CGM coverage in New Brunswick

New Brunswick provides financial support for continuous glucose monitoring systems (CGMs) through the New Brunswick Insulin Pump Program (NBIPP). Coverage is available for eligible residents living with diabetes who meet the program requirements and may be responsible for an income tested contribution toward costs. In 2023, New Brunswick expanded NBIPP to include CGM support for residents of all ages living with diabetes who require intensive insulin therapy. This expansion followed earlier program changes in 2023 that removed the age cap on insulin pump eligibility.

To learn more about which CGM systems are available across Canada, visit Our Guide to Continuous Glucose Monitors in Canada.

NBIPP coverage is available for New Brunswickers living with Type 1 diabetes or Type 2 diabetes requiring intensive insulin therapy who meet specific clinical criteria.

You qualify if all of the following apply: 

• You have a valid New Brunswick Medicare number
• You have Type 1 diabetes or Type 2 diabetes that requires intensive insulin therapy which means three or more insulin injections per day or use of an insulin pump
• You are regularly followed by your diabetes care provider and your care plan is reviewed at least two times per year
• You or your caregiver have sufficient knowledge to use CGM technology appropriately including using the data to make safe and effective diabetes management decisions
• You or your caregiver agree to share CGM data with your diabetes care provider to help optimize your care
• You or your caregiver agree to complete CGM orientation offered through web based learning, virtual support or in person instruction by a CGM trained vendor representative
• You or your caregiver agree to notify the NBIPP office if you discontinue use of your CGM system

There are no age restrictions. Children, youth and adults may qualify if they meet the clinical eligibility criteria.

NBIPP covers CGM systems and supplies that appear on the program's Approved Vendor List. Only devices provided by approved vendors are eligible. Currently approved CGM systems include: 

• Dexcom G6
• Dexcom G7
• FreeStyle Libre 2

Approved CGM products are provided directly to the patient by the vendor once NBIPP approval is granted. A prescription is required as part of the approval process.

What the NBIPP funds:

NBIPP provides income tested coverage for approved CGM components:

• CGM sensors according to program guidelines
• CGM transmitters if required for the device
• FreeStyle Libre 2 reader if needed with a limit of one reader per patient every three years

NBIPP covers only the uninsured portion of CGM supply costs. This means: 

• If you have private insurance, you must use that coverage first
• NBIPP acts as payer of last resort and covers only the portion not paid by insurance
• Applicants whose private insurance covers 100 percent of CGM costs are not eligible for NBIPP

Items not covered include insulin, blood glucose test strips and batteries.

NBIPP uses income testing to determine your required household contribution. How contribution amounts are calculated Your contribution is based on: 

• Total household income from all contributing members
• Household size
• Health insurance coverage if applicable
• The cost of the selected device

Applicants must provide Canada Revenue Agency Notice of Assessment documents for the most recent taxation year for all income contributors in the household. Applications will not be processed without these documents. 

Additionally, NBIPP follows a payer of last resort model. All other sources of coverage including private insurance must be used before NBIPP provides assistance. Only the remaining uninsured costs are eligible and these are income tested.

The application process requires completion of both a medical eligibility form and a financial application. 

Step 1: Schedule an appointment with your diabetes care provider

Your diabetes care provider must complete the Confirmation of Medical Eligibility for Glucose Monitoring Sensor Coverage form. This may be completed by a diabetes specialist, general practitioner, nurse practitioner or certified diabetes educator working in a diabetes clinic. 

Step 2: Healthcare provider submits medical eligibility form

Your healthcare provider must submit the completed form directly to the NBIPP business office at nbipp-ppinb@gnb.ca. 

Step 3: Complete the online client application

You must complete the Application for Continuous Glucose Monitoring Sensor Coverage using the online application tool. This form collects: 

• Health insurance information
• Household income and household size
• Canada Revenue Agency Notice of Assessments for financial assessment

Step 4: Submit application and supporting documents

Submit your completed financial application and all required Notice of Assessments to the NBIPP office. 

Step 5: Wait for approval and notification

Once your application is reviewed and approved, NBIPP will notify the approved vendor. The vendor will contact you to coordinate ordering and shipping of your CGM supplies. Annual renewal All applicants must reapply each year to renew coverage.

Private insurance: Many employer and private insurance plans cover CGM systems. If your private insurance covers 100 percent of CGM costs, you are not eligible for NBIPP coverage but can still obtain supplies through your insurer.

‍Out-of-pocket payment: CGM systems can be purchased directly without insurance. Costs vary by device and usage patterns and typically include sensors and possibly a transmitter or reader.

Managing your supplies and staying connected with your diabetes care team is important for safe and effective CGM use. The Endor Health app supports ongoing communication with your care team so questions about your CGM data or therapy can be addressed promptly. The app also provides convenient home delivery of insulin, prescription items, and CGM sensors at no added cost, helping reduce the risk of missed refills or last minute pharmacy visits.

The information in this article is for educational purposes only and should not replace advice from your healthcare provider. Always consult with your diabetes care team before making changes to your diabetes management.