Australians continue to have access to highly specialised fertility treatments, thanks to support from the Federal Government and the Australian community. The majority of fertility treatment costs are covered by Medicare, and if you have private health insurance your costs may be further reduced.
The Medicare Benefits Schedule (MBS) provides a rebate for out-of-pocket costs for out-of-hospital services (including GP and specialist attendances). The Extended Medicare Safety Net (EMSN) provides an additional rebate for those whose costs go over an annual threshold.
The EMSN provides a capped rebate for IVF-related treatment once an annual threshold has been reached. Your Medicare Safety Net entitlement begins at the start of each calendar year, and once you’ve reached the threshold, Medicare will rebate a proportion of your upfront payment for most medical services where you were not admitted to a hospital.
The Government announced as part of the 2013-14 Budget that the Extended Medicare Safety Net (EMSN) threshold will change from January, meaning you will need to spend more on out-of-pocket medical expenses to reach and become eligible for the additional Medicare benefit. From 1 January 2015, the EMSN threshold will be increased from the current amount of $1,248.70 for singles and families to $2,000.
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. 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.
Please call 1800 111 483 and have a chat with our team, we can explain the treatment fees rebates and what you can expect will be your final out of pocket costs.
What’s not included
The Medicare Safety Net entitlement does not include hospital/day surgery related services, such as egg collection and/or embryo transfer – and it doesn’t reimburse for items without a Medicare item number, such as fertility preservation for social reasons.
The cost of some drugs, cycle monitoring outside of our clinics, and cryostorage does not receive a Medicare rebate. This is also true for day hospital procedures – although you may be able to claim the cost of the anaesthetist from Medicare or your private health fund.
To claim the Medicare rebate, you need a current referral from your GP (valid for 12 months) or specialist gynaecologist/obstetrician (valid for 3 months).
Medicare Electronic Claiming
IVFAustralia will take you through the process of setting up Medicare Electronic Claiming, which is the fastest and easiest way to claim your treatment cycle rebate. We will lodge your claim within 48 – 72 hours after your embryo transfer, and your Medicare rebate will be paid into your nominated bank account within 3-5 days of your claim being lodged. This saves you time, and ensures you get the rebate as quickly as possible.
If you don’t want to register your bank details with Medicare, but would like to take part in Medicare Electronic Claiming, we will lodge your claim on your behalf and you’ll receive a cheque at the postal address you have registered with Medicare. This can take up to 14 working days.
We will continue to send you an itemised invoice and if you have not registered for Medicare Electronic Claiming, you will need to take this to a Medicare office to claim your rebate.
For more information, and to register for online claiming, visit Medicare...
If you want to know more about the Medicare Rebate please call 1800 111 483 or email us.