First thing you need to make sure is that you are registered for your Medicare Safety Net. This ensures that after your out of pocket expenses in a calander year meet $1,058.70, you start to get 80% of out of pocket costs back.
At MIVF a stimulated cycle costs approximately $2,800 up front (you need to be able to cover this cost until about 2 weeks after your cycle finishes). If you have already reached your safety net, your out of pocket expenses will be approximately $670 after Medicare have applied the safety net. Not covered under this is the cost for Syneral and the admission to hospital for egg pick up, pretty much everything else is covered. The cost for the bed at Freemasons is $700 and this is where your private health insurance kicks in. You should be able to get a item number for that procedure from the accounts department at your clinic. Best thing to do is ring your health insurer and ask if they cover that item number.
You should be able to make an appointment with someone in the accounts department who will be able to run through all the costs with you as each clinic is different and I believe that MIVF is one of the cheaper ones.
This morning I have already registered me and my husband under the Medicare safety net. One ticked. I rang HCF and since I only have basic hospital and pregnancy cover, any reproductive services are not covered. So I may as well have no cover at this point, and I am not going to wait the 12 month waiting period.
When I rang QFG, the lady there said that if I did not have any cover, I would look at being $3295 out-of-pocket. I am not sure though whether that includes any medicare cover. By the way, what is the medicare safety net amount for the calendar year for IVF related procedures.
Anyway, I have made an appointment with the IVF nurse at QFG this coming wednesday. So I hope all goes well.
Another question, how long does the drug preparation take before the doctor can do the egg pickup. And does menstrual cycle play a part in when you commence your medications?
Elaine, The amount QFG told you, you would be OOP, do you know if that includes your bed fees? Your basic hospital cover would cover bed and theatre fees wouldn't it? During our cycle last year the day theatre fee was approx $795 and bed for transfer was listed as $240. Don't know if the prices have changed for the theatre and transfer fees? That could be a nice amount that you don't need upfront if your health insurer pays out for that.
I do have the new prices for a stim cycle, will go find them....
ok, IVF cycle is now $5830. or if you have to do an IVF/ICSI cycle, it is now $6210 This amount is payable upfront. I think you pay it when you pick up your meds to start your cycle. We live quite a distance from QFG, so they said just to make sure that I had paid before we went in for EPU.
They tell you that you have to be able to carry this cost for about a month. They will send you a receipt when you pay, but it will not have the medicare item numbers on it for you to claim from medicare. I think we got our actual receipt with item numbers about 2 weeks after egg pick up. It was another week before we could get to the closest medicare office, and they did the refund by bank transfer which only took a couple of days.
The amount they told you, you would be OOP, i think is the amount you will be OOP after medicare reimburses you. Our QFG paperwork said $1845 OOP with Top PHI, and we were a little less because we already had a small amount towards our safety net.
I think the amount they estimate OOP, does not consider the safety net, as everyone could be sitting at different amounts with it, so they assume for everyone that you are starting out with a safety net balance of $0.
When you have your meeting with the nurse next week, make sure you completely understand everything, as it is so overwhelming when they hand you all the paperwork. we had our interview over the phone and our nurse was an absolute gem, she went through every piece of paper in our pack, read it out and explained it all to us. She was fantastic at explaining the costs to us, as it was just so mind blowing to see all these figures! The fees will have some medicare item numbers listed on it, so you can ring your PHI and ask them if they pay out on them or not. I took the piece of paper into our PHI and asked them if they would pay out on those item numbers or not.
Hope I haven't babbled on too much and confused you.
Actually Nic, you've been a real gem! Thanks so much for your help. I can't tell you how much I want next wednesday to come. I am so excited about it. However, I don't know if my husband shares the same enthusiasm. The IVF costs really is alot of money. However, time waits for no man or woman.
By the way, is this your first IVF? I wish you all the best!
My DH was really worried about the cost as well Elaine. I was a clever little chook and applied for an ANZ visa which had 6 months interest free, we saved for 3 months while on Synarel, then whacked the IVF bill on, put what medicare gave us back on it, and then paid the difference with what we had saved.
Was our first IVF cycle in October, and it worked fortunately for us the first time.
Goodluck with everything hope you are announcing a BFP very soon.
Have you checked out the thread for long term TTC and Assisted Conception? There are plenty of people in there going through the same thing and so helpful and understanding.
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