Diabetes Care
Manitoba has expanded coverage for advanced glucose monitors and insulin pumps to Manitobans over the age of 18.
Advanced Glucose Monitoring
Manitoba Pharmacare has extended coverage for advanced glucose monitors (AGMs) to all adults with Type 1 or Type 2 Diabetes who meet the established criteria. Patients who meet the criteria may be provided with a prescription from a primary care provider.
Who is eligible?
Anyone with Type 1 or Type 2 diabetes requiring the use of insulin and who meets the eligibility criteria available here is eligible for an advanced glucose monitor through the Pharmacare Program.
What types of AGMs are included?
Both Continuous Glucose Monitors (CGM) and Flash Glucose Monitors (FGM) are covered for all eligible Manitobans.
How do I access my advanced glucose monitor?
- A prescription is not required for obtaining an AGM. Application for coverage under Exception Drug Status (EDS) is also no longer required. However, to be eligible for AGM coverage under Pharmacare, clients must meet eligibility criteria as established via Bulletin #125 | Manitoba Drug Benefits and Interchangeability Formulary Amendments (gov.mb.ca) – specifically: For patients with type 1 or type 2 diabetes currently on both basal and bolus insulin or using an insulin pump.
- For clients purchasing AGM at a community pharmacy – as noted in the Claims Submission Procedure – Advanced Glucose Monitors (gov.mb.ca): “the pharmacist must verify against the DPIN history that the client meets the above eligibility criteria before submitting a claim to DPIN”. Any services, specified drugs or benefits provided by Manitoba and all claims that are adjudicated to, or reimbursed in whole or in part by any Manitoba programs are subject to audit to confirm compliance with the provisions of the Pharmacy Agreement and applicable Manitoba policies, procedures and regulations.
- For clients purchasing AGM directly from a supplier – as noted in the FAQ: Diabetes Supports for Manitobans Advance Glucose Monitors (gov.mb.ca):
- When adjudicating claims for reimbursement, Manitoba Health assesses each client’s drug utilization history to confirm that the eligibility criteria for AGM coverage is met.
- If a client submits a claim for AGM and they are not eligible for AGM coverage, their AGM costs will not count toward their Pharmacare deductible and will not be reimbursed.
How will I be reimbursed for covering my advanced AGM monitor?
Information on reimbursement can be found here: https://www.gov.mb.ca/health/pharmacare/index.html
Adult Insulin Pump
Manitoba Health has expanded coverage for insulin pumps to eligible Manitobans with Type 1 Diabetes who are 18 years of age or older. More information on eligibility can be found on the Government of Manitoba’s Adult Insulin Pump page.
How you access the program will differ depending on if you currently have an insulin pump or not.
Resources
- Financial resources in diabetes care
- Frequently Asked Questions
- When an Insulin Pump may be Beneficial
For your safety, do not attempt to begin using an insulin pump prior to receiving appropriate orientation and education.
What is an insulin pump?
Frequently Asked Questions
Am I eligible for coverage if I currently have an insulin pump?
If your insulin pump is less than five years old, please continue to use your current pump. If your pump stops working, you may be eligible for a funded replacement pump.
If your insulin pump is more than five years old, you can be covered under the expanded program for a new pump.
Individuals who have previously used an insulin pump will not be required to repeat education unless experiencing challenges or in need of additional support.
Am I eligible for coverage if I do not currently have an insulin pump?
If you do not currently have an insulin pump, pre-approval is required to access the program. You will have to be assessed by either an endocrinologist or approved Diabetes Specialist who will submit a form to Manitoba Health for funding approval.
Once approved, your chosen pump can be ordered.
After you receive your pump, you will need to complete education and orientation on its safe use.
For more information visit the Manitoba Adult Insulin Pump Program web page.
For your safety, do not attempt to begin using an insulin pump prior to orientation and education.
I am a health-care provider looking for resources
Information for health-care providers can be found on our health-care providers site.
What types of pumps are eligible for reimbursement?
The insulin pumps eligible for reimbursement through this program are listed here.
More information on these pumps can be found on the suppliers’ website:
Where can I find more information about insulin pumps?
It is very important for your safety that you receive education on how to use your insulin pump before starting insulin pump therapy. More information can be found on the Manitoba Insulin Pump Program page.
