Medicare Rebate for IVF

Medicare rebate. Baby holding their mums hand.Currently, Medicare rebates for fertility treatments are only available if a medical cause of infertility is diagnosed. Surrogacy treatments do not qualify.

If diagnosed with medical infertility, you can claim Medicare rebates for most fertility treatments. A current referral from a GP or specialist gynaecologist/obstetrician is required, including your name, your partner’s name (if applicable), and your date of birth.

For more information on eligibility and the process, visit Medicare Australia.

 

What is the Medicare Safety Net?

In addition to the standard Medicare rebate for fertility treatments, you may also qualify for the Medicare Safety Net rebate. This scheme provides additional reimbursements once your out-of-pocket costs exceed a certain threshold within a calendar year.

 

How does the Medicare Safety Net work?

Out-of-pocket expenses refer to the “gap” between the doctor/clinic fee and the standard Medicare rebate. Rainbow Fertility fees are classified as out-of-hospital, meaning they count towards the Medicare Safety Net. This rebate is not means-tested, and there is no limit on the number of treatment cycles covered within a calendar year.

Individuals are automatically registered for the Safety Net, but registering as a couple or family may offer additional benefits. To check your registration status or learn more, visit Medicare Online Services or your nearest Medicare office.

 

Medicare Online

Medicare Online is available at Rainbow Fertility. This is a secure and convenient way for patients to claim their rebate without having to visit a Medicare office. Please contact your nearest Medicare office or go online at Medicare Online Services to register your bank account details.

 

NSW Rebate

NSW residents can access the Affordable IVF Initiative, which provides a $2,000 rebate to help reduce the cost of IVF and other assisted reproductive treatments. To learn more, visit our NSW Rebate page.

 

PBS Safety Net for Fertility Medications

Patients eligible for the Pharmaceutical Benefits Scheme (PBS) pay a co-payment per prescription. Once the PBS Safety Net threshold is reached, the co-payment rate is reduced. Families can combine their PBS amounts to reach the threshold sooner.

To access Safety Net benefits, keep records of your PBS expenditure on a Prescription Record Form, available at all pharmacies.

 

FAQs

Is IVF covered by Medicare?

Currently, Medicare rebates for fertility treatments are only available if a medical cause of infertility is diagnosed. Unfortunately, surrogacy treatments do not qualify for Medicare rebates.

For LGBTQ+ individuals and couples, this means Medicare coverage may not apply unless a diagnosed medical condition affects fertility. We recommend speaking with a fertility specialist to explore your options and eligibility.

If you do receive a medical diagnosis of infertility, you can claim a Medicare rebate on:

  • your fertility specialist consultations
  • your IUI, IVF and ICSI treatment cycle
  • your FET (Frozen Embryo Transfer)
  • medical egg freezing

How long does a Medicare rebate take?

Medicare rebates for IVF are typically deposited into your nominated bank account within three to five days of lodgement.

Is there a Medicare rebate for egg freezing??

Egg freezing is only eligible for a Medicare rebate if it is deemed medically necessary. This includes conditions such as severe endometriosis, which may affect future fertility, or a cancer diagnosis, where treatment like chemotherapy could impact egg reserves.

Is there an age limit for an IVF Medicare rebate?

There is generally no age limit for claiming an IVF rebate through Medicare, but a patient must be diagnosed as medically infertile.

In Victoria, specific age restrictions apply:

  • Under 46 years of age to access IVF for the first time
  • Before your 51st birthday for embryo transfers.

Are there any IVF Medicare rebate eligibility criteria?

Yes, to be eligible for an IVF Medicare rebate, you must meet the following criteria:

  • Be diagnosed as medically infertile by a fertility specialist
  • Have a valid referral from a GP or specialist gynaecologist/obstetrician
  • Surrogacy treatments are not covered under Medicare rebates
  • All treatments must comply with state and territory regulations

 

 

 

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