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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.
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Compare health insurance with cover for insulin pumps
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.
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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?
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.
In hospital
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:
- The cost of the insulin pump
- Your hospital accommodation fees
- Your doctor's fees
Out of hospital
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.
Other diabetes coverage
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.
Case study: Caitlin's diabetes and private health insurance
What type of diabetes do you have?
"I've have type 1 diabetes since I was 13 years old (I'm 26 now)."
How do you treat your diabetes?
"With an insulin pump. I take a short acting insulin intravenously throughout the day, administered via an insulin pump."
Do you have health insurance?
"I am with ahm and have its Silver Plus Hospital and Lifestyle Extras cover. I'm currently looking at changing this policy as after the price increase it will be costing me a fair bit each month – over $140 a month."
Was your insulin pump covered by your health fund?
"My current insurance policy covers the cost of an insulin pump every 4 years, if my health professional says it's a necessary item and completes all the paperwork."
Did you have any issues with getting health insurance?
"Not so far. The only issues I've had are the cost of the pump and understanding the fine print of each policy (i.e. finding out information specific to the insulin pump)."
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
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
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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Ask an Expert
Hi. I’m a student going to Sydney for my postgraduate degree. I’m a Type 1 diabetic since the last 14 years. Can you tell me what insurer and what package I should go for, in order to get my Insulin pens, and Glucometer strips covered?
Hi Zain,
Thanks for getting in touch with finder. We are a comparison website and are not insurance experts so we can only offer a general advice.
Typically, the cost of your insulin pump may be covered by your private health fund when you have the right level of hospital or extras cover in place. While we can’t really recommend a specific insurer and insurance package for you, it would be best to compare your options by filling out the form/panel above and click on the orange “Search Policies” button.
Cheers,
May
I have type 1 diabetes and have an insulin pump. I am looking for private health insurance which covers the replacement of the pump. I need to know which funds replace after four years please.
Hi Alison,
Thank you for your question. I’m sorry to hear about your medical condition.
In our panel of health insurers, HCF and ahm do provide cover for the replace of an insulin pump. Although the time limits vary between insurers, they’re commonly around four or five years. You will need to contact the insurer directly to verify the time limit.
All the best,
Zubair
Mi hija es diabética tipo 1 , quiere viajar por un año Australia. Qué cobertura médica me aconseja pagar dentro de este país. Gracias
Hi Bea,
Thanks for getting in touch with Finder!
You may find our guide about overseas visitors health cover helpful.
All the best,
Richard