Children and young people under 21 years with Type 1 diabetes

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 and Flash GM if they meet ALL of the following criteria:

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

NOTE: A child who has been accessing CGM or Flash GM products through the initiative will continue to have fully 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 years 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 and Flash GM products if they meet ALL of the following criteria:

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

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.

 

Children/young people under 21 years with similar conditions

Category A - For children 10 years or younger with similar conditions

Children 10 years of age and younger who have been diagnosed with one of the chronic conditions listed in this table will be eligible for subsidised access to CGM and Flash GM if they meet ALL of the following criteria:

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

NOTE: A child who has been accessing CGM and Flash GM products through the CGM Initiative as part of the NDSS will continue to have fully subsidised access after they turn 11. They will not need to be re-assessed under Category B.

Category B – For people aged 11 to 21 years with similar conditions

Children and young people who have been diagnosed with one of the chronic conditions listed in this table will be eligible to access fully subsidised CGM and Flash GM products through the CGM Initiative as part of the NDSS if they meet ALL of the following criteria:

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

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.

For children and young people in either category, fully subsidised access to CGM and Flash 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 chronic conditions listed in this table

 

21 or older with type 1 diabetes who have valid concessional status

 

To be eligible to access subsidised Dexcom CGM products through the NDSS:

  1. The person is expected to benefit clinically from the use of CGM; and
  2. The person or family/carer has the willingness and capability to use CGM; and
  3. The person or family/carer has the commitment to actively participate in a diabetes management plan which incorporates CGM 
  4. In addition, the person must be 21 years or older, have a valid concessional status as listed below.

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):

 

Which Concession Types?

Concession types

  • 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

*DHS Department of Human Services
**DVA Department of Veterans’ Affairs

.

How to access Dexcom CGM through NDSS Subsidy Initiative?

Dexcom G5 Mobile CGM systems are available to eligible patients who meet the above criteria.

In addition, as of 18th January 2021, if you are using a Tandem t:slim X2™ insulin pump and meet the NDSS CGM Subsidy criteria you can now have access to Dexcom G6 CGM.

Step 1-2
NDSS will certify your eligibility
Order your Dexcom through your local Pharmacy

Temporary update: To make things easier during COVID-19 pandemic, only your healthcare professional needs to complete the form. You will not be required to co-sign.

 

Looking to switch over to Dexcom?

Already on the CGM Subsidy Initiative but wanting to switch to Dexcom CGM?

Eligible NDSS registrants are able to switch from another subsidised device/product to Dexcom for free.

Speak to your healthcare professional today to see if Dexcom is right for you. Your healthcare professional will be able to submit a switch form on your behalf to the NDSS.

Step 1: You can download the switching (Update or Cease Access) form here

Step 2: Take it to your next appointment with your healthcare professional.

Last updated: 8th March 2021

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