IVFMedicare and the Medicare Safety Net provides substantial financial support for people who need fertility treatment, and protects you from very large medical bills. Make sure you are registered with Medicare before you start any fertility treatment.
The majority of fertility treatment costs are covered by Medicare, and if you have private health insurance your out of pocket costs may be further reduced.
Medicare provides a rebate for Australians who incur out-of-pocket costs for out-of-hospital services (including GP and specialist appointments, and diagnostic tests). The Medicare Safety Net provides an additional capped rebate when those costs go over an annual threshold, currently $2,000 or $638.40 for concession cardholders and families eligible for Family Tax Benefit Part A. Your Medicare Safety Net entitlement begins at the start of each calendar year.
As well as IVF, most ART (Assisted Reproductive Technology) treatments receive some level of Medicare rebate, including IUI (intra-uterine insemination), Frozen Embryo Transfer, and ICSI.
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.
What things are not covered by Medicare?
Your Medicare Safety Net entitlement does not include hospital or day surgery related services, such as egg collection, but your private health fund may cover this cost. It also doesn’t reimburse for items without a Medicare item number, such as testicular biopsy.
The cost of some drugs, as well as cryostorage, will not receive a Medicare rebate.
From 1 July 2015 the Federal Government has made changes to the Pharmaceutical Benefits Scheme (PBS) relating to the way the PBS subsidised fertility medicines are prescribed, dispensed and accessed. This Government change means patients will have to contribute a PBS patient co-payment, for each fertility medicine, of $37.70 or $6.10 if you have a concession card.
This is not a QFG cost, it is a government initiated new co-payment that is associated with all fertility medicines from 1 July 2015. Previously, fertility medicines were classified differently by the Government and as such did not attract the co-payment. Each PBS patient co-payment will count towards your PBS Safety Net record. We estimate, on average, this change will mean an additional $200 for a patient undergoing fertility treatment.
The Government changes mean once you are ready to start treatment your fertility specialist will give you a prescription for the fertility medicines and you will need to collect the medicines from a pharmacy. At Queensland Fertility Group we understand how important the ability to collect your medicines from our clinic is and for your convenience and we have options to facilitate this for you.
Please ask any of our patient support team for more information.
To claim any Medicare rebate, you need a current referral from your GP (valid for 12 months) or specialist gynaecologist/obstetrician (valid for 3 months).
For more information, and to register your details with Medicare, visit www.medicareaustralia.gov.au