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Late last year T1DN asked for your feedback on funding of insulin pumps through private health insurance (PHI). We had a great response with over 300 people providing some fantastic detail around the trials and tribulations of dealing with PHIs (plus some of you who had successes and no problems!).
The collated data was recently presented to Samantha Gavel, the Private Health Insurance Ombudsman (yes there is an ombudsman for this, put your hand up if you knew that), by our project leader Chris with support from our president Natasha. The meeting produced some great insights into how the ombudsman operates, and was an opportunity to provide detail about issues faced by people with type 1 when accessing funding for insulin pumps.
The ombudsman agreed that more information needs to be available on how funding of insulin pumps works and the insurer's responsibility to provide this. We are also working closely with the ombudsman's office to re-write the Insulin Pump fact sheet to be more user friendly and helpful; we hope to have the revised document available to you mid-year.
Our next step in the coming months is to continue our advocacy on this issue by taking a jump into politics and hopefully presenting the data to the Federal Health Minister and Shadow Health Minister, along with the Department of Health and Ageing (who are running the PBS review into insulin pumps).
In the meantime, if you experience any issues accessing funding for a pump (new or replacement), and you're unable to resolve it with your insurer, don't be afraid to contact the ombudsman to seek assistance. They work closely with the insurers to make your interactions as smooth as possible, and if they aren't aware of the issues then they can't help!
Use the following link to contact the ombudsman: www.phio.org.au.
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