Insulin Pump Coverage in British Columbia

British Columbia’s public drug program, PharmaCare, helps reduce the cost of essential diabetes technology, including insulin pumps and supplies. While the exact amount of coverage depends on your PharmaCare plan, the program makes pump therapy more accessible for people who meet clinical and eligibility requirements.

To learn more about which insulin pumps are available across Canada, check out Our guide to insulin pumps in Canada.

Insulin Pumps

• PharmaCare covers one new insulin pump every five years. If your current pump was not originally covered by PharmaCare, you may be eligible for a new one after four years.
  
• Only makes and models approved by PharmaCare are eligible. You must purchase through an approved vendor listed in your Special Authority approval letter.
  
• The Omnipod system’s Personal Diabetes Manager (PDM) is provided at no cost, regardless of your PharmaCare plan. Pods themselves are treated as supplies.
  
• For pumps such as the YpsoPump and Medtronic MiniMed, coverage depends on your plan:
  
  • Plan C, Plan F, Plan W, and Plan B: 100% of eligible costs are covered.
    
  • Fair PharmaCare: Coverage depends on your income-based deductible. Once your deductible is met, PharmaCare pays 70% of costs, and after you reach your family maximum, it covers 100%.
    

Pump Supplies

• Supplies such as infusion sets, cartridges, and reservoirs are covered under PharmaCare.
  
• Coverage follows the same rules as pumps: 100% for Plan C, F, W, or B; partial then full coverage under Fair PharmaCare once your deductible and maximum are reached.
  
• Batteries, adhesive pads, and carrying cases are not covered.
  
• On average, supplies can cost $250–$350 per month, meaning that depending on your income and deductible, you may still need to budget for out-of-pocket expenses until you reach full coverage.
  

Replacements and Repairs

• Pumps are generally only replaced every five years. Early replacement is only considered if your pump is at least four years old, your warranty has expired, and your physician confirms that a replacement is medically necessary.
  
• Repairs outside of warranty, accidental damage, or replacement of lost or stolen pumps are not covered.
  

By combining device and supply coverage, PharmaCare reduces the long-term financial burden of pump therapy, though out-of-pocket costs may vary depending on your plan and income.

Eligibility under PharmaCare is tied both to your medical needs and your PharmaCare plan type. To qualify, you must:

• Be a resident of British Columbia and registered with PharmaCare.
  
• Be enrolled in an eligible plan:
  
  
  • Fair PharmaCare (income-based for most residents)
    
  • Plan C (Income Assistance)
    
  • Plan F (At Home program for children with complex medical needs)
    
  • Plan W (First Nations Health Benefits)
    
  • Plan B (residents of licensed residential care facilities).
    
• Have a confirmed diagnosis of Type 1 diabetes or another insulin-requiring form of diabetes.
  
• Have your physician or endocrinologist submit a Special Authority request to PharmaCare, documenting your clinical need for pump therapy.
  

Medical criteria also apply. To be approved, you must:

• Demonstrate frequent blood glucose monitoring (at least four times daily).
  
• Have experienced unpredictable hypoglycemia, marked glucose variability, or episodes of diabetic ketoacidosis despite multiple daily injections.
  
• Commit to diabetes education and regular follow-ups with your care team.
  

Renewal criteria for ongoing coverage or replacement include:

• A1C consistently ≤ 9.0% on two measurements.
  
• No more than one hospitalization for diabetic ketoacidosis in the past year.
  
• Ongoing participation in follow-up visits and diabetes education.
  

These requirements ensure that pump therapy is being used safely and effectively, and that public funding supports those who are actively engaged in their diabetes management.

PharmaCare restricts coverage to specific pump models to ensure safety, reliability, and warranty support. Current approved devices include:

• Insulet Omnipod (pods covered as supplies; PDM provided at no cost)
  
• YpsoPump by Ypsomed (starter kit and supplies supported)
  
• Medtronic MiniMed insulin pumps (including Minimed 780g)
  

PharmaCare may update this list as new technologies are approved and older models are retired. To confirm which models are eligible, your physician must submit a Special Authority request, and you will receive an approval letter specifying the exact device and vendor.

👉 Approved pump list and vendor details: BC PharmaCare Insulin Pump Policy

If you already own a pump not originally covered by PharmaCare, you may qualify for a replacement once it is at least four years old and out of warranty, provided you still meet medical criteria.

The application process involves close coordination between you, your specialist, and PharmaCare:

1. Assessment: Your endocrinologist or diabetes specialist reviews your diabetes management history and determines whether you meet medical criteria for pump therapy.
   
2. Special Authority Application: Your physician submits the Special Authority form (HLTH 5375) to PharmaCare, requesting coverage for a specific pump model.
   
3. Approval: If approved, you will receive a confirmation letter. This document specifies the approved pump and vendor—do not purchase a pump before receiving this approval.
   
4. Purchase: Take the approval letter to the designated vendor to obtain your pump. The vendor will bill PharmaCare directly for the eligible portion of the cost.
   
5. Pump Supplies: Once your pump is approved, eligible supplies are covered under your PharmaCare plan, subject to the deductible and maximum rules.
   
6. Ongoing Monitoring: Continue regular check-ins with your diabetes care team and follow all medical guidance.
   
7. Renewal or Replacement: Every five years (or four years under certain conditions), your physician may submit a new Special Authority request if you require a replacement pump. Renewal is contingent on meeting the clinical criteria for continued funding.
   

👉 Forms and details: BC PharmaCare Special Authority Request – Insulin Pumps

This structured process ensures that patients are carefully assessed before beginning pump therapy and remain supported throughout their use of the technology.

PharmaCare ensures the cost of pumps and supplies is covered, but many people still face challenges with the day-to-day details of diabetes care. That is where additional support can make a real difference.

• Clinician access when you need it: The Endor Health app allows ongoing communication with your care team, so questions about therapy or adjustments do not have to wait for the next appointment.
  
• Reliable supply delivery: The Endor Health app makes it easy and free to get home delivery of insulin, prescription items and pump supplies, reducing the risk of missed refills or last-minute pharmacy visits.