Health Insurance For IVF

Compare health insurance policies which offer cover for IVF treatment through Savvy today. 

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, updated on July 6th, 2023       

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Research has revealed that in 2021, more than one in 18 babies born in Australia were conceived with the help of IVF. For women aged over 35, this figure increases to more than one in ten being the result of assisted fertility treatments. If you need this expensive treatment, it can be crucial to have adequate private health insurance to help cover some of the costs.  

You can compare private health insurance policies which offer top cover for fertility treatments through Savvy. You’ll be able to get free, no-obligation quotes from a panel of Australia’s leading health insurers and consider them side-by-side to help you make an informed choice about which offers the best value private health insurance for you. Compare the cost of increasing your health cover or swapping health funds in one place through Savvy today. 

What is health insurance for IVF treatment?

Health insurance for IVF treatment can assist couples with the high cost of getting medical assistance to have a baby. However, it isn’t a simple area to cover with health insurance, as it may involve a range of treatments which fall under different types of cover.  

IVF treatment can take place in several settings, including:  

  • a public or private hospital 
  • a day surgery unit 
  • a doctor’s clinic 
  • an outpatient fertility clinic 

What is IVF? 

In vitro fertilisation (IVF) treatment involves the collection and fertilisation of an egg outside of the body to create an embryo. This embryo is then transferred back into the female uterus to grow to maturity through the pregnancy process. IVF can either be used as a treatment for infertility, or as a way to reduce the transmission of genetic or chromosomal disorders.  

With so many different steps involved in IVF treatment, the process can be very expensive, often costing thousands of dollars per cycle. Many couples have to go through numerous cycles before they successfully conceive and have a baby.  

Because IVF treatment cover is so expensive, it's only offered by a limited number of health insurers. It's necessary to buy the top level of hospital cover available to have coverage for IVF treatments. However, even if you pay for the best health insurance cover on a gold hospital policy, you should still expect to pay out-of-pocket costs when you have IVF treatment.  

What aspects of IVF treatment can be covered by private health insurance?

The following elements of IVF treatment can be covered under a hospital cover private health insurance policy: 

  1. only procedures performed while you're an in-patient will be included under your hospital cover 
  2. only procedures which have a Medicare item number will be partially or wholly covered by your insurance 
  3. these may include the cost of hospital accommodation and theatre fees associated with egg collection and the embryo transfer process 
  4. your hospital cover health insurance may also assist with the fees charged by your anaesthetist and fertility specialist doctor when you're an in-patient in a day-surgery unit or fertility clinic. Medicare may cover some of the cost of medical fees, but you may have to pay the gap 

What aspects of IVF treatment won’t be covered by my hospital cover insurance? 

  1. consultations at your fertility clinic and with your specialist doctor and GP 
  2. scans, ultrasounds and other tests which may be performed when you’re an outpatient 
  3. diagnostic procedures and tests to find out the cause of the infertility 
  4. pathology services including blood and semen tests 
  5. costs involved in egg transportation, testing, freezing and storage 
  6. IVF drugs used for hormone stimulation which aren’t covered by Medicare 

What may be covered during my IVF treatment by an extras cover policy? 

An extras policy may assist with the cost of some medications which are required by the IVF process, such as hormone treatment to stimulate ovulation. If these required medications aren’t listed on the Pharmaceutical Benefits Scheme, your extras policy may assist you with the cost of paying for these medications and prescriptions. 

An extras policy may also assist you with the cost of mental health counselling to help you and your partner manage the stress that can be involved with IVF treatment.  

Is IVF covered by Medicare?

Some procedures associated with IVF and other fertility treatments can be partially covered by Medicare. If you exceed the Medicare Safety Net Threshold during any financial year, the amount that Medicare will assist you will increase. Procedures which attract a Medicare subsidy include:  

  • the collection of eggs 
  • the transfer of embryos 
  • the freezing and storing of embryos 

However, the extent to which these processes may be covered by Medicare will vary according to where you live, where the procedures are performed (whether as an in-patient or out-patient) and the type of treatment you require. 

