Prince Edward Island provides financial support for continuous glucose monitoring systems through the Glucose Sensor Program. Coverage is available for eligible residents living with diabetes who require intensive insulin management and meet income testing criteria. Out of pocket costs are based on household income and private health insurance coverage. The Glucose Sensor Program launched in June 2022, making Prince Edward Island the first province in Atlantic Canada to offer comprehensive CGM coverage. The program covers both Type 1 and Type 2 diabetes for residents of all ages, removing typical age restrictions found in other provincial programs.
To learn more about which CGM systems are available across Canada, visit Our Guide to Continuous Glucose Monitors in Canada.
You qualify for the Glucose Sensor Program if all of the following apply:
The program was announced in June 2022 with eligibility starting at age 2 and over. Some CGM manufacturers may have specific age requirements for their devices. Contact the Glucose Sensor Program directly to confirm eligibility for young children under age 4.
There are no upper age restrictions for the Glucose Sensor Program. Children and adults of all ages with diabetes who meet the eligibility criteria can access coverage.
The Glucose Sensor Program covers four approved continuous glucose monitoring systems:
A valid prescription is required for all CGM systems as part of the coverage approval process. Prescriptions can be provided by your doctor, certified diabetes educator or nurse practitioner.
What the program funds:
The Glucose Sensor Program provides coverage for approved CGM sensors and related supplies according to program guidelines. Coverage amounts depend on your household income and whether you have private insurance.
Prince Edward Island uses an income based copayment model. You may be responsible for a copayment at the pharmacy based on your household income level.
What is not covered:
Under the Glucose Sensor Program, replacement sensors are not available through your local pharmacy if a sensor fails or needs to be replaced. You will need to contact the manufacturer directly for sensor replacements.
You will not be reimbursed for sensors you have already purchased before enrolling in the program.
Your out of pocket costs when purchasing CGM supplies at the pharmacy depend on your household income and whether you have private health insurance coverage.
If you do not have private health insurance, your copayment per dispense is based on your household income:
If you have private health insurance, your copayment will be the amount listed above based on your household income, OR the amount remaining after payment by your private health insurance, whichever is less.
For example, if your private insurance covers most of the cost and leaves only $5 remaining, but your income based copayment is $12, you would only pay the $5 remaining after insurance.
A household includes you, your spouse (if you have a spouse), and any dependants. No person may be part of more than one household. Spouses are considered part of the same household unless otherwise confirmed. A dependent is a child of you or your spouse who is:
Household income is the total income of the persons in a household (other than any dependents), calculated on the amounts reported on your income tax return for the preceding tax year as filed with and verified by the Canada Revenue Agency.
The application process requires forms to be completed by both you and your healthcare provider.
Step 1: Obtain application form
Download and print the Glucose Sensor Program Initial Application Form from the Prince Edward Island government website, or pick up a copy at your local Health PEI Diabetes Education Centre. If you are under 25 and already enrolled in the Insulin Pump Program, use the Insulin Pump Program or Insulin Pump Program plus Glucose Sensor Program Initial Application Form instead.
Step 2: Complete Special Authorization section
Your doctor, nurse practitioner or certified diabetes educator must complete and sign the Special Authorization section of the application form. This section confirms that you meet medical eligibility criteria for CGM use.
Step 3: Complete your portion of the application
Complete your portion of the application form with:
Ensure the application is complete and signed before submission.
Step 4: Submit application by mail
Mail your completed application to:
Glucose Sensor Program Administrator, Health PEI
Four Neighborhoods Health Center
152 St Peter's Rd.
Charlottetown, PE, C1A 5P8
Faxes and electronic copies will not be accepted.
Step 5: Receive approval and purchase supplies
You are eligible for benefits up to a maximum of one year or the portion of the year after your approval until June 30. Benefits end each year on June 30, regardless of your approval date. Once approved, you can purchase your CGM supplies at any Prince Edward Island pharmacy using your approval and prescription.
You must reapply for the Glucose Sensor Program each year between April 1 and June 30 to maintain your benefits. Before you apply for renewal, you must have filed your income tax statement for the preceding year with the Canada Revenue Agency.
Private insurance: Many employer and private insurance plans cover CGM systems. Eligibility criteria vary and may be less restrictive than the public program. Check your policy for device coverage and limits.
Out-of-pocket payment: CGM systems can be purchased directly without insurance. Costs vary by device and usage patterns. Expenses typically include sensors and transmitters and can amount to several thousand dollars annually.
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.
