Health Insurance for Insulin Pumps

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What is an insulin pump?

How much does an insulin pump cost?

What out-of-pocket costs could there be?

Are there ongoing costs for an insulin pump?

Can private health insurance help with other diabetes management?

How long will I have to wait for an insulin pump?

Which health insurance covers insulin pumps?

Where can I find and compare health insurance?

Long story short

Insulin pumps can cost as much as $10,000

The device, which delivers regular insulin doses to people with diabetes, can be reused for many years. But the refills need to be replaced multiple times a week.

Medicare doesn’t cover insulin pumps, but private health insurance can

Look for a hospital policy that includes insulin pump cover, such as a silver plus or gold hospital policy.

Private health insurance could help cover allied health appointments

For instance, you could get money back on visits to a dietitian or diabetes educator.

What is an insulin pump?

An insulin pump is a small programmable device that delivers insulin doses to people with diabetes. It needs to be worn 24 hours a day and uses an infusion set, which typically includes a small cannula secured with adhesive and – for tubed pumps – some tubing. The infusion set needs to be replaced every three days or so, but the pump can continue to work for years.

While insulin pumps don’t measure a person’s blood glucose, they can be connected to a continuous glucose monitor (CGM). Otherwise, you’ll need to manually monitor your blood glucose levels.

Insulin pumps can be an option for those with Type 1 diabetes, helping ensure they get regular insulin injections. Some people with Type 2 diabetes might also use an insulin pump if other treatments, like lifestyle changes and tablet medications, can’t control their glucose levels. An insulin pump isn’t the best treatment option for everyone – your doctor or diabetes educator can help you decide if an insulin pump is right for you.

To be fitted with an insulin pump, you might need to go to hospital as a day patient. However, hospital admission isn’t always necessary to get an insulin pump.

How much does an insulin pump cost?

Insulin pumps can cost anywhere in the range of $5,000–$10,000 if you intend to buy one outright, according to Diabetes Victoria. Sometimes, you might be able to pay for the device over time, like $2,000 a year for a few years.

What out-of-pocket costs could there be?

If you use your hospital cover to pay for your insulin pump, your only out-of-pocket cost could be your excess (a nominated amount, at most $750, paid upon hospital admission), and any co-payments, if applicable. This assumes you have appropriate private hospital insurance, and your treating doctor and the hospital you attend have no-gap agreements with your health insurer.

If you don’t have private health insurance or your policy doesn’t cover insulin pumps, you’ll need to pay for your pump out of your own pocket. As mentioned above, this could be an out-of-pocket expense of as much as $10,000. If you’re admitted to hospital to get your pump, you may have additional out-of-pocket costs to cover hospital and specialist fees.

If you start pump therapy as a private patient outside of hospital, health insurance doesn’t cover your doctor’s or the clinic’s fees. This is similar to other out-of-hospital appointments, like seeing a specialist in their rooms.

Are there ongoing costs for an insulin pump?

There are three main ongoing costs for an insulin pump: the insulin it dispenses, the infusion consumables (i.e. the cannula and adhesive), and follow-up appointments with your treating doctor as you begin pump therapy.

Prescribed insulin is subsidised through the Pharmaceutical Benefits Scheme (PBS). The PBS subsidy covers the majority of the medication’s cost while you pay a small co-payment of $25 (as of 1 January 2026).

The National Diabetes Services Scheme (NDSS) subsidises pump consumables for eligible people, so that your monthly out-of-pocket cost for these items is between $20 and $30. Eligibility criteria include having Type 1 diabetes, completing comprehensive diabetes education, and demonstrating competence using your insulin pump. The NDSS doesn’t cover all kinds of insulin pump consumables.

In the 12 months following getting your insulin pump, you’ll likely need to see your treating specialist multiple times to check in on your condition and assess if it’s helping you manage your diabetes. Some specialists may bulk-bill these appointments, so you don’t have any out-of-pocket costs. However, others might not; your out-of-pocket cost will be the difference between what they charge and the Medicare Benefits Schedule (MBS) rebate for the service. In most instances, your rebate would be $43.35.

Can private health insurance help with other diabetes management?

Yes, hospital insurance can cover treatment in hospital for a range of diabetes-related conditions. Extras insurance can help cover things like visits to allied health professionals – such as a dietitian or diabetes educator – and glucose monitors. What’s available to you will depend on your policy’s level of cover.

Helpful tip

Extras insurance can be handy for holistically managing chronic conditions, like diabetes.

For instance, regular exercise can be an important management tool for Type 2 diabetes, but it can be easy to overdo it. But with your extras health insurance, you could see a physio or exercise physiologist to get back on track. Your health insurance might even come with gym membership benefits.

Andres Gutierrez

General Manager – Health

How long will I have to wait for an insulin pump?

If you intend to use your hospital insurance to pay for your insulin pump, you’ll need to fulfil the relevant waiting period of either two months or 12 months. If your diabetes is considered a pre-existing condition, the 12-month waiting period applies. Otherwise, you’ll only need to hold your policy for two months before you can make a claim.

In some cases, you might be able to access a loaner pump from a manufacturer while you serve your 12-month waiting period.

Which health insurance covers insulin pumps?

Your best bet for finding health insurance that includes insulin pumps is looking at silver plus and gold hospital policies. Insurers must offer this cover on gold policies, but some insurers may offer this cover on silver plus and bronze plus hospital policies, too.

Health insurers can cover insulin pumps on extras policies, however, it can be hard to find an extras policy that offers this. But extras policies paying benefits for diabetes-related services, like dietetics, can be much easier to nail down.

Where can I find and compare health insurance?

An insulin pump can be a literal lifesaver if you have diabetes. If you’re struggling to find time to compare health insurance, iSelect can be your timesaver. We make it easy to quickly compare a range of private health insurance covers from different providers. All you need to do is speak with one of our health comparison experts on 1800 784 772 or use our online comparison tool.