FreeStyle Libre 2 coverage in Nova Scotia

Yes! The FreeStyle Libre 2 system is covered for patients 2 years of age or older with diabetes mellitus AND who require multiple daily injections of insulin or insulin pump therapy as part of intensive insulin therapy.

The FreeStyle Libre 2 system is covered under multiple programs:

• Nova Scotia Pharmacare programs such as the Seniors’ Pharmacare Program, Family Pharmacare Program, and Department of Community Services Pharmacare Benefits Program.
  
• A new sensor-based glucose monitoring (SBGM) program - an income-based program with an annual maximum deductible (the deductible is the amount you need to pay before the program begins coverage). The SBGM program is the payer of last resort, which means that your private insurance would be the first to pay a claim.

NOTE: You can only have coverage under 1 program. Compare the programs to determine which one best suits your personal and financial needs.

You may be eligible for coverage for the FreeStyle Libre 2 system if you qualify for one of the above-mentioned programs AND you are:

• Are 2 years of age or older with diabetes mellitus, AND
• Require multiple daily injections of insulin or insulin pump therapy as part of intensive insulin therapy

NOTE: “Multiple daily injections of insulin” is defined as 1 (or more) injection(s) of basal insulin and 3 (or more) injections of bolus insulin, with a minimum of at least of 4 total insulin injections per day

Coverage includes the FreeStyle Libre 2 system sensors. A reader is available at no cost by calling Libre Customer Service at 1-888-205-8296.

A maximum of six sensors will be covered within a three-month period.

First, talk to your healthcare professional to get a prescription. Your healthcare professional will also need to complete an exception status request form. They will need to include information such as your Health Card number, diabetes diagnosis, and confirm that you meet the eligibility criteria. Once submitted, exception status coverage requests are usually processed within 7-10 days.

Your healthcare professional should mail or fax your completed form:

By mail:
Nova Scotia Pharmacare Programs
P.O. Box 500
Halifax, NS
B3J 2S1

By fax:
(902) 468-9402

Under the Sensor-Based Glucose Monitoring Program, you will need to pay a deductible. This means that you will pay the full cost of the CGM supplies at the pharmacy until you reach your deductible amount. After this, the SBGM program will pay the cost until the end of the program year.

NOTE: Your deductible amount is determined by your family income. Visit the NovaScotia Health website to learn more.

Under the Seniors’ Pharmacare Program, you will pay an annual premium based on your household income. You will also need to pay an annual copayment, either at the pharmacy or directly to the Seniors’ Pharmacare Program. Both the premium and copayment have annual maximums. The province then covers the rest of the costs. You can calculate your premium using an online calculator.

Under the Family Pharmacare Program, you will be required to pay a part of the cost of certain prescription drugs and devices. The Program has annual family copayment and deductible maximums that are set depending on a family’s size and annual income. When you pay for a prescription, the first 20% is put towards your annual maximum copayment. The remaining 80% of the prescription cost will be applied against your annual maximum deductible. When you have paid both the total annual maximum copayment and total annual maximum deductible, Pharmacare will pay the full cost of your CGM system until the end of the program year, which is March 31st.  

Sensor-Based Glucose Monitoring Program
To register for the Sensor-Based Glucose Monitoring Program, you need to be living with diabetes and use multiple daily injections of insulin. You can review the detailed criteria in the Sensor-Based Glucose Monitoring Program brochure.

Seniors’ Pharmacare Program
To become a member of the Seniors’ Pharmacare Program, you must:

• Be a resident of Nova Scotia
• Have a valid Nova Scotia Health Card
• Be at least 65 years of age, and
• Not have prescription drug coverage under any other plan or programs
  

Family Pharmacare Program
To be eligible for the Family Pharmacare Program, you must:

• Be a resident of Nova Scotia
• Have a valid Nova Scotia Health Card
• Agree to family income verification through Canada Revenue Agency each year
• Agree to provide family size information each year

You must also NOT be receiving drug coverage through the:

• Nova Scotia Seniors’ Pharmacare Program
• Under 65-Long Term Care Pharmacare Plan, or
• Any Nova Scotia Department of Community Services Pharmacare Benefits

Department of Community Services Pharmacare Benefits
The Department of Community Services Pharmacare Benefits Program provides prescription drug coverage to:

• Income Assistance clients (which includes Extended Pharmacare and Transitional Pharmacare clients)
• Disability Support Program clients
• Children in the care of child welfare through either a district office of the Department of Community Services or a Children's Aid Society/Family and Children's Services agency
• Low Income Pharmacare for Children clients
  

Sensor-Based Glucose Monitoring Program
You’ll need to complete the enrolment form and forward it to the Program office. It should take 1 to 2 weeks to get registered in the program.

Submit your form by mail:
Nova Scotia Sensor-based Glucose Monitoring Program
PO Box 500
Halifax, NS
B3J 2S1

Submit your form by fax:
(902) 468-9402

NOTE:

• There is a section on the form that must be completed by a physician, nurse practitioner, or pharmacist.
• Include all family members on the registration form - even those who don’t have diabetes. All family members are included in the deductible calculations, which may help to lower your deductible.

Seniors’ Pharmacare Program
To join the program, complete and return the registration form no later than 90 days from the first day of the month in which you turned 65.

You can send it to:
Nova Scotia Seniors’ Pharmacare Program
PO Box 9322
Halifax, NS B3K 6A1

Please note that program information and enrolment packages are mailed to residents with a valid Nova Scotia Health Card approximately two to three months before their 65th birthday.

Family Pharmacare Program
Each family is required to complete only one Registration Form.

NOTE: For the purposes of the Family Pharmacare Program, a family is:

• A single adult
• An adult and spouse
• An adult and all dependant children
• An adult, spouse, and all dependant children

You can either mail or fax your completed form:

By mail:
Nova Scotia Family Pharmacare Program
Nova Scotia Pharmacare Programs
PO Box 500
Halifax, NS
B3J 2S1

By fax:
(902) 468-9402
 

Visit the Nova Scotia Pharmacare website to learn more.