Costs and Financial Assistance

Costs related to diabetes treatment may include

• Medications
• Insulin
• Insulin pumps and supplies
• Blood sugar monitoring strips
• Needle tips
• Lancets
• Foot care
• Eye care
• Dental care

What funding is available for medications?

Employment benefit plans or private health insurance plans

Each plan works differently. Most plans cover medications, insulin and blood sugar monitoring strips. Dental, eye and foot care will be variable. Contact your plan administrator for details.

Non Insured Health Benefits (NIHB)

Health Canada provides eligible First Nations people and Inuit with a specified range of medically necessary health-related goods and services when they are not covered through private insurance plans or provincial/territorial health and social programs.
Non Insured Health Benefits (NIHB) include prescription drugs, over-the-counter medication, medical supplies and equipment, mental health counselling, dental care, vision care, and medical transportation.

For more information, click HERE to visit the Health Canada website.

Ontario Drug Benefits (ODB)

Covers the cost of most medications (including insulin and blood sugar monitoring strips) for all people:

• Under age 25 – take your OHIP card and prescription to the pharmacy
• Over age 65 –  click HERE for more information
• Who have Trillium Drug Benefits – click HERE for more information
• Receive Ontario Disability Support Program (ODSP) benefits – click HERE for more information
• Receive Ontario Works (OW) benefits – click HERE for more information

Over Age 65

On the first day of the month after you turn 65 years of age, take your prescription and health card to your pharmacy. Tell the pharmacist that you are now eligible for the ODB program. Under the ODB program, you pay a yearly set amount of up to $100 towards your drugs, called a deductible. Once the yearly deductible is paid, there will be a ‘co-payment’ of the pharmacy dispensing fee of $6.11 for each prescription. Depending on your income, you might be able to pay a lower payment per prescription through the Seniors Co-Payment Program.

For more information, click HERE to visit the Ministry of Health website to see if you are eligible for ODB.

For the Seniors Co-Payment Program application, click HERE .

Trillium Drug Benefits

Trillium Drug Program is funded through the Ministry and provides access to ODB for medication, insulin and blood sugar monitoring strips. Everyone can access this program but there is a deductible amount which must be paid every three months. The deductible amount is determined by household income and the number of people in the household, so a cost/benefit analysis should be done to ensure that this program will be worthwhile financially.

For more information on deductibles and the application, click HERE .

Ontario Disability Support Program (ODSP)

ODSP provides access to ODB for medication, insulin and blood sugar monitoring strips. Extra money may be added to your monthly cheque to pay for needle tips, lancets, glucose sensors special diets and in some cases travel to appointments. Your worker can give you the Medical Necessities and Special Diet Allowance forms that we can assist you with. Your worker can also give you information about dental, eye and foot care.

For more information on who this program is for, click HERE .

OW (Ontario Works)

OW provides access to ODB for medication, insulin and blood sugar monitoring strips. Ask your worker about other costs like: needle tips, lancets, special diets, dental, eye and foot care and travel to appointments.

For more information on who this program is for, click HERE .

What funding is available for children with diabetes?

Assistance for Children with Severe Disabilities (ACSD)

Children with Type 1 diabetes will medically qualify for this program. Call 519-376-1951 to ask if you qualify based on your family income.

ACSD can provide a monthly cheque to pay for needle tips, lancets, glucose sensors, special diets and in some cases travel to appointments. Your worker can give you the Medical Necessities and Special Diet Allowance forms that we can assist you with. Your worker can also give you information about dental, eye, foot care or other medical expenses.

For information on who this program is for, click HERE .

What funding is available for monitoring and needle tips?

Ministry of Health

Ministry of Health provides yearly grants for seniors on insulin to assist with costs of needle tips or syringes.

Click HERE for information and application form.

Monitoring for Health

Monitoring for Health is an Ontario Ministry of Health funded program that is administered by Diabetes Canada. For people on insulin with no medication coverage, this program will pay 75% of the cost for blood glucose monitoring strips up to a maximum of $920.00/year.

For more information and/or to receive an Ontario Monitoring for Health Program claim form, call 1-800-361-0796 or ask your Diabetes Educator.

For more information on the Monitoring for Health program, click HERE .

What funding is available for eye care?

OHIP (Ontario Health Insurance Plan)

OHIP covers one full eye exam plus any follow-up assessments that are needed per year for people with diabetes.

What funding is available for glasses, foot or dental care?

Employment benefit plans or private health insurance plans will have variable coverage. Call your plan administrator for details.

People who get benefits from ODSP, OW or ACSD can ask their worker about discresionary funding.

What if none of these programs will cover my diabetes expenses?

Compassionate Supplies

Ask your Diabetes Educator for information about compassionate insulin, medications or diabetes supplies. Call 519-376-2121 ext. 2876.

What funding is available for insulin pumps and supplies or continuous glucose sensors?

Pumps

Insulin pumps are 100% paid for by the Assistive Devices Program (ADP) through the Ministry of Health if you meet the eligibility criteria.

Click HERE to visit the Ministry of Health website for details on the ADP program funding for Inulin Pumps and Supplies.

Pump Supplies

The ADP program provides a grant of $2400.00/year for the purchase of insulin reservoirs, tubing and infusion sets or pods for the delivery of insulin. The annual estimated cost of supplies is $3000.00. You are responsible for paying about $600 a year. Consult individual pump companies for assistance in estimating costs. The insulin pump supply grant does not cover the cost of blood glucose monitoring strips, insulin, continuous glucose transmitters or glucose sensors. The government program conducts random audits requiring receipts for insulin pump supplies only.

Employment benefit plans or private health insurance plans may cover expenses that exceed the $2400.00 grant. Consult your plan administrator for details.

If you receive benefits from ODSP, OW or ACSD you may be eligible for additional money to cover the expenses that exceed the $2,400.00 grant. Consult your worker about these costs.

Continuous Glucose Transmitters & Sensors

Employment plans or private health insurance plans may cover these expenses. Insulin pump or monitoring companies will assist you in seeking this coverage if you are interested.

Ontario Disability Support Program or the Assistance for Children with Severe Disabilities may provide some coverage. Please inquire with your worker.

Good News! The FreeStyle LIBRE flash glucose monitoring system is covered by ODB (for those under age 25, over age 65, on Trillium, ODSP or OW).