Health Insurance for IVF in Australia
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If doctors have told you that you need help getting pregnant, you are not alone. Thousands of Australians turn to Assisted Reproductive Technology (ART) to help them start their families.
Infertility treatments, like In Vitro Fertilisation (IVF), can help you become pregnant but costs upwards of $9,000 per cycle. Private health insurance for IVF; for example, Gold Hospital policies could pay for your in-hospital expenses that are not covered by Medicare, saving you around $2000 per cycle.
One of the ways to find an affordable assisted reproductive insurance policy is by comparing similar options from major health insurance brands in Australia.
How much does IVF cost in Australia
Assisted reproductive services can involve several steps and are very expensive. You can expect upwards of $9,430, of which $4,640 is out of pocket costs, for the first IVF cycle in a calendar year.
|Treatment type||Out-of-pocket cost after Medicare (safety net not reached)||Out-of-pocket cost after Medicare (safety net reached)|
|Frozen embryo transfer (FET)||$2,309||$2,250|
|Ovulation Induction (OI)||$700||$700|
|Intra-Uterine Insemination (IUI)||$2,037||$1,896|
Take note: The above is the estimated cost of fertility treatments for 1 cycle in a calendar year.
Fees you can expect before and during your IFV journey
The cost of infertility treatments in Australia generally depends on your unique requirements. For example, the fertility clinic you choose, if you need ovulation induction (OI) and whether the sperm must be manually injected directly into the egg - Intracytoplasmic Sperm Injection (ICSI). Generally, the IVF costs you should prepare yourself for include:
- IVF cycle: Retrieval of eggs, in-lab fertilisation and frozen embryo transfer (FET). You may also be charged for ovulation induction and ovulation tracking.
- Specialist fees: Payment for fertility specialist and nurses, embryologist, and anaesthetist.
- Other cycle costs: Blood tests, ultrasounds, counselling services, and laboratory and administrative costs. The freezing and storage of embryos will also incur a fee.
- Day surgery procedures: Required for treatment involving the collection of eggs and transfer of embryos.
- Medications: Specific fertility medications might be required.
Reduce your IVF cost with health insurance
Does Medicare cover IVF?
Yes, Medicare rebates are generally available to cover a portion of the costs for IVF (up to 75%) and most Assisted Reproductive Technologies (ART). Some level of reimbursement might also be available for Intra-Uterine Insemination (IUI), Frozen Embryo Transfer, and Intracytoplasmic Sperm Injection (ICSI). You might also be eligible for the Medicare Safety Net rebate to assist you with your out-of-pocket medical expenses.
To claim a Medicare rebate for IVF, you generally need to provide the fertility centre with a valid referral from your GP or specialist. Make sure you are registered with Medicare before you start your fertility journey.
The Medicare Safety Net is where Medicare pays you an additional amount when you've reached the Medicare Safety Net threshold. However, it does not cover hospital or day surgery procedures, for example, egg collection. This is where private health insurance can help.
Does health insurance provide IVF coverage?
Generally, private Hospital policies that include IVF coverage pays a benefit towards some of the in-hospital procedures that have a valid Medicare item number. For example, egg collection and embryo transfer.
If your Hospital policy covers assisted reproductive services, your health fund might provide a benefit towards:
- Hospital accommodation and theatre fees,
- The fees charged by your treating doctor and anaesthetist,
- Some of the costs for IVF related medications might also be subsidised.
If the treatment you require does not have a Medicare Benefit Schedule number, your health fund might not cover the cost. Always check with your health fund before scheduling your IFV or GIFT treatments.
How much is IVF with insurance?
Private health insurance can help reduce the cost of IVF treatments by paying day hospital expenses not covered by Medicare, saving you around $2000 per cycle.
Can you get health insurance IVF with no waiting period?
No, generally, all private health funds require you to serve a 12 month waiting period before you can claim for assisted reproductive services. Meaning, you need to have been covered by an appropriate Hospital policy for at least 12 months, before you are eligible to claim IFV treatments.
Important: Some Hospital policies apply a Benefit Limitation Period, meaning, only a minimal benefit is payable for specific treatments. Be sure to check your policy or speak with a health insurance specialist.
Which health insurance plans cover assisted reproductive services?
Assisted reproductive services are generally available with Gold Hospital policies, which is typically the most comprehensive Hospital policy type. Some health funds offering IVF coverage, include:
- HCF Hospital Gold
- AHM Top Hospital Gold
- myOwn Gold Hospital
- Australian Unity Ultimate Hospital (Gold)
- Medibank Gold Complete Hospital
- Bupa Top Hospital with Pregnancy – Gold
Frequently asked questions and answers
Bulk billing assisted reproductive services are still scarce because most fertility clinics are private. However, recently, some centres have started to offer bulk billing services to compete with other clinics offering similar services. Some Bulk Billing IVF centres in Australia include:
- The Fertility Centre
- Bulk Bill IVF
- First Step Fertility
- Life Fertility Clinic
- Primary IVF
Infertility treatments usually have a 12-month waiting period. If you are aware of any reason why you might need help getting pregnant, then you might want to invest in a Hospital policy early on. This way, you will have served the waiting period by the time you want to claim IVF treatments.
The best private Hospital policy that covers IVF depends on your unique fertility requirements, the state you live in, the premium you can afford, other treatments and benefits you want covered. You might want to request health insurance quotes from some of Australia’s most significant brands.
Yes, typically health insurance will cover IVF after a vasectomy. This will most likely be deemed a pre-existing condition, which means that you will need to complete the 12-month waiting period that is usually attached to pre-existing conditions. It's best to contact your insurer to confirm this with them.
Yes, private health funds will usually cover IVF even after tubal ligation. However, every health fund has its specific terms and conditions, so you must check with them first.
Patients with a Reciprocal Health Care Agreement are generally not eligible for the Medicare Rebate on Assisted Reproductive Technology (ART) services. You might want to invest in private hospital policy.
Storing a woman's unfertilised eggs so she can conceive later can cost around $820 for 12 months. However, the exact cost will depend on your specific requirements, and a Medicare rebate will only be available if freezing your eggs is medically necessary.
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