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Trying for a Baby? Compare Health Cover for Fertility Treatment

January 11th, 2012 0 comments
Fertility treatment and health insurance

For couples who are looking to conceive and are having trouble, fertility consultations and treatments may be a necessity that has ramifications both financially and emotionally. Having limited assets can restrict a couple’s dreams of raising a family, and many would-be parents would happily part with much of their hard-earned money to turn their hopes into reality.

Medicare for Infertility Treatment

Fortunately, in Australia, much of the cost of treatments for infertility is covered by Medicare. Not all treatments are covered, and not all of the cost is covered, but Medicare takes care of a large amount of the total cost, opening up a world of opportunity for couples who may otherwise not be able to afford fertility treatments.

Image by gniliep

The two main treatment efforts covered by Medicare are IVF, or in vitro fertilization, and IUI, or intra-uterine insemination. Both of these treatments are invasive procedures that require specialized tasks combined with effective timing and expert, professional staff, pushing the cost up quite high. A typical IVF treatment runs over $7,000, with almost $5,000 covered by Medicare Australia through a post-treatment payment rebate.

The issue is how to pay the remaining balance, $2,000 or more, that Medicare doesn’t cover. Many couples might be able to afford one cycle of treatment, or even two, but for families on a budget, this would require scraping together the necessary funds, and if the initial treatments are not successful, they may not be able to continue financing the endeavor.

This is where it becomes useful to compare health insurance options. Beyond Medicare, what sort of private health insurance is there for couples who are interested in fertility treatment coverage?

Private Health Funds and Infertility Treatment

Private health fund coverage may be a good option for many couples seeking fertility or infertility treatments. Most private health funds offer treatment coverage for fertility treatments, even below their top tier plans, at a saving to customers compared to the actual cost of the treatments.

Evaluate each plan and see what companies offer assisted reproduction services through their medium coverage plans. If these plans don’t seem sufficient for your needs, you may be able to get the coverage and services you desire through a comprehensive health insurance plan. So the first factor to check into is what level plan you would need to register for to get the treatments you need at a fair value, once you’ve claimed your Medicare rebate.

What to Look For

If you are currently registered for a private health insurance plan, make sure to check whether the treatments you want to try are covered under your current arrangement. If you find out that they aren’t, it may be fairly simple and inexpensive to fix this by extending your coverage, rather than paying out of pocket for those treatments.

Next, find out about waiting periods for private health insurance cover. There may be one you need to serve before going for treatments, and if you get treatments before the waiting period is up, you may not be covered.

Even if you have a health insurance plan that covers your treatments, you may still be obliged to pay an excess, according to your arrangement with your health fund. Sometimes patients have the option of choosing between a higher premium with a lower excess, or a lower premium with a higher excess, so be sure to find out all of your options from the private health fund representative and choose the structure that works best for your finances.

Finally, find out exactly what parts of the procedure are or are not covered by the plan. Some of the elements that may be relevant to your specific treatment may be:

  • Actual procedural cost
  • Ultrasounds
  • Laboratory fees
  • Hospital bed fee
  • Specialist fee
  • Theatre fee
  • Anaesthetist fee
  • Medications
  • Nurse fees
  • Counselling

These may be completely or only partially covered by your plan. The decision to compare health insurance plans before you go for treatment can help you plan financially to meet your goals and make your dreams come true as well as help you save money in the long run.

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