Couples struggling with reproductive health issues may stand to benefit financially from private health insurance. Assisted Reproductive Technology (ART) services, including in-vitro fertilisation (IVF), intrauterine insemination (IUI), and Gamete Intra Fallopian Transfer (GIFT), can help families struggling with infertility achieve a successful pregnancy.
If you are considering ART for your family, you should compare health insurance packages to determine the best match for your individual needs.
Struggling with reproductive health issues can be emotionally and physically trying for many couples that wish to start a family. According to The Fertility Society of Australia, one in six Aussie couples struggles with infertility.
Infertility is defined as an inability to achieve pregnancy after one year of regular, unprotected sexual intercourse. There are many factors that contribute to infertility, some of them genetic. However, there is also a correlation between lifestyle choices and fertility.
Women of a healthy body weight are more likely to achieve pregnancy than women who are overweight, obese or underweight. Both overweight and underweight women may ovulate irregularly, and obesity is often associated with polycystic ovary syndrome (PCOS), a known cause of infertility.
There are also a number of factors that are known to lead to infertility in men. Low sperm count is a common problem, as is difficulty producing healthy sperm that are able to reach the female egg. Common risk factors associated with male infertility include tobacco use, obesity, genetic fertility disorders and overheating of the testicles.
ART services for infertile couples
Families should know that ART isn't covered by all private health insurance providers. If you are looking to reduce your medical costs for ART, you will want to choose a plan that provides such coverage.
Under comprehensive plans, many components of IVF (and similar treatments) are covered as in-patient services – that is, you are admitted into the hospital for a surgery or procedure. Egg collection, for example, is a surgical procedure in the IVF process that requires patients to check into a hospital. Hospital fees associated with the stay will usually be covered under your policy if you select a plan that includes ARS.
Out-patient procedures associated with ART services will not be covered by private health insurance – again, it is beneficial to compare plans and rates if you plan on claiming ART benefits. Out-patient services may include clinic visits, scans, egg freezing and diagnostic procedures.
The cost of drugs related to IVF or other ART treatments is another thing to consider. Many medications associated with these services aren't covered by all health insurance providers, so you'll need to do your research if coverage of those drugs is a priority.
Making changes to your plan
It is also important to note that couples don't often know they are facing fertility issues until after one year of trying to conceive. If your plan didn't previously cover ART services and you had to make changes to your private health insurance plan, you may be required to wait up to 12 months before your new benefits kick in.
The amount of time you have to wait will be determined by how your infertility is coded. If it is considered a pre-existing condition (as is common), you will need to wait a full year for your IVF/ART coverage to begin. It will be your fund's medical advisor – not your doctor – that decides this status based on your medical records.
For many couples, IVF and other ART treatments are the missing link to starting a family, and private health insurance may help reduce the costs associated with such treatments.