Children and young people aged under 21 years with type 1 diabetes

To be eligible for access to NDSS subsidy under this eligibility group, a child or young person must meet the criteria in one of the following categories:

Category A – for children 10 years or younger

Children 10 years of age and younger with type 1 diabetes will be eligible for NDSS subsidy if they meet ALL of the following criteria:

• the child is expected to benefit clinically from the use of FreeStyle Libre/CGM; and
• the family/carer has the willingness and capability to use FreeStyle Libre/CGM; and
• the family/carer has the commitment to actively participate in a diabetes management plan that incorporates FreeStyle Libre/CGM.

NOTE: A child who has been accessing FreeStyle Libre/CGM products through the initiative will continue to have subsidised access after they turn 11. They will not need to be re-assessed under Category B.

Category B – for children and young people aged 11 to less than 21 years

Children and young people with type 1 diabetes aged from 11 years to less than 21 years will be eligible for NDSS subsidy if they meet ALL of the following criteria:

• the person is expected to benefit clinically from the use of FreeStyle Libre/CGM; and
• the person or family/carer has the willingness and capability to use FreeStyle Libre/CGM; and
• the person or family/carer has the commitment to actively participate in a diabetes management plan which incorporates FreeStyle Libre/CGM.

AND they meet ONE OR MORE of the following criteria:

• frequent significant hypoglycaemia—more than one episode a year of significant hypoglycaemia requiring external, third-party assistance; and/or
• impaired awareness of hypoglycaemia; and/or
• inability to recognise, or communicate about, symptoms of hypoglycaemia; and/or
• significant fear of hypoglycaemia for the child/young person or a family member/carer, which is seriously affecting the health and wellbeing of the child or young person or contributing to hyperglycaemia as a reaction to this fear.

Find the Eligibility Assessment Form for type 1 diabetes; age under 21 years here.

People with type 1 diabetes aged 21 years and older who have valid concessional status

To be eligible for access to NDSS subsidy under this eligibility group, the person must have type 1 diabetes, aged 21 years or older and meet ALL of the following criteria:

• the person is expected to benefit clinically from the use of FreeStyle Libre/CGM; and
• the person or family/carer has the willingness and capability to use FreeStyle Libre/CGM; and
• the person or family/carer has the commitment to actively participate in a diabetes management plan which incorporates FreeStyle Libre/CGM.

In addition, the person must have valid concession status. 

Concessional Status

The required concessional status for this eligibility group is consistent with existing NDSS concessional arrangements but excludes the Safety Net Concession Card (SNCC) and the Safety Net Entitlement Card (SNEC) categories. People with the following valid concessional types will be eligible for the initiative (if they also meet the other eligibility criteria):

• Commonwealth Seniors Health Card (as issued by DHS* or DVA**)
• Commonwealth Pensioner Concession Card (as issued by DHS or DVA)
• Commonwealth Health Care Card (as issued by DHS or DVA)
• DVA Gold Card
• DVA White Card
• Identifies as Aboriginal and/or Torres Strait Islander person

Find the Eligibility Assessment Form for type 1, age 21 years and older with valid concessional status here.

*DHS Department of Human Services, now known as Services Australia

**DVA Department of Veterans’ Affairs

Women with type 1 diabetes who are actively planning pregnancy, pregnant, or immediately post-pregnancy 

To be eligible for access to NDSS subsidy under this eligibility group, the person must meet ALL of the following criteria:

• the person is expected to benefit clinically from the use of FreeStyle Libre/CGM; and
• the person or family/carer has the willingness and capability to use FreeStyle Libre/CGM; and
• the person or family/carer has the commitment to actively participate in a diabetes management plan which incorporates FreeStyle Libre/CGM.

In addition, the person must meet the criteria in one of the following categories:

Catergory A - Pre-pregnancy

The person with type 1 diabetes is considered as actively planning pregnancy and should be having regular engagement with pre-conception care services such as an endocrinologist, diabetologist and/or specialist physician, ideally at least every 6-8 weeks and more frequently if there is sub-optimal glycaemic control. An authorised health professional may certify eligibility for an initial 6-month period on the basis of the person seeking active pre-pregnancy care and committing to regular engagement with the pre-conception care service provider.

