What costs are involved in assisted reproductive services and how much will my health fund cover?

When you're considering starting or growing your family with the assistance of reproductive technology like In Vitro Fertilisation (IVF), Gammete Intrafallopian Tube Transfer (GIFT) or Intracytoplasmic Sperm Injection (ICSI), you need to know what costs are involved, and how much you can claim from Medicare or your health fund.

Every assisted reproductive treatment is individualised, and depending on the steps involved, the costs will vary. There are several steps involved in assisted reproductive treatment, and the type of treatment you receive at each step determines whether you can receive financial assistance. Medicare will cover some portion of the fees sometimes, and your health fund will cover your costs at others,but there will also be times when neither will cover your costs, and you will be required to pay them yourself.

As a general guide, the the costs involved in assisted reproductive treatment include:

Consultations for your treatment cycle

This is when you begin your treatment cycle with an assisted reproductive specialist, including blood tests, pathology, ultrasounds, medications and counselling. The costs of this step in treatment is not covered by your health fund as you are not required to be admitted to hospital to undertake these procedures, but Medicare does help cover some of these costs.

If your clinic requires up-front payment, you will need to pay first, then claim a rebate from Medicare. By registering your bank details with Medicare, you will receive your rebate faster, within 3-5 days of receiving treatment. If your clinic does not require up-front payment, you may request Medicare to make a cheque out in your doctor's name, which you can pay along with any outstanding balance (but be aware that this option is not available at all clinics).

Please keep in mind:

• You must have a current referral in order to claim the Medicare rebate (a GP referral is valid for 12 months, and a specialist gynaecologist/obstetrician referral is valid for 3 months).
• Couples need to register for the Medicare Safety Net (read about the Medicare Safety Net on the Medicare website).

According to our research, average out-of-pocket costs after Medicare rebates for this treatment appear to range between $10,000-$15,000.

Medication costs

IVF treatments require medications such as Lucrin, Provera and progesterone pessaries amongst others, but these costs are not covered by Medicare or your health fund, and will need to be paid from your own pocket. Ask your doctor or clinic for information regarding costs of medication.

According to our research, medication can cost up to around $500.

Day surgery fees

When it comes to collecting eggs and transferring embryos, you will need to be admitted to day surgery. This is the part of assisted reproductive treatment that your health fund will cover your costs for. Keep in mind that to be covered for assisted reproductive features, you must:

• have a health insurance policy that includes assisted reproductive services;
• have served any waiting periods under the terms of your health cover (usually 12 months).

If you have an excess or co-payment as part of your hospital cover, you will need to pay it unless your health fund waives the excess for day surgery.

If you do not have private health insurance, the cost of day surgery will vary. Depending on your private hospital and the anaesthetist involved, it may cost up to around $1,750. There is no Medicare rebate for day surgery procedures.

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This information is correct as at September 2010, and is provided as a guide only. moneytime strongly encourages you to check with Medicare, your doctor(s) and your health fund before you undertake any procedure, to receive the most correct and up-to-date information.