Medicare rebate for IVF treatments

Fertility treatment is now more affordable and accessible, thanks to the Medicare rebate for IVF. Medicare provides rebates for most fertility treatments to help hopeful parents with their costs.

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

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.

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

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

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.