Private health insurance for ivf and fertility treatments

For couples and individuals struggling to conceive, there are fertility treatments such as IVF that can help you get pregnant. Each cycle of IVF may cost several thousands of dollars – and the success rate of each cycle can be as low as 5.2%^, according to recent Australian figures – so it can be an expensive journey because you may need to complete IVF several times.

The good news is that with the right private health insurance you can get covered for a portion of your fertility treatment costs. Here’s everything you need to know about IVF and health insurance:

Key Points

IVF is the most effective form of assisted reproductive technology available right now.
Medicare covers a portion of the cost of IVF treatments, however you’ll be out of pocket for things like hospital stays and anaesthetics.
A single cycle of IVF treatment can cost up to $10,000*.
With a success rate depending on a variety of factors, such as your age, it may take several cycles for IVF treatment to lead to conception – which can be very expensive without private health cover.

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What is IVF?

In vitro fertilisation (IVF) is one of the most common fertility treatments around – alongside other procedures like intrauterine insemination (IUI). IVF helps with fertility for women of various ages, with the ultimate goal of assisting in the conception of a child.

The actual process involves retrieving mature eggs from a female’s ovaries and then fertilising them with sperm in a lab. The fertilised eggs (aka embryos) are transferred into the uterus, with results generally achieved after the three-week mark, or one ‘cycle’ of IVF treatment.

According to the Mayo Clinic, IVF is “the most effective form of assisted reproductive technology”, so it makes sense that so many Australians who are struggling to conceive decide to go down the IVF route.

Couples & individuals decisions around IVF and fertility are not smalls ones. Below we answer some of the important questions around private health can help you with these fertility treatments.

Does private health insurance cover IVF in Australia?

The good news for Australians is that Medicare rebates cover a portion of the costs of IVF, depending on your circumstances. In some cases, this can be up to 75% of the cost, where the Medicare Schedule Fee is charged.

However, a full IVF cycle is very expensive, and can approach $10,000 each time you try*. Given the generally low success rate of a single cycle, your out-of-pocket expenses can quickly add up after several cycles – even accounting for the Medicare rebates.

That’s where private health insurance for couples or individuals can help. Because you’ll need to spend a day in the hospital to undergo the procedure, you will incur costs for hospital expenses and anaesthetics etc. You can find out more about the costs of hospital stays here.

Depending on your level of private health cover (e.g. Gold tier), you may be eligible for part or all of these expenses to be taken care of by your health fund, and Medicare.

What is the success rate of IVF in Australia?

There are a few different factors to consider when assessing the success rate of IVF treatment in Australia. They vary depending on age, whether it is a fresh or frozen embryo when transferred, as well as whether it leads to a clinical pregnancy or a live birth. Here’s the breakdown for fresh embryo transfers (one cycle) that led to successful live births, as of 2019:

Age 18–34: 38.8%
Age 35–38: 32.2%
Age 39–42: 13.1%
Age 43 and over: 5.2%

For frozen embryo transfers, the success rate drops for younger age groups (33.0% for 18–34) but rises significantly for those aged 43 and over (18.4%).

How much does private IVF treatment cost?

As of 1 July 2021, various fertility procedures cost*:

IVF cycle: $9,974.
ICSI cycle: $10,754.
Frozen embryo transfer (FET): $3,797.
Intrauterine insemination (IUI): $2,611.
Ovulation induction (OI): $700.

How much does Medicare cover for IVF?

According to the latest figures from IVF Australia, Medicare will cover a portion of your IVF treatments and this amount varies, depending on whether your ‘safety net’ is reached or not.

For example, as of 1 July 2021, a typical IVF cycle cost $9,974. Without private health insurance, your out-of-pocket expenses for the first cycle in the calendar year would be $5,021 if the safety net is not reached, and $4,456 if the safety net is reached.

There are also additional services like embryo freezing ($600 for up to six months in storage) and sperm freezing ($450 for up to six months in storage) which are not covered under a Medicare rebate.

What waiting periods apply to IVF?

Not all health funds cover IVF treatments, so it’s important that you compare private health insurance to find the right provider for your fertility needs.

For health funds that do cover these procedures, you'll generally need to wait out a 12-month period before you can access benefits related to IVF. Our guide to health fund waiting periods is found here.

How do I find the best health insurance for my situation?

Because the costs of fertility treatment are so high and the success rate can vary depending on your age and other circumstances, you’ll want to ensure your private health insurance offers adequate coverage for your individual needs.

Take the time to compare health policies, as some will be more cost-effective than others. Also make sure you choose the right tier (Gold, Silver, Bronze and Basic).

The higher your tier, the more likely it is your policy will cover IVF treatments. Make sure you read the policy carefully, so you’re aware of any hidden costs or out-of-pocket expenses that may affect you.

At Compare Club, our experts will do all this legwork for you. They’ll compare a variety of policies from private health fund partners to find one that matches your fertility treatment needs#.

Looking for a health insurance provider that covers IVF or other fertility treatments? Get started today by comparing health insurance policies with Compare Club#.