What does the subsidy actually cover?
CGMs measure blood glucose levels (BGLs) continuously throughout the day and night. Each device has three main parts:
- A small disposable glucose sensor which is inserted just under the skin and which needs to be replaced every six to seven days, depending on the device
- A transmitter which attaches to the sensor and sends glucose readings to the wireless receiver, a mobile phone or insulin pump
- A receiver, compatible mobile phone or compatible insulin pump that displays and stores the glucose readings.
Subsidised access is only available for CGM devices that have alarms alerting the user when BGLs are getting too low or too high – these include Dexcom and Medtronic CGM devices. The subsidy will cover the full cost of sensors and transmitters, however, you will need to pay if you decide to use a receiver, rather than a pump or smartphone.
Does my child qualify?
For kids aged 10 and under:
These youngsters must be expected to benefit clinically from the use of CGM, and their family/carer must be willing and capable to use CGM. They must also be committed to actively participating in a diabetes management plan that incorporates CGM. Children who meet these criteria and who access subsidised CGM products through this initiative will continue to have subsidised access after they turn 11 and won’t be reassessed.
For young people aged 11-21:
This group faces the same criteria as above, however, they must also meet one of four additional criteria. These are:
- Frequent, significant hypoglycaemia, or low BGLs – this means more than one episode a year requiring assistance.
- Impaired awareness of hypoglycaemia
- An inability to recognise or communicate about symptoms of hypoglycaemia
- A significant fear of hypoglycaemia that is seriously affecting their overall health and wellbeing, or that is contributing to hyperglycaemia as a reaction to this fear.
My child meets the criteria – what next?
To access CGM sensors and transmitters through the NDSS, you or your child will need to be assessed by an authorised health professional: an endocrinologist or diabetes educator. They’ll fill out and sign the NDSS Continuous Glucose Monitoring Eligibility Assessment. If you or your child are new users of CGM, a starter kit will be sent to the health professional nominated on the form. They can assist you in setting up the device. After this, and for those of you already using CGM, you’ll be able to order products through your pharmacy in the same way you order blood glucose test strips, insulin pen needles and pump consumables.