Medicare and many private health fund plans cover many of the costs involved with IVF treatment – making it a more affordable option for Australian couples who want to have a baby.
Am I eligible for a Medicare rebate?
If you are diagnosed as being ‘medically infertile’, Medicare will cover any eligible treatment with Hunter IVF.
This includes IVF, most ART (Assisted Reproductive Technology) treatments such as IUI (intra-uterine insemination), Frozen Embryo Transfer, and ICSI. Ovulation induction only receives a rebate when it involves an insemination procedure.
These rebates are not means tested and are available to all holders of a current Medicare card. There are no limits to the amount you can claim.
If you are not medically infertile – for example, if you have no pre-existing fertility conditions and are a single woman or a woman in a same-sex relationship – Medicare will not cover your treatment with Hunter IVF.
What is the Medicare safety net?
The Extended Medicare Safety Net (EMSN) provides an additional capped rebate for individuals and families whose costs go over an annual threshold. This is calculated on a calendar year basis.
What things will Medicare not cover?
Medicare will not cover hospital/day surgery related services, such as egg collection – and it doesn’t reimburse for items without a Medicare item number, such as testicular biopsy.
Some drugs, cycle monitoring outside of our clinics, and cryostorage also will not receive a Medicare rebate. This also goes for day surgery procedures – although you may be able to claim the cost of the anaesthetist, or your private health fund may cover this cost.
Make sure your referral is valid
To claim the Medicare rebate, you need a current referral from your GP (valid for 12 months or indefinite) or specialist gynaecologist/obstetrician (valid for 3 months).
Medicare Electronic Claiming
You can now claim your Medicare rebate quickly and easily through Medicare Electronic Claiming. If you pay your fees in full at the time of treatment, we will lodge your claim for you on the first business day after your embryo transfer, and your Medicare rebate will be paid into your nominated bank account within 48-72 hours of your claim being lodged. This saves you time, and ensures you get the rebate as quickly as possible.
If you’d rather not register your bank details with Medicare, but would still like us to lodge your claim on your behalf, you’ll receive a cheque in the mail.
If you don’t want to register for Medicare Electronic Claiming, we will send you an itemised invoice and you can take this to a Medicare office to claim your rebate.
Find out more, or register your details with Medicare
Private health insurance rebates
If you have private health insurance, you may also receive rebates for day hospital expenses and some medications that not covered by Medicare.
We strongly advise you to contact your own health fund for advice about rebates, waiting periods and your eligibility for fertility treatment.
Any excess or co-payment will need to be paid to the hospital on the day of your day surgery admission. Some funds treat infertility as a pre-existing condition, which means a waiting period may apply before you are eligible for claiming benefits.
Please keep us informed of your private health insurance hospital cover details. We will need your private health insurance company name, membership number and whether you are covered for IVF treatment under your hospital cover.
Find out more about fertility treatment costs.