Can I Afford Fertility Treatment?
For many of us, it can be daunting to consider the cost of Fertility Treatment. It’s a historically expensive process, and many may feel or assume that they simply cannot afford it. If this resonates, we’re here to help with a complete guide to your options.
At Fertility North, we believe that fertility treatment shouldn’t break the bank. We know that you’ll need to save as much as possible for when you’re little one arrives, so we are proud to maintain some of WA’s most competitive and comprehensive fees, without sacrificing your quality of care.
Firstly, a bit of background information. We are very lucky to have access to Medicare co-funding for fertility services in Australia, and many patients are surprised to see their out-of-pocket doesn’t equate to as much as they’d expect. Medicare cover co-funding for all treatment cycles, except Tracking, ERA/ERPeak Cycles, Pregnancy Monitoring, and some Donor Insemination or Oocyte Retrieval Cycles, depending on your medical history. In addition to this, the Medicare rebate can increase over the calendar year, if you reach the Extended Medicare Safety Net Threshold.
So, what’s the Extended Medicare Safety Net? And what’s the Threshold? The Extended Medicare Safety Net (EMSN) is a scheme where anyone entitled to Medicare is subsequently eligible for elevated Medicare rebates, once they’ve spent the ‘threshold’ amount on out-of-pocket costs. The Threshold varies, depending on your social and familial circumstances:
- $770.30 for Commonwealth concession cardholders, and people who receive Family Tax Benefit (Part A); or
- $2,414.00 for all other singles and families.
These figures are relevant for 2023 but do change per calendar year.
Based on these figures, many patients will hit their EMSN after their first round of IVF. But then what? Well, if you’re pregnant, this will help a lot towards your antenatal care. And if you’re not, you’ll be able to undergo further treatment for the rest of the calendar year, knowing your Medicare rebates will be higher. Your new rebate amount will be paid at either; a). up to 80% of your out-of-pocket cost, or, b). the standard rebate plus the EMSN Benefit Cap, depending on the item number. This all requires a bit of maths, so we’re worked it all out for you, and condensed this information per treatment cycle, into our Fee Structure.
Can I use my Private Health?
The answer is both yes and no. Before explaining that, first we need to talk about Inpatient vs Outpatient. For those who don’t know, Inpatient expenses are classified as quite literally in-hospital medical expenses. This covers services provided while a patient is admitted to hospital (ie. surgery), say for an egg collection, for example. Outpatient expenses are classified as expenses rendered on medical services provided outside of hospital admission. An example of this would be any of the steps for the rest of the treatment cycle.
Private Health cover costs on Inpatient services on Medicare-claimable items only. Because not much is done in-hospital, not much can be claimed with your Private Health, except the egg collection (TVOA), if you’re undergoing IVF/ICSI. If that’s you, rest assured all our surgeons are no-gap providers, so your Private Health will come in handy here.
Its important to note that just having Private Health wont automatically ensure you’re covered for your TVOA. Your policy needs to include Assisted Reproductive Services. Without this, you’ll need to admit as a self-insured private patient (see Page 8 of our Fee Structure – Non-Fertility North Fees).
Finally, we encourage all patients to enquire about costs of Medications with their Private Health. Many will have an amount they can claim included on their policy, so if this is you, please don’t hesitate to ask us for a letter that you can submit to your fund to claim back those costs.
Can I access any payment options?
SuperCare is an Australian-owned company that assists patients to access their superannuation to pay for medical treatment, including fertility services. Once you have a treatment plan from your Specialist, we can put you in touch with SuperCare, who will discuss your eligibility, and begin the Compassionate Release of Super (CRS) application for you. Their in-house GP and Psych will see you to sign off on your paperwork, and then they’ll submit this all to the ATO along with a tailored quote from us. Once your application is lodged, it takes about two weeks to get approved, and your Super will release the funds within the next week or so. As the treating patient, if you don’t have enough in your own Super, you can access from a partner or even selected family members. For more information, please see our Fertility North Landing Page.
Handypay specialise in flexible payment plans for medical treatment, and patients can obtain pre-approval within minutes. Their interest rates are really competitive, and up to two people can apply for a joint loan, which can help you obtain approval. You won’t require a quote from us, and Handypay will release the funds directly to you, to make payment for your accounts. More information can be found on the Handypay Website, or you can submit your information directly to the Enquiry Page.
When and how do I pay?
For most cycle costs, payment is due on your procedural date, which is usually going to fall between the second and third week of your cycle. On the due date, you’ll make payment in full, whether that be via cash, EFTPOS, or bank transfer, and if your treatment is Medicare-claimable, we’ll lodge it on the day. The rebate will come back into your bank account within a couple of days. If you’ve accessed any of the above payment options for treatment, you do not have to submit your rebate back to your Super or pay it against your loan.
If you’ve had an Inpatient procedure, such as an Egg Collection (TVOA), we’ll submit this account directly to your fund, and you’ll have no out-of-pocket expense on our fee.
For more specific information, our Admin team can advise you of costs and due dates tailored to your Treatment Cycle.