Private Health Funds

Private health fund coverage in fertility treatment is limited to any hospitalisation and inpatient services provided, see Fees>Medicare section.  From the Fees>Service Providers and the chart in the Fees introduction section it can be seen that most fertility services are classified as outpatient and are therefore ineligible for any private health insurance refund.

Below are listed the areas of fertility treatment which are commonly covered by private health funds, however this list is not exhaustive and patients are advised to consult their health funds.

IVF

The main area where patients can expect to receive a refund from their private health fund is in an IVF treatment for the egg pickup (oocyte collection) procedure.   Only hospital inpatient services are covered by private health funds.  The sections Fees>Medicare and Fees>Clinic Fees Example provide relevant information relating to inpatient and outpatient services.

Fertility clinic staff are unable to provide information on health fund rebates.  It is necessary for patients to ask their health fund themselves.  It is advisable for patients to know their proposed treatments and the Medicare Item Numbers that apply to these treatments before approaching the health fund.

As with many other services, fertility treatment coverage often involves an ineligibility period before coverage is available.

Laparoscopy

Laparoscopy may be performed to determine the cause of a woman’s infertility.  Laparoscopy is a surgical procedure that involves hospitalisation.  It can be done in a public hospital, however as it is classified as an elective surgery it is of low priority and delays of 1 to 2 years may occur.    It can also be done in most private hospitals usually within a month of seeing the specialist doctor.  Most private health funds will cover laparoscopy but patients should check with their health funds.

Maternity care

If patients want to attend a private maternity hospital and be attended by their doctor they should consider private health cover prior to treatment.  If patients take out private health cover after becoming pregnant coverage may be denied as most health funds have an ineligibility period for maternity care.