In shortPolice Health's Gold Hospital and Gold Combined cover helps reduce the cost of some assisted reproductive services and IVF*. |
On this page
- Does Police Health cover IVF?
- Examples of when you're covered
- What does IVF treatment cost?
- Outpatient services; when private health doesn't cover IVF
Does Police Health cover In vitro fertilisation (IVF)?
Yes, Police Health’s Gold Hospital and Gold Combined includes cover for in-hospital services relating to In vitro fertilisation (IVF) and other assisted reproductive services that treat infertility.
It's important to remember that your hospital cover is only for the components that involve an admission to hospital as an ‘inpatient’ for services that have a valid Medicare item number.
Examples of when you're covered
Here are some common examples of when you're covered
- If your surgical procedure of harvesting eggs is carried out in an operating theatre and you're admitted as an inpatient to hospital
- If you're admitted as an inpatient for the embryo transfer procedure
In these instances, Police Health's Gold Hospital cover or Gold Combined cover will provide a benefit toward the theatre fees, hospital accommodation, anaesthetist and treating doctors’ fees.
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Some pharmaceutical items such as IVF Nasal Sprays and Pessaries may also be partly covered under Police Health's Rolling Extras cover and Gold Combined cover.
What does IVF treatment cost?
This can vary significantly depending on your individual circumstances, including where you live, the type of treatment recommended, and how many treatment cycles or procedures are required.
You may need to pay a gap if medical fees are more than the Medicare Benefits Schedule fee.
Ask for an IVF quote
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 Police Health before undertaking treatment will assist us.
This will help us to provide advice that is as accurate as possible based on the information provided about what you are covered for and what costs you are likely to incur.
When private health doesn't cover IVF
We don’t cover IVF Services which occur outside of a hospital admission (as an ‘outpatient’).
You’re an outpatient if you receive treatment at a doctor’s office, clinic, or emergency department (without being admitted to a hospital).
In this context, if you go to a IVF specialist and aren’t admitted to hospital you won’t be covered by private hospital insurance.
Most of IVF treatment involves outpatient services. This incudes initial specialist consultations, ultrasounds, and blood tests. Private health insurance does not cover these.
Also, the hormone medications required for an IVF cycle are not covered by private health.
The processing and storage of embryos outside of the hospital setting are also generally excluded from private health.
However, these services may be claimable on Medicare which will reduce your out-of-pocket costs.
There may also be additional costs associated with egg transportation, testing and freezing that will need to be covered at your own expense.
A 12 month waiting period applies, in general and for pre-existing conditions.
Police Health follows relevant Medicare and clinical guidance when assessing claims for fertility-related treatment and services.
*All benefits may be subject to Waiting Periods, Limits and other conditions. Rollover applies once you’ve completed your first 12 months membership (2 years for Major Dental). Providers must be recognised by us. Review the cover tables on the Combined, Hospital and Extras pages, and your State Premium and Benefit Guide or contact us for more information.