Diabetes is a costly disease both financially and emotionally. Trying to afford diabetes supplies and managing high and low blood glucose levels can be taxing.Thankfully someprovinces and states in North America offer financial assistance to help cover the costs of some or even all diabetes supplies.
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That is still not enough though. There should not be a gap in care. It should not matter where you live or what your work benefits package is. Until this happens, we will continue to advocate for change.
Through the continued dedication of individuals and groups, we are seeing small steps towards change. One day there will be complete equity in access to diabetes care and devices. Until that happens, here is an overview of assistance available for people with diabetes across Canada.
If you live in the United States, please check out our tax savings page for options also available to you.
RDSP
Registered Disability Savings Plan from the government of Canada offers eligible claimants annual grant money that can later be used to offset some of the costs of diabetes supplies. This plan is similar in principle to an RRSP but for the assistance of medical expenses. It is only available to those who qualify for the Disability Tax Credit.
Read more about RDSPs below.
RDSP >>>
Provincial Assistance Programs
Download the provincial programs overview here
Alberta
Albertans who meet the eligibility and clinical criteria will be able to receive coverage for the cost of an insulin pump and its supplies as well as other diabetes management supplies. The program currently covers the Omnipod Insulin Management Systemand the MiniMed 630G Insulin Pump System and their supplies.
At some point in 2022 or 2023, coverage will be expanded to include:
- the Minimed 670G Insulin Pump System and Minimed 770G Insulin Pump System manufactured by Medtronic Canada
- the YpsoPump insulin pump manufactured by Ypsomed Canada Inc.
- the t:slim X2 Insulin Pump with Basal IQ technology and the t:slim X2 Insulin Pump with Control IQ technology manufactured by Tandem Diabetes Care Canada, Inc.
The Alberta government has stated “No changes will be made to the Insulin Pump Therapy Program. The program will continue as it was designed and will add access to the next generation of insulin pumps starting as soon as possible this year.”
For more information contact your health care provider or go tothe
Alberta government website.
British Columbia
B.C. offers a PharmaCare program. Financial assistance under this program depends on income level. They cover all insulin listed on the BC formulary as well as aninsulin pump every 5 years and supplies for all agesunder a two-tiered system.
Under Tier 1, PharmaCare covers 100% of the cost ofan Omnipod or Ypsopump and supplies every five years subject to the rules ofyour PharmaCare plan.
Under Tier 2, PharmaCare will cover a portionof a tubed (Medtronic) insulin pump, but only IF this pump is prescribed byyour doctor and approved by special authorization.
Important: Be sure to register for Fair PharmaCare beforepurchasing an insulin pump to ensure you get maximum coverage.
PharmaCare covers infusion sets/kits and insulin pump reservoirs/cartridges. It does not cover batteries, batterycaps, adhesive pads, etc.
The PharmaCare program covers needles and syringes if you have insulin-dependentdiabetes and you are covered under Fair PharmaCare, Plan C (IncomeAssistance) and Plan F (At Home Program). You do not need aCertificate of Training from a Diabetes Education Centre to qualify forthis coverage.For needles and syringes for insulin therapy, PharmaCare covers theregular retail price but does not cover a dispensing fee.
As of June 2021, BC provideslimited-coverage benefit for the Dexcom G6 CGM. Coverage is available to people with diabetes who meet the special authority criteria for CGMs. For patients who receive special authority approval, coverage will be provided to people enrolled in Fair PharmaCare and to those with PharmaCare coverage through Plan C (income assistance), Plan F (children in the At Home program) or Plan W (First Nations health benefits).
Manitoba
Manitoba offers coverage forinsulin pumps and supplies for those under 25 years of age.
In theApril 2021 budget, the government of Manitoba announced that they were providingcontinuous glucose monitor coverage for eligible children and youth under 25years of age.
For more information on how to access this program, contact Diabetes Education Resourcefor Children and Adolescents (DER-CA) at 204-787-3011
New Brunswick
Financial assistance for insulin in New Brunswick is only available to individuals who are receiving income support or low-income seniors. Coverage is further limited to those insulins listed on their provincial formularies unless specialauthorization is given. Insulin pumps are covered forthose with type 1 diabetes until they reach 25 years of age.
MARCH 21, 2023 the provincial government has announced that they will be expanding the New Brunswick insulin pump program to include insulin pumps and CGMs for individuals with type 1 and type 2 diabetes. Details are still pending.
Newfoundland andLabrador
Newfoundland and Labrador has an Assurance Drug Plan that offers protection against the financial burdenof eligible high drug costs, whether from the cost of one extremelyhigh-cost drug or the combined cost of different drugs.
