Medicare rebate for IVF
To apply for a Medicare rebate, you must have a current referral from a GP or specialist gynaecologist/obstetrician with both your name and your partner’s name (if applicable) and date of birth.
All eligible Australians can access Medicare rebates, and we recommend you contact Medicare to learn more about the process and your eligibility http://www.medicareaustralia.gov.au/online
What is the Medicare Safety Net?
In addition to receiving the standard Medicare fertility treatment rebate, you may also be eligible for the Medicare Safety Net rebate. The scheme provides extra refunds once your out-of-pocket expenses reach a certain amount within a calendar year.
How the Medicare Safety Net Works
The scheme is based on a calendar year and the current threshold as of January 2025 is $2615.50. The Medicare Safety Net applies only to out-of-pocket expenses you incur out of hospital, not inpatient out-of-pocket expenses such as the anaesthetist, hospital and some doctors’ fees.
- An out-of-pocket expense is known as the ‘gap’ between the doctor/clinic fee and the standard Medicare rebate.
- City Fertility fees are classed as out-of-hospital, so they do count towards the Medicare Safety Net.
- Safety Net rebates are ‘capped’ for assisted reproductive technology (ART) services, which means there is a limit on the Medicare Safety Net rebate you receive.
- The Safety Net is not means-tested, and there is no restriction on the number of treatment cycles patients can undergo in a calendar year.
- Threshold limits can vary for Health Care Card and Pension holders.
Individuals are automatically registered on the Safety Net threshold; however, there are benefits in registering as a couple or family (if applicable). For more information please visit http://www.medicareaustralia.gov.au/online
NSW IVF Rebate
Residents of NSW can access the “Affordable IVF Initiative” which offers a $2000 Fertility treatment rebate to reduce the cost of IVF and other assisted reproductive treatments for women in NSW. You can learn more about this rebate here NSW IVF Rebate | City Fertility
PBS Safety Net for Fertility Medications
Those patients eligible for the Pharmaceutical Benefits Scheme (PBS) will pay a co-payment to the pharmacy per prescription. The PBS Safety Net threshold reduces the co-payment rate once reached. You can combine your family’s PBS amounts to reach the Safety Net threshold sooner.
To access the Safety Net arrangements, you need to maintain records of your PBS expenditure on a Prescription Record Form. These forms are available at all pharmacies.
FAQs
Is IVF covered by Medicare?
Yes, there are many costs and several fertility treatments that patients can claim a Medicare rebate on including:
- 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?
An IVF rebate will usually be 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’s considered medically necessary or non-elective. Examples of this include severe endometriosis which may impact future fertility or a cancer diagnosis where chemotherapy may reduce a woman’s eggs.
Is there an age limit for an IVF Medicare rebate?
Generally, there is no age limit, but a patient must be diagnosed as medically infertile to be able to claim an IVF rebate through Medicare. However, in Victoria there is an age cut off of 46 years to access IVF for the first time and your 51st birthday for embryo transfers.
Are there any IVF Medicare rebate eligibility criteria?
Yes, IVF Medicare rebate eligibility is measured against the following criteria:
- You must be deemed medically infertile by your fertility specialist.
- You must have a referral from a GP or specialist gynaecologist/obstetrician.
- Surrogacy treatments are not eligible for a Medicare rebate.
- Services performed must comply with the relevant state and territory laws.
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