For many couples who are having difficulty conceiving, fertility assistance through a specialised clinic becomes their only chance of having a baby. This is rarely a simple option and for some, the cost can make this an unrealistic choice. Currently in Australia, In Vitro Fertilisation (IVF) treatment is only available in the private health system and is not offered in free, public hospitals.
Although the drive to have a baby can be almost overwhelming, if you are considering using IVF to help with conception it is very important that you do careful research first. No fertility program or clinic can offer a 100% guarantee of success.
What’s IVF Going to Cost Me?
Like many other medical procedures and treatments, the cost of having IVF varies considerably between practitioners and individual centres. There is no one consistent fee between every fertility clinic in Australia, with each setting their own fee structure for services provided. However, Medicare sets very clear guidelines on the amounts which can be claimed back to patients and the percentage of fees for which Medicare will provide a financial rebate.
If you are considering having IVF treatments, it would be wise for you to organize your health insurance cover first and to ensure this covers fertility assistance as well as other services. Pathology, radiology, hospital and ancillary cover is also important so that you are not faced with a large unexpected bill for services you cannot claim at the end of your treatment. In addition, ensure that childbirth is covered in your health insurance. After all, the whole point of embarking on IVF is to have your own baby at the end of it all.
It is also important to ensure you are registered with Medicare Australia and fit the criteria for eligibility to hold a Medicare Card.
Where Can I Find Out How Much it will Cost?
In the interests of transparency, fertility clinics need to state their fees for services very early in the consultation process. Some provide written quotes if the treatment plan is clear, but this isn’t always the case.
Although most clinics have very well designed and comprehensive internet sites, cost explanations are frequently prefaced by very positive statements regarding the quality of the services they provide as well as their conception success rate. The information can also be confusing, especially to parents who may not understand all of the medical technology or treatment descriptions.
Most practices have nurse coordinators and reception staff who are experts in explaining how different treatment components are charged and what percentage of rebates apply. Most clinics have payment/fee structures which match specific times in the treatment program. For example, pre-payments before the cycles begin, at the time of collecting medication to stimulate ovarian follicles and when the embryo is transferred.
Most couples tend not to do individual research into fertility clinics unless they are particularly interested or they are aiming to minimise cost as much as possible. There is some financial competition amongst different clinics, so satisfy yourself that you are getting good value for money.
Generally, a couple’s GP will refer them to a particular fertility clinic which the GP practice has had prior dealings with. Remember, you need to be an active participant in your own care, so don’t be afraid to request a referral to a clinic which you may prefer and which may better suit your individual budget.
Medicare rebates cover a portion of the cost of each treatment cycle by estimating a percentage of the fee which is to be paid back. This is normally 75% of the standard fee charge. However, most doctors don’t charge the standard fee and the gap between what is charged and what patients can claim is frequently very large.
There were changes to the Medicare Safety net early in 2010 which now means that couples are entitled to an additional refund of up to 80% of out of pocket fees for those items/treatments which were conducted out of hospital and have a Medicare item number. This amount varies between individuals and the extent of their treatment. Check www.medicareaustralia.gov.au or ring 132 011 for more specific information.
For couples who require many rounds/cycles of IVF, this change in funding structure has eased a lot of potential financial burden. The Australian Government Department of Health and Aging is also a major player in the decision making around funding rebates for assisted reproductive technologies. For more information check their “web-site”: www.mbsonline.gov.au/internet/mbsonline/publishing.nsf/Content/News-20091224-Assisted-Reproductive-Technologies
How Many Times Can I Claim?
There is no limit to the number of cycles which can be claimed through Medicare. Likewise, there is no means test applicable to qualify for Medicare rebates. All IVF and Artificial Fertility Treatments are eligible for some percentage of financial rebates.
Each treatment cycle can be different and involve different processes. So avoid budgeting too specifically and not allowing for some variation between cycles. Final out of pocket costs add up and the Medicare Safety Net Rebate only applies once the safety net threshold has been reached.
Why is it so Expensive?
Most fertility clinics provide a range of services, which are ultimately designed to assist in successful conception. These are unique and require significant expertise with medical, nursing, scientific and pathology staff as well as equipment.
Understandably, not all couples will require the full suite of services offered, or need to pay for services their individual situation does not warrant. Typical services are:
Intrauterine Insemination with either the partner’s sperm or donor sperm
In Vitro Fertilisation
Intra Cytoplasmic Sperm Injection also referred to as ICSI
Hatching of Embryos
Culture of Blastocyst
Storage of frozen embryos and then transfer
Storage of semen. Freezing of sperm tissue
Biopsy of Embryo and diagnosis of genetic conditions
Surgical treatment for gynaecological conditions which are impacting on fertility
N.B. The following chart is only an approximate indication of cost. Each fertility clinic outlines their own fee structure and these can vary significantly. Ask for brochures, pamphlets and hard copies of information to take away from your initial consultation. It can be very difficult to remember specific costing without some reminders.
1st Consultation From $180-$250 May cost more if additional testing is necessary Up Front payment is necessary Semen Analysis and testing will incur additional costs
Subsequent Consultation Around $90-$170 dependent on tests which are required
Up Front payment is necessary
A counselling appointment and fee may be necessary
Day 7 of treatment Approximately $7,000
Drug Therapy Approximately $2,000 Advance Payment may be necessary
Additional Drugs Approximately $1,000
Fee on Day of Trigger Approximately $3,200
TOTAL Around $10,000
Intra Cytoplasmic Sperm Injection
What’s covered in Fees?
This depends on the individual clinic but generally, the main costing areas in IVF treatment are:
Treatment Cycle Fee: This is eligible for Medicare rebates and generally includes specialist fees, (some) blood tests and pathology, ultrasounds and standard medications.
Medication Costs: There are generally additional costs for medications which become a necessary part of treatment. The cost for these is not covered by Medicare but may qualify for a portion of refund through private health insurance.
What’s not covered in Fees?
The cost of some drugs
Initial investigations, GP consultation and referral and preliminary consultations with fertility clinic staff and specialist.
Pre-screening blood investigations and ultrasound
Day surgery and anaesthetist fees. Surgery fees are covered by most private health insurance companies; however, there is no Medicare rebate for private hospital or day surgery procedures. Anaesthetist fees can only attract a rebate from Medicare.
Some of the more specialized procedures e.g. surgical sperm collection, assisted hatching,
Embryo and semen storage are not routinely included in fees and will attract extra funding.
Day Surgery is necessary for collection of eggs and embryo transfer. Some hospitals and health insurance companies have arrangements between themselves where excess to kept to a minimum.
Points to Remember
Before you embark on any fertility treatment, speak with your private health insurance fund about your individual cover. Don’t assume you are insured for extras.
If you don’t have private health insurance cover, either join, or start saving. The costs can really add up.
Do your research into what services different clinics provide, what’s included in their standard charges and what’s separate.
Keep all your receipts and paperwork. Don’t forget you may be able to claim on out of pocket expenses through the Medicare Safety Net Scheme.
Speak with your friends or others who have undergone fertility treatments. Often the best source of support and insight comes from those who’ve had firsthand experience.