It's worth noting that some state governments are now offering financial assistance to those seeking IVF treatment. For example, as of October 2022, residents of NSW who have paid for fertility treatment can apply for a $2,000 rebate as a one-off assistance with the cost. 

How much will IVF treatment cost?

According to one leading IVF clinic based in NSW, you should expect to pay at least $10,500 for an IVF cycle (as of March 2023). How much of this cost you can claim on your private health insurance will depend on the health cover you decide to buy. 

Indicative costs of IVF*:  

Treatment procedure Full payment cost Estimated out-of-pocket cost for initial cycle Estimated out-of-pocket cost for subsequent cycle
First IVF cycle
ICSI cycle
Frozen embryo transfer
Intra-uterine insemination
Ovulation induction
Embryo freeze (6 months)
Sperm freeze (6 months)
Surgical sperm collection
$675 to $850
$675 to $850

Some couples may be successful in their first IVF cycle, while others may require multiple cycles before a successful pregnancy is achieved. 

*Costs correct as of March 2023, but may be subject to change. 

How do I compare health insurance policies which cover IVF treatment?

Some of the aspects to compare when you’re considering the best gold or silver plus hospital cover health insurance policies which include IVF are: 

  • Cost – while you may want the cheapest health insurance policy available, there are many other important considerations to take into account when comparing policies that offer a similar level of cover, such as comparing gold hospital cover policies 
  • Coverage – compare how much you will be able to claim back on the policy for your IVF treatment and which costs it covers 
  • Benefit limits – look at the total amount you can claim back for fertility treatments per year 
  • Waiting periods – you should expect to have a waiting period when you first take out any top-tier hospital cover policy. This can range from one year up to three years, with 12 months being the average waiting period for IVF treatment 
  • Excess – you may be required to pay an excess if you are admitted to hospital. You can often choose the level of excess you pay, ranging from zero to a maximum of $750. Higher excesses will generally lead to cheaper premiums 
  • Co-payments – some top tier gold hospital cover policies may also require you to make a co-payment for each night you spend in hospital 
  • Reset date – most health funds have annual extras benefit limits which reset on a certain date, which is commonly either 1st January or 1st July. You should check your fund’s reset date if you’re considering IVF treatment, as you may be able to claim some costs over more than one financial year  

By comparing different hospital cover policies through Savvy, you may be able to get a clearer idea of which health fund offers the most benefits if you’re undertaking fertility treatment. You can also request a call-back from a health insurance specialist, who may be able to assist you with your choice of health fund to cover your IVF treatment. Start the process through Savvy today.

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Frequently asked questions about health insurance for IVF

What is the Medicare Safety Net?

The Medicare Safety Net is a threshold for the amount you have to pay in out-of-pocket expenses in any one financial year. Once you reach the threshold, you may be entitled to receive 100% of the schedule fee for out of hospital services, including medications.  

If I change health funds, will I have to serve the waiting periods again?

If you increase your level of health cover, say from a silver policy to a gold hospital cover policy, then you may have to serve additional waiting periods for those areas of treatment you have not previously had cover for. However, if you’re swapping policies at the same level – for example from one gold policy to another, then you should not have to re-serve any waiting periods.  

Is there a limit on the gap fees which can be charged for IVF treatment?

No – it’s up to fertility clinics and specialists to set their own charges. There aren’t any government regulations which restrict how much can be charged for fertility treatments. Prices do vary considerably around the country, so it's important to consider which specialist you see or whether it’s worth getting private health insurance which covers IVF treatment.  

What is ICSI when it’s used as part of IVF treatment?

Another common process which is also covered by assisted reproductive treatment (ART) funding is ICSI, which is intracytoplasmic sperm injection. This involves injecting a single sperm into the centre of an egg. This process also involves a series of steps which are carried out over several weeks, just like the traditional IVF process. 

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