11 things Nurses, Paramedics, Firefighters and their family need to know about insulin pumps

1 Sep 2025

A girl with an insulin pump standing

In short

We’ve put together some key points to guide you through everything you need to know about using an insulin pump. From understanding how it works to managing costs and getting the right support, this guide is here to make the process simpler.

So how can your Emergency Services Health cover help you? We've listed 11 things you should know to help make the most of your cover and confidently manage your insulin pump needs.

1. Insulin pumps; how they work

An insulin pump is a wearable device which continuously delivers rapid acting insulin through a cannula that is inserted under the skin.

They are mainly used to manage blood glucose levels in people with Type 1 Diabetes by continuously delivering rapid-acting insulin, mimicking the body's natural insulin production.

It offers an alternative to multiple daily injections by providing a steady, programmable dose of insulin throughout the day and night and allowing for additional doses to be delivered before meals or to correct high blood sugar.

2. Up front and ongoing costs

There can be big costs associated with insulin pumps, especially when factoring in ongoing supplies and maintenance.

Across Emergency Servies Health and Police Health, our data from the last 5 calendar years (2020-2024), showed the average cost to be $8,470.

Those high costs explains the Australian Institute of Health and Wellness’ research. They found approximately 80% of insulin pump users with Type 1 Diabetes obtained a private health insurance rebate for the purchase of their pump.

The ongoing costs for consumables, accessories and maintenance can vary depending on your eligibility for the Australian Government's National Diabetes Services Scheme (NDSS).

We recommend you check if you're eligible, and read below to see what we cover and don't cover.

3. Emergency Services Health's cover

If it's your first time having an insulin pump fitted, and you hold Gold Hospital cover or Gold Combined cover with Emergency Services Health, you’re likely entitled to claim benefits for;

Your first insulin pump
Hospital accommodation fees
The gap on doctor fees (up to the Medicare Benefit Schedule Fee)

We also cover the replacement or upgrade of an insulin pump that is outside of the manufacturer's warranty period and it is medically required, or when the insulin pump is faulty.

A replacement pump fitting generally takes place in a clinic and does not require a hospital admission. However, an admission may be necessary in certain circumstances, and we will cover in that circumstance.

4. Important info for replacement or upgrades

It's important to note that either the hospital, insulin pump supplier, or Diabetes Educator will be required to do the following to help us determine what benefits can be claimed;

Complete an AHSA Insulin Pump Replacement Application Form to get pre-approval from Emergency Services Health
Attach a letter from treating doctor outlining reason for upgrade, BSL results and clinical history
Attach a supplier report indicating that the insulin pump is no longer functioning

Ensuring these steps are taken will also save you any nasty surprise bills.

5. You need a certain type of cover

To be covered for insulin pumps, you'll need our Gold Hospital cover or Gold Combined cover. If you'd like to join upgrade your cover, call us on 1300 703 703.

6. Fitted in a hospital (inpatient) vs out a hospital (outpatient)

There's an important difference between getting your insulin pump fitted in a hospital as an inpatient versus outside a hospital as an outpatient.

When an insulin pump is fitted in hospital as part of an inpatient admission, our Gold Hospital or Gold Combined cover pays benefits towards eligible hospital accommodation and specialist fees.

If your pump is fitted as an outpatient in a clinic or specialist’s rooms, these costs aren’t covered under our respective cover, and we can’t pay benefits towards specialist fees.

7. There are waiting periods

Keep in mind that like many private health insurers, Emergency Services Health has waiting periods for insulin pumps.

Our waiting period is 2 months, however if you have a pre-existing condition it's 12 months

8. Emergency Services Health covers Omnipods

The Omnipod is a patch pump — small, tubeless, and fully self-contained. Unlike traditional insulin pumps, which use tubing to connect the pump to the body.

The Omnipod has 2 parts; the Personal Diabetes Manager (PDM) devise and the Omnipod Pod - a small disposable device which adheres directly to the skin.

This design provides greater freedom of movement and may feel less intrusive in daily life.

9. Important differences wth Omnipods

There are some key differences in what’s included compared with standard insulin pump cover.

The big difference is that Omnipod Pods are fitted as an outpatient

You won’t need to go to hospital to have your Omnipod Pod fitted. Because it is fitted outside of a hospital setting, we are unable to pay benefits towards gaps on doctor fees for this service.

10. Getting additional boxes of Omnipod Pods

Additional Omnipod Pods — the small, disposable devices worn on the body that hold and deliver insulin — are not covered under your Emergency Services Health Gold Hospital cover.

However, subsidised Pods may be available, depending on eligibility, through the NDSS.

11. Other items not covered

We don't cover the replacement or upgrade of an insulin pump unless it is medically required. This applies regardless of the manufacturer's warranty status.

Two other groups of items we don't cover are consumables and accessories. Consumable items include;

Syringes and needles
Blood glucose test strips
Urine test strips
Insulin pump consumables (including Omnipod Pods)
Continuous glucose monitoring (CGM) products

Subsidised products may be available through the NDSS. Accessories that we don't cover include;

Batteries
Carrying case
Pouches
Clips for the pump