Case study: Caitlin's diabetes and private health insurance
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Below are some hospital policies from Finder partners that cover insulin pumps. All have a 12-month waiting period for pre-existing conditions and a 2-month waiting period if not.
We update our data regularly, but information can change between updates. Confirm details with the provider you're interested in before making a decision.
The Private Health Insurance Act 2007 says private health funds must meet the cost of insulin pumps under either their hospital cover or general treatment cover for gold-tier policies. However, the level of cover provided varies depending on factors, including whether you receive the pump as part of hospital treatment or not.
If you're hospitalised due to diabetes and receive an insulin pump, and if you have an adequate level of hospital cover in place, your health fund is required to provide cover for:
If you do not need to be hospitalised in order to receive an insulin pump, then your health fund may or may not cover your costs. You'll need to check whether your fund covers the cost of an insulin pump where hospitalisation is not required.
Depending on your health fund and the level of extras cover you have, you may receive a benefit for other costs, including blood glucose monitoring devices, test strips and meters. The cost of consumables or sensors is not typically included in this cover, but some health funds will also cover the cost of dietary education services. Check with your health fund for details.
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:
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 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:
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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