/diabetes-supplies/insulin-pumps-expansion
If you have any questions regarding this or any other concern, please contact your advisor.
