Continuous Glucose Monitors and Insulin Pumps: Funding and Private Insurance for Diabetes
Modern diabetes care, especially for type 1 diabetes, increasingly relies on devices — a continuous glucose monitor (CGM) that tracks sugar levels around the clock, and an insulin pump that delivers insulin precisely instead of individual injections. This technology is expensive, so it's important to understand the funding layers: what the health fund provides by default, what supplementary health services (Shaban) add, and what's left to private health insurance or out-of-pocket payment. Here is a guide to the general principles — the exact eligibility criteria and funding change and are updated over time, and should be checked with your specific health fund and insurer.
Key takeaways
- Continuous glucose monitors and insulin pumps are usually, to some degree, subsidized publicly for part of the population with diabetes, subject to medical and age criteria that are updated from time to time.
- Private health insurance may provide an answer for those who don't meet the full public subsidy criteria, or help cover costs of more advanced equipment or supplies — but this depends on the specific policy and is not automatic.
- It's worth checking the funding layers in the right order — health fund, Shaban, then private insurance — to understand exactly what's already covered and what remains to check under the relevant rider.
What the public system provides for people with diabetes
Health funds subsidize, subject to medical criteria that vary by diabetes type, age, and clinical need, equipment for monitoring and treating diabetes — including, in some cases, insulin pumps, continuous glucose monitor sensors, and consumables like needles and test strips. The exact eligibility criteria, subsidy scope, and eligible ages are updated from time to time and vary between health funds, so check them directly with your own health fund rather than relying on general information.
When private insurance comes into the picture
Private health insurance can be especially relevant for those who don't meet the full public subsidy criteria — for example due to age or diabetes type — or who want more advanced equipment than what's subsidized. How a private policy treats this kind of ongoing medical equipment varies between insurers, and it is sometimes included under a general medical devices rider rather than a dedicated diabetes rider.
What's typically not included, and worth checking
Different policies may exclude or limit funding for consumables (strips, sensors, infusion sets) compared with the device itself, or require the device to be purchased through an approved supplier list. Some policies also require an opinion from a diabetes specialist as a condition of coverage. These are typical exclusions only, so it's important to check the exact wording in the relevant rider of your policy, and not assume the device and its ongoing maintenance are covered identically.
How to check the funding layers in the right order
It's recommended to first check what the health fund subsidizes under current criteria, then what Shaban adds if you have it, and only then check what's left for private insurance or out-of-pocket payment. This order helps avoid buying duplicate cover for something already covered, and helps identify exactly the gap private insurance is meant to close, if there is one in your case.
How Ravit can help
Send Ravit your policy documents on WhatsApp, and ask in plain language whether it covers diabetes monitoring and treatment devices and on what terms. Ravit answers based on what is written in your own policy, with a pointer to the relevant clause, and when information is partial or depends on medical criteria, she says so honestly instead of guessing.
The information in this article is general only and does not constitute medical, insurance, legal, or pension advice, and is not a substitute for reading your policy terms or consulting a licensed professional. Coverage, amounts, and conditions vary between policies and change over time — always verify against your own specific policy and an authorized professional.
Frequently asked questions
Does the health fund subsidize a continuous glucose monitor and insulin pump?
Subject to medical criteria, age, and diabetes type that are updated from time to time, health funds subsidize monitoring and treatment equipment for some insured people, including sometimes pumps and continuous glucose monitor sensors. Check the current criteria directly with your health fund.
When is it worth checking private insurance for diabetes equipment?
It's mainly worth checking private insurance when you don't meet the full public subsidy criteria, or want more advanced equipment than what's subsidized. Private treatment of such equipment varies a lot between insurers and should be checked in the relevant rider.
Does private insurance also cover consumables like strips and sensors?
Not necessarily to the same extent as the device itself — some policies treat consumables differently, so it's important to check the exact wording in the relevant rider of your policy.
Is a medical opinion needed for private insurance to recognize diabetes equipment?
Many policies require medical documentation or an opinion from a diabetes specialist as a condition of coverage, but the exact requirement varies between insurers and should be checked in advance, not only when filing a claim.
In what order should you check the funding layers for diabetes equipment?
It's recommended to first check the health fund's subsidy, then Shaban if you have it, and only then private health insurance — to identify exactly the gap that remains for coverage and avoid unnecessary double insurance.
Want to check this against your own policy? Ravit answers usually within minutes, on WhatsApp.
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