Depending ontheir income level, individuals and families will be assured that theirannual out-of-pocket costs for eligible drugs will be capped at apercentage of their net family income.
| Annual Income (net) | Maximum % of Income to Spend on Eligible Drug Costs |
| $0 -$39,999 | 5% |
| $40,000- $74,999 | 7.5% |
| $75,000to $149,999 | 10% |
Applications are available in physician’s offices and pharmacies aswell as on-line at www.gov.nl.ca/health.
Insulin pumps and supplies are now covered for all ages, but are subject to income means tests. Individuals with a combined family income over $150,000 will not qualify for the expanded insulin pump program.
March 23, 2023, the Newfoundland Government announced that they would be launching a pilot project to evaluate the effectiveness and outcomes of continuous glucose monitors.
Nova Scotia
In Nova Scotia the Diabetes Assistance Plan covers test strips, lancets, syringes and insulin listed on its formulary.
This financial assistance plan assists low-income families and people who are under the age of 65 and have no other drug coverage. Registration forms and information booklets are available by calling the Nova Scotia Diabetes Assistance Program. Information is also available on the Department of Health website. You can also find forms and booklets in doctors’ offices, pharmacies, and diabetes centres.
Insulin pumps and supplies are covered for those under 26 years.
FEBRUARY 2024 BUDGET:
The February 2024 provincial budget offers to expand the insulin pump program to people with type 1 and type 2 diabetes who use multiple daily injections or insulin pumps regardless of age. Under the expanded program, the cost of continuous glucose monitors would also be covered.
Like the previous program, this updated program will be based on income with individuals earning less than $60,000 per year having no deductible for their supplies.
Ontario
Ontario has a number of drug plans including the Ontario Drug Benefit Plan, OHIP+ and Seniors Co-Payment Program.
Those using the Ontario Drug Benefits Program may also qualify to have coverage of the FreeStyle Libre system.
OHIP+
OHIP+provides drug coverage for anyone age 24 years or younger who is not covered by a private plan. Residents of Ontario do not need to enroll in this plan. According to the website, those eligible forOHIP+only need to give pharmacists their health card number and a valid prescription for an eligible medication. The pharmacist may ask the patient or their parent/guardian if they are covered by a private plan. In some cases, it may be possible to have Libre covered under this plan.
Trillium Drug Plan
The Trillium Drug plan (TDP) works in a similar way to the OHIP+. It is for people who spend approximately 3 to 4 per cent or more of their after-tax household income on prescription-drug costs. The incomes ofTDPhousehold members under age 25 would still be factored into the household deductible calculation.
Any medications funded throughOHIP+(for children and youth that do not have coverage through a private plan) do not contribute towards the household’sTDPdeductible, as they are not considered out-of-pocket expenses.
Both Trillium and OHIP+ cover for most insulins (but not Fiasp), most medications, the Freestyle Libre, and, for their children under age 25, blood glucose test strips up to 3,000 per annum. If the family gets a letter from their endocrinologist that says they need test strips, the Senior Pharmacist of Ontario can approve the allowance of more strips.
Ontario has two provincial drug programs that work the same way. The Ontario Drug Benefits Program and the Trillium Drug Plan both offer insulincoverage for families meeting the provincial criteria. Insulin coveredonly includes those listed on the provincial drug formulary.
Ontario Disability Support Program
The Ontario Disability Support Program (ODSP) also provides coverage for diabetes supplies for those who qualify. Under this program, some individuals are being granted coverage for continuous glucose monitors despite the fact that these devices are not listed on the website.
Prince Edward Island
The province of PEI covers 90% of the cost of an insulin pump every 5 years for residents under 26 years of age. It also covers 140 infusion sets and 140 insulin reservoirs per year.
The 2020 budget also announced expanded invested in coverage for diabetes supplies and test strips under the Diabetes Drug Program. Monthly glucose test strip coverage will now expand to 120 strips per month effective January 2021.
EffectJune 1, 2022, residents of PEI with who are using 3 or more injections of insulin per day and/or are using an insulin pump may be eligible for financial assistance when using aFreestyle Libre sensor or Freestyle Libre 2 sensor; aDexcom G6 sensor and transmitter; or aMedtronic Integrated Guardian or Guardian Connect CGM sensor and transmitter. Applications for assistance can be made through theP.E.I. Glucose Sensor Program.
Quebec
On April 16, 2011 Quebec Health Minister Bolduc announced areimbursem*nt program that will cover insulin pumps for Type 1diabetes patients aged 0 to 18 years old. To get the device, thepatient and parents must pledge their compliance to the treatmentprotocol.
The government has also announced that they will cover the cost of the FreeStyle Libre system. You can view details here.
