Does Emergency Services Health cover In vitro fertilisation (IVF)?
Yes, but only for the components that involve an admission to hospital as an ‘in-patient’ as well as those services that have a valid medicare item number that are eligible for benefits.
For example, if your surgical procedure of harvesting eggs is carried out in an operating theatre you’ll be admitted as an in-patient to hospital.
In this instance, Emergency Services Health's Gold Hospital cover will provide a benefit toward the theatre fees, hospital accommodation, anaesthetist and treating doctors’ fees.
It is important to be aware that you may need to pay a gap if medical fees are more than the Medicare Benefits Schedule fee. Ask your doctor whether you'll incur any out-of-pocket costs.
Some patients are also admitted as an in-patient for the embryo transfer procedure, if so, the same benefit as described above applies.
Other instances that may be covered
Some pharmaceutical items such as IVF Nasal Sprays and Pessaries may also be partly covered under Emergency Services Health's Rolling Extras cover.
Please get in touch for more information.
So when don’t we cover IVF?
We don’t cover IVF Services which occur outside of a hospital admission (as an ‘out-patient’).
However, they may be claimable on Medicare which will reduce your out-of-pocket costs.
What’s an outpatient?
You’re an outpatient if you receive treatment at a doctor’s office, clinic, or emergency department (without being admitted).
In this context, if you go to a IVF specialist and aren’t admitted to hospital you won’t be covered by Emergency Services Health.
Are there any other costs I should be aware of?
Yes, There may also be additional costs associated with egg transportation, testing and freezing that will need to be covered at your own expense.
To help determine what you will be covered for, we strongly recommend you ask your IVF clinic for a detailed quote of your expected treatment plan, including all medical item numbers.
Providing this quote to Emergency Services Health before undertaking treatment will assist us.
This will helps us to provide advice that is as accurate as possible based on the information provided in regard to what you are covered for and what costs you are likely to incur.