I first wish to thank the help of Marco Bianchi, who is a CDE (and also an insulin pump user) at the Montreal Children's Hospital. I have been trying to find more information on the insulin pump program established in my province of Quebec where I currently reside back in Spring 2011. It was like looking for a needle in a haystack, but luckily he provided me with the website link (only in French which is why I couldn’t locate it on the English section of the Government of Quebec). I’ve taken the liberty to translate it the best I can (it's in very polite wording when translated to English - almost like we are back in the 1800's with gloves and top hats - which is knd of cute). Hopefully it will help you understand what is offered and perhaps give you the courage to speak up in the province where you live - to demand the same type of program (e.g. Alberta as of Spring 2013 will have a pump program - no word on what age group it will apply to at the moment). I know for myself, I will continue to write letters to my provincial government to see if ALL age groups will be covered, but until then, at least this is now in place.
If you need further information about current pump programs set up here in Canada - I strongly recommend checking out Diabetes Advocacy - which I am hoping will link up this blog for their section on insulin pump coverage in Quebec to help those like myself that do not speak/read French well.
This program was put in force in 2012 in the province of Quebec to provide access to the insulin pumps program to obtain a refund for the purchase of the device and supplies necessary for its use. This program is only offered to persons that meet the eligibility criteria and the clinical indications and currently you must be UNDER 18.
The insulin pump is the size of a pager. It is programmed to inject insulin as needed. Thanks to its use at all times, this pump allows:
- Controlling unstable diabetes;
- Decrease the episodes of hypoglycemia;
- Reduce the frequency of insulin injections;
- To relax the timing of meals and the organization of daily activities.
The rebate program is in effect from April 16, 2011. To be admitted to the program, the person must be 18 years old and meet all of the clinical eligibility criteria.
Those who received insulin pump during the project pilot preceding the program are considered eligible.
Once admitted, a person is maintained in the program, even after the age of 18, as long as it meets the clinical criteria of eligibility. An assessment of eligibility must be made annually.
To ensure the effectiveness of the treatment, the parents and the child must commit themselves to certain measures:
- Monitor blood glucose levels hair, at least before each meal and at bedtime;
- Register or record the results of capillary blood glucose levels on a regular basis;
- Master the advanced calculation of carbohydrates concepts and apply them in the child’s food plan;
- Provide the child support, supervision and parental supervision required to ensure a safe and appropriate use of the pump insulin;
- Participate in a program of training of pump designed by age of the child;
- Attend regular follow-up in clinic with a multidisciplinary team of care in diabetes at least 3 times per year and participate on a regular basis to update knowledge on care.
Reimbursement of costs
Only insulin pumps purchased under the program are eligible for a refund.
The program provides a maximum reimbursement of $6,300 by insulin pump. The pump can be replaced every 4 years, subject to certain conditions. A maximum of $4,000 per year is granted for supplies. Supplies are, for example, insulin reservoirs or catheters.
For parents with private insurance, the Government program covers amounts not covered by insurance in force.
Membership in the program
Parents should contact their pediatrician, endocrinologist or their child's family physician. The doctor will inform you about the program, assess if the child could wear a pump, and will direct you to a hospital where a designated team will assess their eligibility.
These hospitals are designated for the assessment of children less than 18 years:
Centre hospitalier universitaire de Québec (CHUQ) - CHUL
Montreal hospital for children - MUHC
Centre hospitalier universitaire de Sherbrooke - CHUS
Centre hospitalier régional de Trois-Rivières
CSSS Vallée - de - l'Or
CSSS de Rimouski-Neigette
CSSS de Rivière-du-Loup
Other hospitals could be added to this list in the near future.
Several hospital centers will be also identified over the next year for the follow-up of participants 18 and older. For now, only the CSSS de Trois-Rivières is appointed for this purpose.
Certification of eligibility
When the child meets the eligibility criteria, the designated licensed physician of the hospital will provide proof of eligibility to program. The parents must then complete the section of the certificate on the current cover of insurance in force, in collaboration with the doctor.
Information to include is:
- The name of the company;
- The name of the holder of insurance;
- The police or contract number.
Later, the form is sent by the physician to the paying agent, which will carry out the opening of the file.
Choice of the model of the pump
Before you can use the pump, the eligible child and his parents should follow a training program on Type 1 diabetes provided by the multidisciplinary team of the hospital on the following components:
- The food and the advanced calculation of carbohydrates;
- Rigorous maintenance of a log of blood glucose levels;
- Basic knowledge on insulin pump therapy.
Then, the child and its parents choose the doctor or a member of the medical team pump model that suits them.
For the insulin pump
Depending on the choice of pump, parents will contact the selected insulin pump company in order to proceed with the purchase of the pump. Parents should give this company a copy of the eligibility of the child form.
The parents of the child will be responsible for purchase of supplies. To benefit from the refund, they must send the original invoices or original insurance records to the paying agent. A maximum of $4,000 per year is granted for these supplies.
The reimbursement of supplies will be considered by the paying agent to the receipt of the invoice or original insurance records.
For supplies delivered to home
Some supply companies can deliver to the home of the parents. These companies have an agreement with the paying agent; they may receive reimbursement of costs directly by the program, according to certain rules in force.
The pump will be installed at the designated hospital. The child and its parents must meet with a member of the medical team to receive the necessary training before the start of the insulin pump. The medical team will monitor the settings of the pump for insulin to ensure they meet the child’s requirements.