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NL Insulin Pump Program (NLIPP)

 

What is the Newfoundland and Labrador Insulin Pump Program?
The use of insulin pumps for patients with Type 1 Diabetes Mellitus (T1DM) is considered to be an effective and efficient way to aid in the management of the disease.
 
In 2007, the Department of Health and Community Services launched the Newfoundland and Labrador Insulin Pump Program (NLIPP), a provincial program designed to offer financial assistance for patients up to the age of 18 years who had been diagnosed with (T1DM). 
 
In 2010, the program was expanded to offer financial assistance to all T1DM patients up to their 25th birthday. Recently, the Department of Health and Community Services broadened the scope of the program to include medically eligible persons of all ages.

 
Who is eligible to apply?
To apply for help with the cost of an insulin pump and/or pump supplies, you must:
  • have been diagnosed with type 1 Diabetes Mellitus (T1DM).   
  • be a resident of Newfoundland and Labrador.
  • have a valid MCP card. 
  • meet the medical eligibility criteria. 
  • meet the requirements for financial assistance through the income testing criteria if you are 18 years of age or older. 
Currently enrolled clients between the ages of 18 and 24 as of March 31, 2021 can refer to the FAQ:  
 

 
What will it cost?
Cost for pumps and supplies will vary from person to person based on income testing. 
  • All medically eligible applicants under the age of 18 will qualify for funding for insulin pumps and supplies after all other financially obligated programs have paid. (I.e. private insurance). 
  • Medically eligible applicants over the age of 18 can apply for financial assistance through the income testing process. If approved, financial assistance will be provided after all other financially obligated programs have paid (i.e. private insurance) and the patient/client copayment (if applicable) has been received. 
 
What is a client monthly copayment amount?
It’s the monthly amount that the client will be responsible for paying if approved for financial assistance. The amount of the payment will be determined through income testing. 
 
The NLIPP is the payer of last resort. What does that mean?
As the payer of last resort, the NLIPP will pay the remaining portion of the pump and supply cost after:
  1. All other financially obligated programs have paid (i.e. private insurance)
  2. The client has contributed the copayment amount indicated by income testing. 

 
What is covered?
The NLIPP will cover all costs for approved insulin pumps and supplies for medically eligible clients under the age of 18, once other financially obligated programs have been exhausted first (i.e. private insurance).
 
Patients 18 year of age and older can apply for financial assistance income testing. If approved for financial assistance, patients/clients over the age of 18 will receive the benefit after all other financially obligated programs have been exhausted first (private insurance) and the patient/client has contributed the copayment amount determined by income testing.
 
Currently enrolled clients of the Insulin Pump Program between the ages of 18 and 24 as of March 31, 2021, please refer to the FAQ: 
 
What is included?
  • One insulin pump every 5 years
  • Insulin pumps supplies including; infusion sets, cartridge/reservoirs and pods.
 
What is not included?
  • Diabetes medication (insulin or oral medication)
  • Continuous Glucose Monitoring (CGM) and Flash Glucose Monitoring (FGM) supplies
  • Blood glucose meters, test strips, and lancets
  • Ketone test strips (urine or blood)
  • Batteries
  • The cost of lost/stolen insulin pumps and/or supplies

 
How do I apply?
Two forms must be completed:
1. Ask your health-care provider to complete the Verification of Medical Eligibility Form.  
 
*If you receive an error when opening these documents, please try opening them from your downloads folder or in Adobe Acrobat directly. 
 
Send both completed forms to the Newfoundland and Labrador Insulin Pump Program via email, fax, mail or in person as follows:
  • Email: NLIPP@easternhealth.ca
  • Fax to 752-3639
  • In person or mail to: 
    • Newfoundland and Labrador Insulin Pump Program, Diabetes Education Centre, Suite 206, 35 Major’s Path, St. John’s, NL, A1A 4Z9
 *Please note: Forms submitted via email must be scanned; pictures of forms will not be accepted. Incomplete or illegible forms will be returned to client.


 
Frequently Asked Questions:
1. How do I know if an insulin pump is right for me?
3. What if I have private insurance? 
4. The NLIPP has a payer of last resort. What does that mean?
5. I bought an insulin pump before the program expansions were put in place, am I eligible to be reimbursed? 
 

 
How do I know if an insulin pump is right for me?
 
Talk to your health-care provider. They can explain to you what the pump is and if it would be a good fit for you and your diabetes management. 

 
How will I know if I am medically eligible?
 
The criteria for medical eligibility are listed below. Your health-care provider must complete the verification of medical eligibility form found in the How to Apply’ section. 
 
The criteria for a new applicant are:
  • Participation in regular appointments with diabetes health-care team at least three times per year (or at a frequency deemed appropriate by the diabetes health-care team);
  • Self-monitoring of blood glucose at least three times per day;
  • Demonstrating motivation to achieve and maintain improved glycemic control; and
  • Completion of comprehensive diabetes education, including carbohydrate counting.
The criteria for a renewal are:
  • Participation in regular appointments with diabetes health-care team at least three times per year (or at a frequency deemed appropriate by the diabetes health-care team);
  • Rotate insertion sites every three days;
  • Demonstrate appropriate sick day knowledge and management;
  • Has not had more than one diabetic ketoacidosis (DKA) event in the previous six months; and 
  • Demonstrate the ability to safely self-manage blood glucose on insulin pump therapy.

 
What if I have private insurance? 
 
When completing the NLIPP application, please ensure insurance information is provided. Failure to disclose third party insurance information may result in termination of benefits.  
  • Include the name of the insurance company and information about your plan.
  • Include the name and information of a second insurance company (if applicable).

 
The NLIPP is the payer of last resort. What does that mean?
 
As the payer of last resort, the NLIPP will pay the remaining portion of the pump and supply costs after:
  1. All other financially obligated programs have paid, (i.e. private insurance).
  2. Client has contributed the copayment amount indicated by income testing, if applicable. 

 
I bought an insulin pump before the program expansions were put in place. Am I eligible to be reimbursed? 
 
Pumps and supplies purchased prior to the program commencing will not be reimbursed. All applicants must apply and be approved by the NLIPP program to gain financial assistance.
 
Once approved, the pump and supplies will be obtained through the NLIPP and approved vendors. 
 

 
I am currently enrolled in the NLIPP and my finances have changed. I can no longer afford my copayment. What do I do now?
 
Contact the Newfoundland and Labrador Insulin Pump Program at at 1-888-246-4888 or by email at NLIPP@easternhealth.ca to request a review of client contribution.
 

 
I was enrolled in the insulin pump program at the time of the expansion. Will there be any changes to the services that I receive? 
 
The NLIPP is available to Newfoundland and Labrador residents of all ages who meet medical and financial eligibility criteria. Children and youth under the age of 18 will be universally covered when medical eligibility is met. 
 
Existing NLIPP clients 18 – 24 years of age as of March 31, 2021 will continue to avail of the legacy NLIPP program criteria until they reach 25 years of age. At the age of 25, those clients will be required to undergo income testing to determine eligibility for financial support under the NLIPP.  
 
New applicants 18 years and older, who are medically eligible, will undergo income testing to determine financial eligibility for NLIPP benefits.  

Contact Us
If you have further questions about the Insulin Pump Program, please contact us at 1-888-246-4888 or by email at NLIPP@easternhealth.ca  
  

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Updated Jan 15, 2021