Capping Medicare Saftey Net for IVF/ART

[Lenny]

Are they over charging us all though Sara? I'm not sure. I guess time will tell if the costs come down at all.
FWIW my experience in NZ is that it cost us a lot more per cycle than it cost us here (if you are funding it yourself or you can go on a public funded wait list).

[Sara69]

I am not sure Lenny, I am just referring to some extracts of the Age article

"Since the advent of the safety net, fees have leapt by 290% for IVF and 40% for obstetrics - giving rise to claims that the system is being rorted."
(...)
"Between 2003 and 2008, the average fee charged for planning and management of an artifical reproductive treatment cycle increased from $294 to $1148. The average obstetrics fee for planning and management of a pregnancy rose 40 per cent between September 2004 and 2008 - from $1238 to $1732. Specialists' incomes in these areas have soared. In 2008, the highest 10 per cent of IVF specialists were paid $4.5 million each through Medicare - including $2.2 million through the safety net."

You never know how much of this is true and how much is manipulated in a way to influence public opinion.

I remember that the first time I looked into PGD for my condition which was about 2002 I was told I would be bulk billed - my last cycle was charged at about $12,000 plus 8*$76 for Orgalutran. Out-of-pocket was about $4000.

I am aware that my friend in America paid way more than we are here....

Sara

[Muppity]

Muppity did you get a sense of whether they will also be limiting the number of times you can claim the increased Medicare rebate, as opposed to a limit on the Safety net?

Current feeling seems to be no limiting the number of times you can visit - just limiting the amount that they will pay above and beyond the the scheduled fee.

[Lenny]

You never know how much of this is true and how much is manipulated in a way to influence public opinion.

Yes, you are so so right.
I noticed that on the 9 news they nicely hid the 'IVF & Obs fee' issue, with a 'oh my goodness, beer and ciggies might be going up'.

[Sara69]

Holding my breath and practicing deep breathing at the same time - all will be revealed tomorrow....

[buliej]

Finally found something on this:
IVF funding hit, nurses get more power - this says:

From January 1, 2010, once a patient reaches the safety net threshold of $1,111.60 in out-of-pocket medical fees, or $555.70 for those on low incomes, safety net payments will be capped at:

- $200 for the planning and management of a pregnancy, including being booked into a hospital for delivery

- $30 for a pregnancy consultation, including blood, urine and weight checks

- $550 for the planning and management of an IVF pregnancy

I think this means that once you hit the safety net (i.e., ONE cycle - don't we all hit it after ONE) the most you can get back is what? I can't figure this part out...$550? it's not an ivf pregnancy until the pregnancy happens unless they take the PUPO approach (that is meant to be funny)...and is it $550 per ivf cycle post safety net? This may mean 1 cycle PER YEAR for people - that's horrible. I never thought it could be this bad (I hope I'm reading this wrong). The clinics will be so busy before this kicks in!

[JodieC65]

Thanks Julie - I have been trying to find something about the MSN after the Budget also. This is just shocking news - I basically read it as once you reach the Safety Net Threshold of the amounts listed, then you will only get $550 back per IVF Cycle. I don't know about this wording of IVF Pregnancy, that's just plain stupid to me. I just don't know how some people are going to afford more than one cycle per year.

[buliej]

I'm having trouble parsing this through as well...

$200 must have something to do with OB fees...but then there's the $30 cap as well which sounds like dr visits during pregnancy (these must be per visit amounts??? or is the $200 a one time amount per pregnancy?)

I think you are right - the $550 must be per cycle post hitting safety net...it can't mean for the remainder of the year? can it? whatever it is, it's cruel.

[buliej]

here's some more...I think the title of this article says it all: Infertile women lose out in budget - budget-09 - LIVENEWS.com.au (there's not much substance to the article)

[buliej]

here's some more...I think the title of this article says it all: Infertile women lose out in budget - budget-09 - LIVENEWS.com.au (there's not much substance to the article)

[JodieC65]

I know that when I had my DD my OB charged a one off managment and planning fee - so I am guessing that this is what the $200 is for. Then each visit her charge varied between $75 and $150 and was basically a weight and urine analysis session, so all that would be covered now is $30. I was going to say at least I had and still have Private Health Insurance, but that is now going to be means tested under the new Budget.

I also hope that the $550 is per cycle. I am actually sitting here quite gobsmacked as is my DH when I explained it all to him.

[buliej]

I really hope that this gets blocked by Parliament (is this possible?). Yes, we still have private health insurance but without any rebate. I'd be OK foregoing the rebate if the ivf safety net payments remained the same - but how much can you take from 1 couple without giving anything in return?

I laughed when Swan said this budget was about taking care of hard working families. DH & I are very hard working and they certainly did not take care of us.

[Sara69]

Godd one Wayne - that means for me instead of $4000 out-of-ocket per cycle now $8000, interesting - Will have to see how many cycle I can do until January 1.

Sorry Girls, but it really makes me angry - $550 is a joke when one cycle costs $12,000 - the only really good thing about it is that it will only come into effect on Jan 1 which is now the deadline for the end of my IVF journey. In theory this can get blocked by parliament but I don't have much hope.

Sara

[Hollybolly]

Will have to see how many cycle I can do until January 1.

Whats scary is that this is going to be a large percentage of us in this country... and so now will come the waiting lists, the people opting for what clinics/FS they can afford (if you can say afford at all ) and not their own clinics/FS out of choice....

I appreciate that the FS' and clinics could do their part & drop prices... but honestly, what are the chances of that happening?

From what I can gather, the 'wording' of $550 to 'plan & manage IVF pregnancies' will include the consults/testing AND the actual cycle - a consult with your FS BEFORE the cycle & to pick up drugs can cost approx $150... so there's a large chunk of it there before you even pay for the actual cycle....

Its a devastating blow.... and much worse than I thought - I honestly was expecting for them to perhaps cap the 80% at 1-2 cycles per year & then drop it to a lesser amount... we're not even getting the opportunity for 1 cycle at an affordable rate

Its devastating.... we can only keep writing & then hope that we have the support to try & get it blocked or at least challenged through parliament......

[dusty]

I am wondering if they mean limiting the planning fee for IVF which is one of the IVF line items that has blown out over time. THis may not mean limiting the actual cost of the cycle though.
I don't have any other info at this stage and am hanging on a thin hope.

[dusty]

Media RElease from Health Department
Department of Health & Ageing - A Sustainable Medicare Safety Net

Its still not clear what the limit is though

[OriginalP]

KK - well, I don't think anybody should keep paying an FS who's not producing results or listening to their patient. If you scroll back through old threads you'll probably come across some rants from me about men and making babies - like their know our bodies better than we do LOL!!! And now with the Government planning to cap IVF and Obstetrics, we all need to preserve the limited opporutnity we've got.

I'll do some research today to see exactly what the cap means. I may raise hell about it as whatever it is, I'm sure it's discriminatory to women and therefore unconstituional. I believe the Government can only get away with it if there is some balancing cap on treatment for men...

OP.

[Bengal]

It will interesting to see if the rate of back to back cycle's increases by Jan 10. This is very hard on us, imagine the young girls that will need IVF in the future.

If it is $550.00 per cycle, would that mean about 66 % is covered by safety net, per cycle ?

Im lost, are they not paying the medicare component of a cycle either ?

So MIVF charges $4400.00 upfront to me, out of pocket atm is $858.36 (without pgd) and then they charge medicare direct another fee (who knows what that is) are they scrapping that, so we need to pay that, hence Sara's post of her cycle costs doubling ... ?