IVF Cost

 MEDICARE IVF COSTS & REBATES

There have been substantial reductions in the cost of many fertility treatments since the introduction of the Extended Medicare Safety Net scheme.  The savings generated from these out-of- pocket cost reductions have clearly made fertility treatment more affordable.  It is important your referral letter to your fertility specialist is current and up-to-date whilst undergoing fertility treatment to ensure you receive the Medicare rebate.

How Does The Medicare Safety Net Work?

In addition to receiving the standard Medicare rebate for fertility treatment, you may also be eligible to receive the Medicare Safety Net rebate.  The Medicare Safety Net provides an additional rebate for patients who incur significant out of pocket expenses for outpatient services in a calendar year, such as City Fertility Centre and outpatient fertility specialist fees where a Medicare rebate is applicable.  Out of pocket expense is commonly referred to as the “gap” between the doctor/clinic fee and the standard Medicare rebate.  The Medicare Safety Net does not apply to inpatient services, such as the anaesthetist, hospital/day surgery and a small portion of the fertility specialist fee.  In order to receive this additional rebate, patients first must register with Medicare and reach the relevant threshold.  You can register online at www.medicareaustralia.gov.au/online. Once registered, Medicare will automatically keep a tally of your out of pocket expenses.  Patients receive an additional rebate from Medicare for the remainder of the calendar year once they have reached their relevant threshold.  Medicare revises these thresholds annually.  On the 1^st January each year, the balance of your Medicare Safety Net threshold reverts to zero.  As of the 1^st January 2012 the Medicare Safety Net Threshold for non concession card holders is $1198.00 and $598.80 for concession card holders or those eligible for Family Tax Benefit A. 

2010 Federal Government Changes To The Medicare Safety Net

From the 1^st January 2010 the Medicare Safety Net rebate will be “capped” for Assisted Reproductive Technology services.    This means there is a limit on the maximum Medicare Safety Net rebate you will receive.  The Medicare Safety Net is not means tested, nor is a restriction placed on the number of treatment cycles patients can undertake in a calendar year. 

All patients are provided with informed financial consent prior to commencing each treatment cycle.  Should you require further information, do not hesitate to contact a member of the Patient Services team who will be glad to discuss the costs involved in your proposed treatment cycle. 

PRIVATE HEALTH COVER & IVF COSTS

Private health insurance covers medical expenses incurred whilst you are admitted to an accredited private hospital or day surgery centre.  It is important you contact your private health fund to find out if your selected insurance level covers fertility treatment and whether you have served the relevant waiting periods.  Many patients have thought they were covered, only to find out later their level of insurance had restricted services or they had not served their waiting period. 

If your health fund confirms they will cover fertility treatment costs, you may receive a rebate from your health fund for the following:

• Hospital/Day Surgery – bed fee and theatre fee
• Portion of the anaesthetist fee
• Portion of the fertility specialist fee
• Medication not included in City Fertility Centre cycle fees (this is dependent on your Extras Pharmacy cover – if applicable)

Your private health fund may advise you need to pay an excess or co-payment when admitted to hospital.  This means you pay to the hospital on admission a nominated amount for your hospital stay.  Your private health fund will pay the remaining balance to the hospital.  Depending on which private health fund you are insured with and level of insurance, an excess or co-payment may not apply to day surgery procedures.  Please enquire directly with your private health fund.

COSTS

What Are The Treatment Cycle Costs and What Do They Include?

As the cost structure for fertility treatment varies depending on the level of treatment required, costs for treatment may be different between patients.  This is because each treatment cycle is tailored to suit individual needs.  Below is a table detailing available treatment options and what the cycle fees include.

*Included in Medicare item numbers billed by fertility specialist

ADDITIONAL IVF COSTS

Fertility Specialist

In addition to the fees payable to City Fertility Centre, you will also receive an account for the treatment cycle from your fertility specialist. These fees are eligible for rebates from both Medicare and Private Health Funds. Please contact your fertility specialist’s receptionist to obtain further information and quotes for these procedures.

Hospital

If you are undergoing IVF treatment, you will be admitted to a private hospital as a day surgery patient.  Medicare does not provide a rebate for private hospital fees.  However, if you have private health insurance and have served the mandatory waiting period, your health fund may cover a portion of the hospital costs.  To find out if you are eligible, please contact your health fund directly and quote item number 13212.

Anaesthetist

If undergoing IVF treatment, you will incur an anesthetist fee for the egg pick up.  The fees charged by the anaesthetist will vary as it is calculated on the length of the procedure and individual billing procedures. A Medicare rebate applies.  If you have private health insurance and have served the mandatory waiting period, you may be entitled to a further rebate from your health fund.

Medication

Your fertility specialist may prescribe medication for your treatment cycle that is not included in the treatment cycle fees.   These include:

• Clomid
• Synarel
• Orgalutran
• Cetrotide
• Pregnyl
• Ovidrel
• Crinone
• Progesterone Pessaries
• Lucrin
• Luveris

Other Laboratory Services

In addition to the standard embryology services offered, your fertility specialist may recommend other embryology services which may assist in you achieving a successful pregnancy.

Additional services include:

• Assisted Hatching
• Blastocyst
• Donor Sperm
• Embryo Glue
• Embryo/Oocyte Freeze
• ICSI *
• Pre-Implantation Genetic Diagnosis (PGD)
• Sperm Freeze
• TESA

*Denotes Medicare rebate applicable

Counselling

Whilst undergoing a fully stimulated IVF cycle, you are entitled to one complimentary counseling session.  If you wish to attend further counseling sessions, you will receive an account directly from the psychologist or dietician.  If you have private health insurance, you may receive a rebate for these services.  Please contact your private health fund directly to find out if you are eligible.

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