For a comprehensive look at the current program please view the work of Anna Kiff.
Saskatchewan
The province of Saskatchewan covers syringes and lancets for people with diabetes.
Saskatchewan’s 2021-2022 budget has added a $5.0 million investment to increase supports for people with diabetes. Financialcoverage will now include continuous and flash glucose monitoring systems for children and youth under 18 who are insulin dependent. The Insulin Pump Program will also expand to support individuals of all ages with Type 1 Diabetes.
Financial Assistance in the Territories
The situation in the Yukon and other territories remains somewhatunique. Many people living in the north receive 100% coverage of allinsulins, pumps and pump supplies under the Non-Insured Health Benefitsplan (NIHB).
For those not covered under NIHB, there are differentpolicies for the different territories. In the Yukon for example, allinsulins except Levemir® are covered. They also cover insulin pumps and supplies. To have your pump paid for, you must have an applicationfilled that gives details of your case history stating your failure onMDI, evidence of your commitment and competence to use the pumps, aswell as support for initiation and follow up therapy. If your request is based on a lifestyle choice, it will not be considered. The request must be signedby an endocrinologist. There are no specialists in the North. Patientsseeking the support of doctors such as endocrinologists must go to majorcentres such as Vancouver, Edmonton, and Winnipeg to have their pumpsprescribed
Download our ebook detailing all provincial programs here.
Insulin assistance options for those living in the United States of America
We all know that insulin prices in the US are now out of control. Many individuals living with diabetes in the US and desperate for any sort of financial assistance that will assist them in paying for their insulin.
On March 1, 2023, Eli Lilly announced that they will be reducing the costs of their insulin by 70%.
According to their press release, they will be doing this by:
- Cutting the list price of its non-branded insulin, Insulin Lispro Injection 100 units/mL, to $25 a vial. Effective May 1, 2023, it will be the lowest list-priced mealtime insulin available, and less than the price of a Humalog® vial in 1999.
- Cutting the list price of Humalog® (insulin lispro injection) 100 units/mL1, Lilly’s most commonly prescribed insulin, and Humulin® (insulin human) injection 100 units/mL2 by 70%, effective in Q4 2023.
- Launching RezvoglarTM (insulin glargine-aglr) injection, a basal insulin that is biosimilar to, and interchangeable with, Lantus® (insulin glargine) injection, for $92 per five pack of KwikPens®, a 78% discount to Lantus, effective April 1, 2023.
- They will further improve access to insulin by immediately capping out-of-pocket costs at $35 at participating retail pharmacies for people with commercial insurance using Lilly insulin.
People who don’t have insurance can continue to go to InsulinAffordability.com and download the Lilly Insulin Value Program savings card to receive Lilly insulins for $35 per month.
Colorado
Colorado has capped insulin costs at $100 dollars per monthly supply.
Diatribe has noted that there are a few loopholes to this legislation. Some health planswere exempt from the legislation, leaving the people on those health plans ineligible for the insulin price cap when purchasing their monthly insulin. Also, instead of offering a flat $100 maximum on monthly insulin prescriptions, Diatribe has found that “the current legislation allows insurers to charge $100per prescriptionper month, which translates to $200 for those who take both basal and mealtime insulin or two other insulins, such as short-acting and long-acting.”
Connecticut
Connecticut’s proposed insulin bill for 2021 limits out-of-pocket insulin expenses to $50 per month.
Illinois
Illinois has capped insulin costs at $100 for a 30-day supply beginning January 1, 2021.
Maine
Maine has capped insulin costs at $35 for a 30-day supply, including before a plan’s deductible is met, and applies to state-regulated commercial insurance. This provision takes effect as plans are renewed or issued on or after January 1, 2021.
New Mexico
Effective January 1, 2021, New Mexico has capped insulin costs at $25 for a 30-day supply .
New York
New York has capped insulin costs at $100 for 30-day supply (for state-regulated commercial plans) effective January 1, 2021.
Utah
Utah has capped insulin costs at $30 cap for 30-day supply effective January 1, 2021.
Washington
Washington has capped insulin copayments, deductibles, and other forms of cost-sharing at $100 cap for 30-day supply effective January 1, 2021.
West Virginia
West Virginia has capped insulin costs at $100 cap for 30-day supply effective July 1, 2021.
Insulin Assistance programs
The American Diabetes Association offers information on obtaining local help with insulin costs as well as a way to contact the three insulin manufacturers to help obtain a long term solution. Go to the ADA site here.
Lilly Cares Patient Assistance Program
Lilly Cares offers assistance to help people obtain the Lilly medicines they need including diabetes products.
