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  1. #1
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    Default What is the best private health insurance for IVF?

    Hi ladies Just wondering if you could help me out here? I really have no idea about how private health insurance works, and which ones provide the best cover for IVF.

    My partner and I would like to get PHI, so that when the time comes for us to start the IVF journey, our expenses would be greatly reduced. We have discussed having our first child together, but that probably won't even come into consideration for another 12 months or so.

    Can you please explain how it all works? Are you still eligible for medicare rebates with PHI? Do you still have to pay a gap? Or do the cycles end up equally as expensive with PHI?

    Forgive my ignorance, I really have NO idea how it all works. Hoping some of you could help shed some light on it. Thanks

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    Hey ElectricPink
    I have just done all the research myself into this! HCF had the best policy for IVF, even though their excess is $450 they waiver that for any day stay procedures. If you were to stay over night in hospital then you pay the $450 (only once though per calendar year, so if you had several over night stays either in conjunction or on separate occasions you only pay the $450 once). But IVF is only a day procedure so you would be exempt from the $450. Hope that makes sense??
    Anyway to confuse you more I decided on Medibank due to the fact that after (or if) I require IVF then I will drop my policy back down to a basic one and they were heaps cheaper than HCF or other policies I looked into. I thought about the longterm not just for IVF.
    But if you soley want it for IVF then HCF was the way to go.
    Hope this helps?!

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    Oh and I believe PHI can save you up to a further thousand or two depending on the costs of the private hospital and anaesthetist you would be using. It is hard to know what is best to do for you could save that money yourself in a year in case you need it and if you didn't then you have extra money saved! However if you require more than one IVF cycle then PHI would be benficial. If only we all knew what the future held!

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    Thanks for your help stormgirl

    I'm trying to work out if ends up cheaper in the long run just going through a public clinic with no health insurance? At least then I don't have to pay excess for admission.

    Ahhhh, it's doing my head in!!! Need to definitely do some more research on this!!

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    Hi electric pink!

    I suggest looking into it as much as possible. I also got PHI (mutual community) knowing ivf might be required & thinking it would save me tons of money. Unfortunately it only pays for *some* drugs and the hospital stay/anesthetist costs for any procedures (which is usually for diagnostic reasons or egg pick ups) it doesnt help towards cycle fees at all in most circumstances.

    What this meant for us is that we pay $250/month for 12 months before being able to claim ($3000) and since starting the ivf journey it's paid roughly $350 for the hospital bed & anaesthetist. We will prob go a private ob if and when we get preg but wish I'd looked into what it actually pays for in more detail first *sigh* I was silly and didn't ask for more info a they say reproductive medicine.

    Medicare does pay you back a fair share though which is much more helpful and most clinics can tell you exactly how much to expect back. HTH

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    So with PHI, do you still have to pay upfront and then claim back for the services that they cover? Or do they do a 'bulk-bill' type service where they pay for it upfront? Ahhh I'm so naive about it all, sorry!

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    If it helps, i have HCF full health insurance. I'm with an expensive IVF clinic, but it saves me about $1500 in day hospital fee's for the egg retrieval procedure, and then about $800 for each frozen embryo transfer so we have saved a bit. You cant really claim a huge amount back on PHI.


    You get a medicare rebate for IVF, so for e.g. our first stim cycle was about 10k up front (it was automatically $1500 less because of our health insurance) then we got about 5.5k back from medicare i think? Then for a frozen embryo transfer its $3200 per transfer and we get $1500 back from medicare. We also spend probably about $400 in drugs for a frozen cycle, i think some of these you can also claim back from your health fund, i haven't yet.


    If you have chosen a clinic, you can make an appointment to sit down and go through all the costs with you, and they will figure out for you how much you'd save with PHI. Its not really that much. We're going for our 4th cycle, 3rd transfer and after this one i'd say we would have spent around 12k out of pocket already. There are always extras like extra tests, cost of freezing embryos, specialists visits (ours is about $390 a visit). If you add it all up, we probably spend almost 2k a month on ivf.


    I think there is also a thread on the IVF forum comparing costs of clinics if that helps.

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    Quote Originally Posted by ~ElectricPink~ View Post
    So with PHI, do you still have to pay upfront and then claim back for the services that they cover? Or do they do a 'bulk-bill' type service where they pay for it upfront? Ahhh I'm so naive about it all, sorry!
    Usually you pay upfront then your clinic claims it back for you. With ours its really fast, we pay for it, then the rebate is back in our account within 4 or 5 days.

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    Rutabaga is offline Getting it together, one day at a time.
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    Dp's job pays for top level phi with Bupa, which has paid for all our hospy expenses. I claim at Medicare for everything else, and do get a fair bit back. Sign up straight away for the safety net, which goes by calendar year. After 1 FET and a stim cycle + et this year I'd reached the safety net, and will now get a higher percentage back each time I claim until the end of year. This makes the biggest difference for us.

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    Hi guys - I have a Q re IVF and PHI - has anyone had to wait 12 months before they could claim the small proportion PHIs pay for IVF? It is technically 3 months waiting period for the fund I'm in but can be classed as pre-existing - I'm curious to know how this is assessed? With thanks!


 

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