Saskatchewan Insulin Pump Program

Inadequate control of diabetes can lead to serious complications affecting the kidneys, heart and eyes, which may result in frequent hospitalization and poor quality of life. The Saskatchewan Insulin Pump Program ensures that cost is not a barrier to appropriate medical treatment for clients 25 years of age and under who require an insulin pump to manage their diabetes.

Eligibility

• Applicants must be 25 years of age and under.
• Applicants must have Type 1 diabetes and require a pump to adequately stabilize their blood glucose levels.
• Applicants eligible for benefits under a federal government program (e.g. Non-Insured Health Benefits program) are not eligible for the Saskatchewan Insulin Pump Program.

Coverage
Coverage will be provided effective from the date the application is received by the Saskatchewan Aids to Independent Living (SAIL) program. Clients who are eligible for coverage will receive:

• Insulin pumps as a fully covered benefit through the Saskatchewan Aids to Independent Living program. Coverage will be available for one pump every five years up to the age of 25.
• Insulin pump supplies as regular benefits under the Saskatchewan Drug Plan. For those who have Special Support coverage, the cost will be based on the family deductible and/or co-payments.
• Supplies will be fully covered for individuals 17 years of age and under who have coverage under Family Health Benefits or for all clients with coverage under the Supplementary Health Program or certain other programs under SAIL.

During the initial trial period (up to three months), the pump and pump supplies will be provided to all applicants at no charge by the pump supplier selected by the applicant.

Applying for Coverage

• The applicant must be assessed by a regional health authority diabetes program, participate in a diabetes education program and meet specific medical criteria.
• Use of an insulin pump as a medical necessity must be recommended by an endocrinologist or a specialist physician who is associated with a regional health authority diabetes program and who has experience with insulin pump management in individuals 25 years of age and under.
• The applicant must also participate in a regional health authority insulin pump information program.

An application must be submitted to SAIL on behalf of an applicant by the regional health authority diabetes education program/specialist following screening, assessment, pump information session and the trial period.

Read detailed medical criteria/application information.

If you have questions about applying for coverage, contact Saskatchewan Drug Plan and Extended Benefits in Regina at 787-7121 or toll free at 1-800-667-7581.