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Health Insurance for IVF in Australia

Megan Fraser Fact Checked Updated: 24 November 2023
Types of Health Insurance

Trying to have a baby can be a daunting time. If you’re struggling and are considering Vitro fertilisation, it’s important to understand the procedure and costs involved. Fortunately, Medicare and private health insurance can help cover some of the fees. It’s important to be informed when it comes to making decisions about your health and finances, so researching different policies to find the one that fits your needs is crucial. 

Private health insurance may provide some coverage for fertility services, though keep in mind that there is no guarantee across all policies. What private health insurance does cover, however, may vary within states and between insurers – so make sure you read the fine print. Knowing what services you can use before you start the process can make all the difference in helping you decide what treatment option is right for you.

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.

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Key facts

  • Health insurance for IVF is available in Australia to help cover some of the costs associated with the procedure.
  • Private health insurance may provide coverage for fertility services, but coverage and benefits vary between states and insurers.
  • Medicare rebates are available to Australians who are eligible for the program, which can cover a portion of the cost of IVF treatment.
  • There is no guarantee that health insurance will cover all costs associated with IVF, so it’s important to research different payment options beforehand.

How much does IVF cost in Australia

Fertility treatments can be costly, with prices ranging from $9,000 to $14,000. The specific cost of treatment depends on the type of procedure you and your healthcare provider determine is best suited for your fertility needs. Generally, a single IVF cycle is the least expensive option, with an average cost of around $9,000, while using a frozen embryo and undergoing ICSI treatment increases costs to approximately $14,000.

It’s important to research different payment options to ensure you get the care you need. Many insurance plans may cover some or all of their associated costs, and numerous financing opportunities are also available.

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Below are the general costs for specific cycles and treatments. It’s important to note that these are not exact prices and are subject to change depending on the doctor, specialist, and place of treatment. 

ProcedureTotal Cycle paymentEstimated out-of-pocket costs for first cycleEstimated out-of-pocket costs for subsequent cycles
IVF cycle$10,532$5,483$4,898
ICSI Cycle$11,332$5,788$5,203
Frozen Embryo Transfer$3,930$2,423$2,356
Intrauterine Insemination$2,676$2,116$1,968
Ovulation Induction$950$2,037$436$311

Source: IVF Australia, 2022

Take note: The above is the estimated cost of fertility treatments for 1 cycle in a calendar year.

What IVF costs are covered by private health insurance?

Fortunately, there are plenty of financial supports that can help to reduce the cost of fertility treatments. These include Medicare rebates and out-of-pocket expenses for some parts of your treatment. Furthermore, many health funds also offer additional rebates or fertility incentives which can lower the cost. It’s important to discuss all options with your medical practitioner to determine which are most suitable and beneficial to you. 

Many IVF clinics are now partnering with private healthcare providers that offer coverage for their patients seeking inpatient treatment, assisting with out-of-pocket costs.

Other costs to consider

While there is the main cost of the treatment itself, it’s important to remember that many additional expenses are required when undergoing birthing and pregnancy treatments such as IVF. Below are the other costs to consider: 

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Can you get health insurance for IVF with no waiting period?

Most private health funds require a 12-month waiting period before offering coverage. This means that to be eligible for assisted reproductive services, you need to have a Hospital policy in effect with your private health fund prior to beginning your treatments. Remember that coverage and waiting periods can vary greatly between funds and policies, so read through your private health insurance policy carefully if you want to utilise the funds you’ve accrued over the past 12 months.

Medicare Rebates for IVF

The Medicare Benefits Schedule (MBS) helps to reduce financial barriers for Australians when accessing essential health care. With the MBS, out-of-pocket costs for specialist appointments will be rebated back. To complement this system, those with private health insurance might be entitled to save even more. Depending on the cover they have taken out, policyholders may find that their private health insurance contributes a certain amount towards necessary treatments or services not included in Medicare. 

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Who is eligible?

To be eligible for the Medicare rebate, you must either be an Australian or New Zealand citizen, have an Australian permanent resident or are in the princess of applying for permanent residency, or have a temporary resident covered by a ministerial order. You also need to be referred by a specialist.

What Does The Rebate Cover?

The rebate covers appointments and IVF cycle costs, including donor and specialist fees and potential genetic screening. Additional costs you are required to pay include medications, accommodation or hospital fees, and storage. Medicare covers around 75% of the overall costs.

How to compare IVF fertility clinics

The Morrison Government is taking innovative steps to make it easier for couples trying to become pregnant to access the information and help they need. The Government has just launched YourIVFSuccess, a website dedicated to assisting couples in navigating their options and researching the best fertility clinic for their needs.

The wealth of information and advice available routes users through an informed decision-making process to find which clinic would work best for them. The interactive mapping tool provides contact details of clinics in each state and territory and helpful tips on what couples should consider when selecting. It’s never been easier for Australians considering IVF treatments to get the advice they need.

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:

Frequently asked questions

  • Does private health insurance cover IVF in Australia?

    Private Health Insurance Policies that provide coverage for In Vitro Fertilization (IVF) generally contribute to significant portions of the in-hospital steps involved, such as egg collection and embryo transfer. These procedures will typically have a Medicare item number used to determine the coverage amount provided by the privacy policy. It’s important to research and compare your health insurance policies when making decisions on fertility treatment so you can maximise your benefits and understand what is included in your policy.
  • Is IVF a pre-existing condition?

    The Affordable Care Act (ACA) was designed to assist individuals in navigating their way around pre-existing conditions regarding accessing health insurance, such as infertility. Before the ACA, those living with pre-existing conditions were often denied health coverage and had nowhere to turn for assistance. Fortunately, with the implementation of the ACA, this is no longer the case. Now those living with infertility have a better chance at obtaining quality medical coverage to help them through their journey towards parenthood.
  • What is the average cost of IVF in Australia?

    Planning to undergo IVF treatments can be a complex and costly journey. It’s important that when assessing options for treatment, you remember to consider not only the cost of the IVF itself but any additional costs that may be associated with it. Although each clinic offers different fee schedules for IVF procedures, other charges, such as screening tests, pathology analysis, and medications, can add to your overall expense.
  • Is IVF covered by Medicare in Australia?

    IVF and other Assisted Reproductive Technologies can often be costly procedures, so it’s great news that Medicare has made access to ART therapies more affordable for many Australians. Medicare currently offers rebates on up to 75% of the cost of these treatments, allowing individuals to use the rebate for services such as infertility consultation, embryology, fertility testing and semen analysis. However, it is important to note that there are eligibility requirements and out-of-pocket costs associated with IVF and other ART treatments, which vary depending on individual circumstances. Therefore, it is always best to discuss the financial implications thoroughly with your treating specialist before beginning a course of treatment.
  • Is IVF in Australia free?

    No, IVF is not free. However, some incentives can help cover most of the cost. These include Medicare, where the rebate can cover up to 75% of the total costs, including the IVF cycle. However, you will have to pay additional out-of-pocket costs for other services, such as medication and accommodation.
  • How do you qualify for IVF in Australia?

    If you are a resident of Australia and eligible for Medicare, you can access the publicly supported IVF clinics. Your doctor must refer you for treatment, and the clinic must deem IVF treatment clinically appropriate. This ensures that only reliable and qualified medical professionals are involved in your care process and that you receive the best attainable outcomes from available treatments. IVF services also ensure various support systems are in place to help those undergoing treatments, including professional counselling and social workers.

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