Health insurance for insulin pumps
Health insurance for insulin pumps is compulsory for gold-tier policies, which cost around $175 a month. However, there are cheaper policies that will cover you – compare top brands below.
Compare health insurance with cover for insulin pumps
Below are some hospital policies from Finder partners that cover insulin pumps and diabetes managmenent. All have a 12-month waiting period for pre-existing conditions and a 2-month waiting period if not.
All prices are based on a single individual with less than $90,000 income and living in Sydney.
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How does private health insurance cover insulin pumps?
All gold-level hospital policies are required to cover insulin pumps. The Private Health Insurance Act 2007 says private health funds can cover the cost of insulin pumps under either hospital cover or general (extras) treatment cover.
While you will need hospital cover that includes insulin pumps, many health funds, such as Medibank, ahm and Teachers Health, often do not require a hospital stay for you to receive benefits.
However, if you aren't receiving treatment in a hospital, you typically won't be covered for any facility or doctor's fees. (If you are hospitalised due to diabetes, you will be covered for hospital accommodation fees and doctor's fees in a private facility).
Insurers can cover you for a replacement insulin pump but only after a set period of time – for example, after 4 or 5 years.
Insulin pumps are on the prosthesis list. This means hospital insurance will usually cover costs up to the specified benefit amount. This ranges from around $8,077 to $8,574.
Some extras insurance policies can pay for diabetes consumables, such as blood glucose monitoring devices, test strips and meters. Many health funds will also cover the cost of dietary education services, podiatry, optometry and give you money off gym memberships, exercise classes and personal training sessions.
What are the different types of diabetes?
Type 1 diabetes
Type 1 diabetes is a hereditary auto-immune condition that accounts for 1 in 10 Australian diabetics. Also known as insulin-dependent diabetes, type 1 diabetes sees the body attack insulin-producing cells in the pancreas. Symptoms include:
- Excessive thirst
- Excessive urination
- Unexplained weight loss
- Fatigue and weakness
- Blurred vision
Skipping a meal or exercising heavily can also cause the patient's blood sugar levels to fall, which can lead to hypoglycaemia.
Type 1 diabetes is typically diagnosed before the age of 30 and those with the condition require insulin injections in order to effectively process glucose. While there is no cure for type 1 diabetes, it can be managed with insulin injections as well as proper diet and exercise.
Type 2 diabetes
Type 2 diabetes is a much more common condition in Australia, representing up to 90% of all cases of diabetes. Also referred to as non-insulin-dependent diabetes, it is a progressive auto-immune condition that occurs as the body stops responding to the effects of insulin. This means carbohydrates and sugars are not properly metabolised, and the condition usually occurs in adults over 45 years of age.
Obesity, insufficient exercise and poor diet are all contributing factors to the onset of type 2 diabetes, but there is currently no cure for the condition. Many people with type 2 diabetes have no symptoms, but some symptoms to keep an eye out for include:
- Excessive thirst and urination
- Feeling tired and lethargic
- Feeling hungry all the time
- Dizziness and mood swings
- Blurred vision
- Itching and skin infections
- Gradually putting on weight
- Leg cramps
Type 2 diabetes can be managed with healthy eating, regular exercise and sometimes medication.
Gestational diabetes is diabetes that occurs during pregnancy. It affects 5-10% of pregnant women but usually goes away once the baby has been born.
A woman's likelihood of developing gestational diabetes is influenced by a range of factors, including a family history of type 2 diabetes, being overweight, and being from certain ethnic backgrounds.
Gestational diabetes can be managed through healthy eating, regular exercise and monitoring your blood glucose levels. Most women with gestational diabetes have a normal pregnancy and a healthy baby, if the condition is not properly managed it can lead to a large baby, miscarriage or stillbirth.
Once the pregnancy is over, blood glucose levels return to normal and gestational diabetes disappears, but women who suffer from the condition have an increased risk of developing type 2 diabetes later in life.
Prediabetes refers to a condition where the body has higher-than-normal blood glucose levels, although not high enough for you to be diagnosed with full diabetes. While prediabetes does not have any signs or symptoms, sufferers are more likely to develop type 2 diabetes or cardiovascular disease later in life. Treatment involves sustained lifestyle changes, including regular exercise and healthy eating.
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Frequently asked questions
- Health.gov: Private health insurance laws
- Health.gov: Diabestes
- Health.gov: The prostheses list part c
- Ombudsman: Diabetic Insulin Pumps
- APRA: quarterly private health insurance statistics for March 2023
- APRA: Private Health Insurance Annual Coverage Survey
- Finder: Consumer Sentiment Tracker (CST)
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