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To be eligible to access fully subsidised continuous glucose monitoring (CGM) through the NDSS, 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 fully subsidised access to CGM if they meet ALL of the following criteria:

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

NOTE: A child who has been accessing 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 fully subsidised access to CGM products if they meet ALL of the following criteria:

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

For children and young people in either category, when they turn 21 their access will continue. They can continue to access fully subsidised CGM products if they have valid concessional status. If they do not have valid concessional status, they will commence paying a co-payment.

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

DOWNLOAD THE ELIGIBILITY ASSESSMENT FORM HERE

DOWNLOAD THE ELIGIBILITY ASSESSMENT FORM HERE

To be eligible to access fully subsidised continuous glucose monitoring (CGM) products through the NDSS, the following three criteria must ALL be met:

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

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

Catergory A - Pregnancy Planning

The woman 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. A health professional authorised to assess and certify eligibility to access CGM products 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 in total) may be authorised.

Category B – Pregnant/Post-Pregnancy

From when the pregnancy is confirmed, until 3 months after the expected or actual date of birth of the baby.

In the event of a pregnancy loss, the currently approved period of CGM access will continue unchanged. In this event, the person may reapply for pregnancy planning status at any time.

When a woman with type 1 diabetes no longer meets the eligibility criteria for pregnancy or immediately post-pregnancy they can continue to access fully subsidised products if they have valid concessional status. If they do not have valid concessional status, they will commence paying a co-payment.

At least 1 month prior to the completion of either the ‘pregnancy planning’ or ‘post–pregnancy’ periods, the person will receive a notification from the NDSS, advising them that their access to fully-subsidised products is ending soon and guidance for ongoing access to subsidised products through the NDSS, including if they should consult their authorised health professional in relation to future access.

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

DOWNLOAD THE ELIGIBILITY ASSESSMENT FORM HERE

DOWNLOAD THE ELIGIBILITY ASSESSMENT FORM HERE

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:

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 Libre/CGM; and
• the family/carer has the willingness and capability to use Libre/CGM; and
• the family/carer has the commitment to actively participate in a diabetes management plan that incorporates Libre/CGM.

NOTE: A child who has been accessing 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 Libre/CGM; and
• the person or family/carer has the willingness and capability to use Libre/CGM; and
• the person or family/carer has the commitment to actively participate in a diabetes management plan which incorporates Libre/CGM.

For children and young people in either category, fully subsidised access to CGM products will cease once they reach 21 years of age.

In addition, the child or young person must be insulin requiring and have been diagnosed with one of the the conditions listed in this table.

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

DOWNLOAD THE ELIGIBILITY ASSESSMENT FORM HERE

DOWNLOAD THE ELIGIBILITY ASSESSMENT FORM HERE

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

All people with type 1 diabetes are eligible to apply for access to subsidised CGM products through the NDSS. People with type 1 diabetes aged 21 years and older who hold valid concessional status can access fully subsidised products, that is, no co-payment will be required. If you do not have valid concessional status, or your concessional access ends, you will pay a co-payment when you purchase at a NDSS Access Point (usually a community pharmacy).

To be eligible to access subsidised CGM products through the NDSS, the following three criteria must ALL be met:

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

In addition, the person must have valid concession status. 

Concessional Status

The required concessional status to access fully subsidised CGM products 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 type 1 diabetes aged 21 years or older with the following valid concessional types will be eligible for fully subsidised products::

• 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

DOWNLOAD THE ELIGIBILITY ASSESSMENT FORM HERE