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 Children’s Insulin Pump Program ensures that cost is not a barrier to appropriate medical treatment for children who require an insulin pump to manage their diabetes.

Eligibility

• Applicants must be 17 years of age or less
• Applicants must have Type 1 diabetes, and require a pump to adequately stabilize their blood sugar levels.

Children eligible for benefits under a federal government program (e.g. Non-Insured Health Benefits program) will not be eligible for the Saskatchewan Children’s 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. Children who are eligible for coverage will receive:

• Insulin pumps free of charge through the SAIL program. Coverage will be available for one pump every five years up to the age of 18.
• 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 the Supplementary Health Program, Family Health Benefits or certain 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 a paediatric endocrinologist or a specialist physician who is associated with a regional health authority diabetes program and who has experience with insulin pump management in diabetic children and adolescents.
• 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 centre/specialist following screening, assessment, pump information session and the trial period.

Read detailed medical criteria/application information or view the chart below.

If you have questions about applying for coverage, contact Saskatchewan Drug Plan and Extended Benefits in Regina at 787-3317 or toll free at 1-800-667-7581.