I'm just so confused abouts private health rebates for IVF - HELP

Hi Ladies,

My partner and I are at the beginning of our IVF journey. I was on the phone to my private health insurer today to ask what I thought was a simple(ish) question.

With my level of cover, what am I entitled to claim back when I pass the 12 month waiting period?

You see, I always thought I had the correct level of cover until I found out last May that I didn't. Needless to say I upgraded however I haven't hit my 12 month waiting period.

We really want to start IVF treatment, but I want to know if the private health rebates are substantial enough to put this off until June or if the rebates are minor. My understanding is the bulk of the rebates come from Medicare safety net.

I know each policy with each company are different, but are you able to share your experiences on how much you actually got back from your insurers??

My assumptions could be very wrong by the way,,,, so please feel free to correct any porkies I may have told :)

Thanks so much ladies, I'd love to hear from you. Thanks a billion....

I didn't have cover for reproductive services. All that this meant was that I wasn't fully covered for the anaesthetist and hospital for EPU. I still had some, but I wasn't completely covered. It didn't really make much difference in the overall cost of the cycle, though. The only time I got bitten was when I was admitted to a private hospital for a week to recover from a nasty bout of OHSS. My doctor had tried to admit me for "ovarian disfunction" but as soon as my papers were changed to "OHSS" my health fund decided not to cover us there fully either. But those parts we were later able to claim as tax deductions.

Even if I were to go through it all again, I would probably do it the same way.

BW

Hi Kimmi,

The best thing to do is to call you IVF clinic for clarity and then check with yoru health fund if they have a gap agreement with yoru clinic, if not switch to another health fund (They will recognize any waiting time that you've already had)

As BW says the only time when you need private health care rebates is for EPU = Egg collection and ET= Embryo transfer, with my clinic these procedures cost $800 for EPU and $600 for ET, all other costs are outpatient costs so not covered by hospital insurance. Extras private health cover is useful if you want to do acupuncture and for any medication you might have to buy if you don't get them from your clinic.

Also when I had my first cycle I only didn't get anything of these costs back even though I had full health cover, first of all I had a $500 excess so that was deducted from the benefit and then my health fund did not have a gap agreement with the clinic so they only rebated a small part of the costs which was eaten up by the excess.

If you make an appointment with the clinic now you porbably have a waiting time for the doctor's appointment, then there may be some investigations which can take some weeks you may need to go on the pill for four weeks and then cycle takes three weeks, so depending on the waiting time for the doctor's appointment if you make an appointment now, EPU may not even be before May anyway.

Hope this helps,

Sara

Thanks ladies.... We have our first appt at the IVF clinic the week after next, so being fairly uninformed about the cost -vs- rebate issue, im really confused.

I will have to call my health insurance and see if the have the Gap coverage 'thingy'

Hi Kimmi,
This is a really confusing area - so good luck. We had basic extras and standard hospital cover - this did not really cover any of the IVF, with the exception of the hospital costs at the hospital when I had the egg collection - so basically the anaesthetist. What I did not realise at the time was in addition to the medicare safety net there is another tax rebate/offset if you reach another out of pocket limit for health costs that you claim when you do your tax. The details will be on the Aust Tax Office website, but basically keep all recepits for any medical expences you incurr for anyone in your family (so you and your partner) including geting pharmacy receipts for meds (need to ask the pharmasist for these, as they are not just the register receipts) - other ones are receipts for prescription glasses. Then at the end of the year if you are registered with medicare online, you can print of a medicare tax statement, and take that along with your receipts to your friendly tax agent and tell him/her to earn their money!

Good luck with it all.
FG

Hi,
When i looked into private health for our IVF/PGD we were told to get any use from it for IVF i'd need the top level of cover, which cost more in the long run than paying for the bed. Medibank actually said it would be a waist of our money to join just for the IVF.
But like the other ladies said its different for each company and person, i didnt have the added cost of an anaesthetist as Sydney IVF do the egg collections awake.
Good luck!