Upcoming changes to provincial insulin pump coverage worry some Albertans

“Many people living with Type 1 diabetes and their parents already pay out of pocket for many other supplies and the premiums and co-pays may be too much to bear.”

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Changes to the way the Alberta government covers insulin pumps has some people with Type 1 diabetes concerned about what extra costs could be coming their way.

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The pumps, which are programmed to deliver life-saving insulin to users throughout the day, are currently covered under Alberta’s Insulin Pump Therapy Program. That program is being discontinued as of Aug. 1, the government announced last week, and the 4,000 Albertans currently using it will need to find a government-sponsored health benefit plan like Blue Cross if they don’t have insurance through their employer or a privateplan.

For some that will mean new co-payments or monthly premiums but attendees who appeared at an NDP press conference Monday calling for the government to stop its plan, said they’re worried about how much the changes could cost them.

Both Lisa Hart and her daughter use a pump. Hart said the lack of detail provided by the government is causing panic in the community.

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“Many people living with Type 1 diabetes and their parents already pay out of pocket for many other supplies and the premiums and co-pays may be too much to bear,” she said.

Lesley Thompson, who helped create a Facebook group for users who are concerned, said most workplace health benefits often don’t cover insulin pumps because the government program existed.

She said having an insulin pump allows her to have a flexible schedule, control her diabetes in real time and no longer fear not waking up due to her blood sugar levels. She said supplies could cost her upwards of $700 a month without the program and she will have to go back to using injections.

“This cut will cause everyone financial hardship, having to make the decision to stay on a pump and go into debt or go back to multiple daily injections causing a lower quality of life and putting one’s life at harm,” she said.

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Tears stream down Lisa Hart's face as she speaks about her and her daughter's struggles with Type 1 diabetes during an NDP press conference Monday, May 9, 2022.
Tears stream down Lisa Hart’s face as she speaks about her and her daughter’s struggles with Type 1 diabetes during an NDP press conference Monday, May 9, 2022. Photo by David Bloom /postmedia

Alberta Health spokesperson Charity Wallace said in an email Monday that premiums under the government-sponsored non-group coverage are $63.50 per month for a single Albertan or $118 for a family. Premiums can be reduced based on income.

Albertans will also need to co-pay 30 per cent up to a maximum of $25 per claim for insulin pumps and their supplies. The maximum co-pay for a pump is $25 “regardless of the cost of the pump,” she said.

Other supplies related to diabetes, such as syringes, do not require the co-pay.

Those with low income will continue to be provided with insulin pumps and supplies at no cost, she said.

Wallace said insulin pumps and insulin pump supplies are separate from the coverage provided for other diabetes management supplies, and are not subject to the $2,400 cap that exists on those supplies.

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NDP health critic David Shepherd said the government needs to halt the plan and consult with people who will be impacted.

“Simply put, a three-month window with no clear plan for the path forward is not only cruel, it is chaos,” he said.

In question period Monday, Premier Jason Kenney said he expects the “vast majority” of people receiving pumps and supplies at no cost currently will continue that way.

Health Minister Jason Copping has said last week that discontinuing the program is expected to save the government $9 million.

“This is setting us up for success down the road because we know that this population is continuing to grow in terms of diabetes and we need to be able to support them,” he said.

“And these pumps are actually getting more and more expensive. So we want to make sure that we can cover the cost for the greatest number of people.”

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