Insulin pumps

What is an insulin pump? 

Insulin pumps are devices that connect an external pump to a tube and fine needle or cannula that is inserted just below the skin. The pumps are programmed to inject fast-acting insulin into type 1 diabetics to mimic the function of a healthy pancreas. 

Diabetes Australia advises that insulin pumps aren’t suited to everyone. Anyone considering an insulin pump will need to speak to their doctor about their diabetes treatment options. 

Insulin pumps: can your hospital cover help? 

Insulin pumps are a clinical category available on Peoplecare’s Silver Plus and Gold hospital covers. 

Things you need to know before we start 

  • Excess
    You’ll need to pay your hospital excess (if you have one) when you enter hospital to get your insulin pump fitted.  
  • Waiting periods
    The waiting period listed for insulin pumps is two months, however, pre-existing conditions have a 12-month waiting period, which is standard across all health funds. The good thing is that if you switch to Peoplecare within 30 days of having a hospital cover where you’d served your 12-month waiting period on a cover with insulin pumps included, you don’t need to re-serve it again after you switch.  
  • Out-of-pocket expenses
    You may also need to pay out-of-pocket fees to your specialist/s for the fitting of your insulin pump. We know our members don’t like paying them if they don’t have to, so we have a Going to Hospital Guide which shows you how to reduce (or remove) your out-of-pocket costs by using Access Gap. Read the guide for all the key info. 

Before you proceed, make sure you: 

  1. chat to your doctor to see if an insulin pump is right for you 
  2. are covered for insulin pumps
  3. have served your waiting periods

Peoplecare insulin pump benefits 

Peoplecare can pay: 

  • the cost of the insulin pump
  • any hospital accommodation and theatre fees (if applicable) 
  • specialist medical fees upto 25% of the Medicare Benefits Schedule fee per item or more if your specialist chooses to use Access Gap (Medicare covers 75% of the MBS fee per item)

If your specialists charge more than the Medicare Scheduled Fee, you’ll have what’s called an ‘out-of-pocket cost’. Your specialists should tell you what that cost will be before you go to hospital. It’s called Informed Financial Consent and you can download the form to help you get it

Peoplecare hospital covers Insulin pumps
Gold $250 excess/$500 excess/$750 excess Included
Silver Plus $500 excess/$750 excess Included
Silver $500 excess/$750 excess Excluded
Bronze $500 excess/$750 excess Excluded
Peoplecare closed hospital covers Insulin pumps
Premium Hospital (Gold) No excess/$150 excess/$250 excess Included
Mid Hospital (Basic Plus) $500 excess Included
Basic Hospital (Basic Plus) $500 excess Included
Public Hospital (Basic) No excess Restricted
  • Included, meaning private hospital accommodation and theatre fees are 100% covered
  • Restricted, meaning that hospital accommodation is paid at a default rate and any treatment at a private hospital could involve large out-of-pocket costs.
  • Excluded, meaning no benefits are paid for members on this cover.

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