If at the end of the initial 6-month period the pre-conception care is continuing, an authorised health professional may certify eligibility for a further 6-month period. A maximum of two, 6-month access periods (up to a maximum period of 12 months) may be authorised.

After an initial 12 months eligibility—supporting documentation is required for an extension of access. 

There may be exceptional circumstances for an extension of this timeframe that will be considered on a case-by-case basis, noting these will be:

• considered by an appropriately constituted expert panel established by Diabetes Australia that will provide a recommendation to the Department of Health; and
• the Department of Health will be the deciding body for all of these cases.

Any extension to the pre-pregnancy period will be considered on a case-by-case basis and require documented evidence of exceptional circumstances—such as that the person has been referred to fertility services for assessment. Your application for an extension of access to FreeStyle Libre/CGM products after the initial 12 months requires supporting documentation (on letterhead):

• from both your diabetes health professional (authorised to certify FreeStyle Libre/CGM applications) and your fertility specialist, obstetrician / gynaecologist, confirming that you are continuing to plan pregnancy;
• with your first name, last name and date of birth;
• with the date you were referred to or first attended fertility specialist services;
• including confirmation of your ongoing fertility assessment or management.

Your applications for an extension of access to FreeStyle Libre/CGM products for a further six-month period, are considered on a case-by-case basis. At the end of this six-month period, further six-month extensions may be granted subject to the same documentation being provided.

To learn more about submitting an application for an extension to access to FreeStyle Libre/CGM products, please contact the NDSS Helpline on 1300 136 588.

Category B – Pregnant/Post-Pregnancy

The person with type 1 diabetes has a confirmed pregnancy and is regularly engaging with a health professional such as an endocrinologist, diabetologist and/or specialist physician. An authorised health professional may certify eligibility that will continue until 3 months after the expected date of birth of the baby.

Find the Eligibility Assessment Form for type 1 diabetes; pregnancy planning, pregnancy or immediately post pregnancy here.

Children and young people under 21 years with conditions very similar to type 1 diabetes who require insulin.

To be eligible for NDSS under this eligibility group, the child or young person must have been diagnosed with one of the conditions listed in this table and meet the criteria in one of the following categories:

Category A – for children 10 years or younger

Children 10 years of age and younger who have been diagnosed with one of the conditions listed in this table will be eligible for NDSS subsidy if they meet ALL of the following criteria:

• the child is expected to benefit clinically from the use of FreeStyle Libre/CGM; and
• the family/carer has the willingness and capability to use FreeStyle Libre/CGM; and
• the family/carer has the commitment to actively participate in a diabetes management plan that incorporates FreeStyle Libre/CGM.

NOTE: A child who has been accessing FreeStyle Libre/CGM products through the initiative will continue to have subsidised access after they turn 11. They will not need to be re-assessed under Category B.

Category B – for children and young people aged 11 to less than 21 years

Children and young people who have been diagnosed with one of the conditions listed in this table will be eligible for NDSS subsidy if they meet ALL of the following criteria:

• the person is expected to benefit clinically from the use of FreeStyle Libre/CGM; and
• the person or family/carer has the willingness and capability to use FreeStyle Libre/CGM; and
• the person or family/carer has the commitment to actively participate in a diabetes management plan which incorporates FreeStyle Libre/CGM.

AND they meet ONE OR MORE of the following criteria:

• frequent significant hypoglycaemia—more than one episode a year of significant hypoglycaemia requiring external, third-party assistance; and/or
• impaired awareness of hypoglycaemia; and/or
• inability to recognise, or communicate about, symptoms of hypoglycaemia; and/or
• significant fear of hypoglycaemia for the child/young person or a family member/carer, which is seriously affecting the health and wellbeing of the child or young person or contributing to hyperglycaemia as a reaction to this fear.

Find the Eligibility Assessment Form for ‘other’ eligible conditions; age under 21 years here.