Diabetes Management

What is covered under Diabetes Management?

Hospital Cover for Diabetes Management includes hospital treatment to investigate and manage diabetes. 

Examples include:

• stabilisation of hypo-or hyper-glycaemia
• body contour problems due to insulin injections.

There is only one treatment for this clinical category listed in the Medicare Benefits Schedule (MBS). This is liposuction for skin contour problems because of repeated insulin injections. 

It does not include insulin pumps.

Some treatments you might expect to be in the Diabetes Management clinical category are in other clinical categories. For example:

• diabetes-related eye conditions are under Eye
• ulcers are under Skin
• provision and replacement of insulin pumps is under Insulin Pumps.

Which Hospital Cover tiers include Diabetes Management?

What does it mean if cover is ‘optional’?

‘Optional’ means that the Australian Government allows insurers to choose whether or not to cover the clinical category under that Hospital Cover tier.

What does ‘restricted cover’ mean? 

Restricted cover means the insurer pays only limited benefits. 

If insurers offer cover for Diabetes Management under Basic Hospital Cover, they can do so on a ‘restricted’ basis. If you are admitted as a private patient in a private hospital for treatments under this clinical category, you will face considerable out-of-pocket costs.

You should check with your insurer before agreeing to be treated as a private patient in a private hospital if you have restricted cover for Diabetes Management. 

Does Medicare cover Diabetes Management?

Medicare covers one treatment under the Diabetes Management clinical category.

If there is an MBS item number for this treatment, Medicare covers it.

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