Cost and Fertility Service Guide for HCPs

Transcription

1 2017 EDITION Cost and Fertility Service Guide for HCPs Current as at 1st January Genea reviews prices annually in January. Please note this is a guide only.

2 Genea Over 30 Years of Fertility Services First known as Sydney IVF, today Genea leads the way in fertility, assisted conception, genetic diagnosis and prenatal screening. We offer more than IVF. 1 Pre-Conception Cystic Fibrosis - GeneScreen CF Genetic Counselling 2 3 Conception Infertility Investigations and Diagnosis (Male and Female) Ovulation Tracking (no out-of-pocket costs*) Ovulation Induction (OI) Intrauterine Insemination (IUI) In-Vitro Fertilisation (IVF) Intracytoplasmic Sperm Injection (ICSI) Pre-Implantation Genetic Diagnosis/Screening (PGD/PGS) - GeneSure Miscarriage Management Program Post-Conception Non-Invasive Prenatal Screening (NIPS) - GeneSyte Reproductive Surgery Management of PCOS/Endometriosis/ Fibroids etc Egg/Sperm/Donor/Surrogacy Program Medical and Social Egg Freezing Sperm Freezing and Storage Embryo Vitrification and Storage Andrology Services (Semen analysis) Anti-Mullerian Hormone (AMH) Testing Sperm Bank Genetic Counselling * no out-of-pocket for Medicare eligible patients when blood tests are conducted at a Genea monitoring centre.

3 Table of Contents Genea Treatment Costs 2 Andrology Costs 3 Specialised Pathology Costs 4 Ovulation Tracking Costs 5 Ovulation Induction (OI) Costs 6 IVF/ICSI/IUI Costs 7 Donor Cycle Costs 8 Surrogacy Cycle Costs 9 Egg Freezing Cycle Costs 10 Freezing & Storage Costs 11 GeneSyte (NIPS) Costs 12 Health Funds 13 Payment Options 1

4 Andrology Costs TEST COST OUT-OF-POCKET MEDICARE REBATE Semen Analysis $ $ $48.85 MAR Test $ $95.15 $32.85 Semen analysis with direct MAR $ $ $72.95 SCIT Only (no semen analysis) $ $ $48.85 SCIT (with semen analysis) $ $ $48.85 SCIT (semen analysis + MAR) $ $ $72.95 SCIT (with freeze) $ $ $48.85 Retrograde Ejaculation Test (per sample) $ $ $48.85 Fructose Testing $ $64.40 $40.60 MESA/TESE/PESA (lab fees only) 1 $ $ $43.15 MESA/TESE/PESA (lab fees + freeze) 1 $ $ $43.15 Sperm Banking (per collection/freeze) 2 $ $ $0.00 Additional Sperm Freeze (In conjunction with other semen testing) 2 $ $ $ Monthly Cryo Storage $ $ $0.00 MAR: Mixed Antiglobulin Reaction Test SCIT: Sperm Chromatin Integrity Test MESA: Microscopic Epididymal Sperm Aspiration TESE: Testicular Sperm Extraction PESA: Percutaneous Epididymal Sperm Aspiration 2

5 Specialised Pathology Costs TEST BULK BILLED Yes/No COST (With Medicare Card) AMH (Anti-Müllerian Hormone) No $80.00 $80.00 COST (No Medicare Card) Anti-Thyroglobulin Antibody Yes $0.00 * $34.55 * Anti-Thyroperoxidase Antibody Yes $0.00 * $34.55 * CA125 Yes $0.00 $24.35 Estradiol Yes $0.00 $30.50 # Free T3 Yes $ Free T4 Yes $0.00 $9.75 FSH (Follicle Stimulating Hormone) Yes $0.00 $30.50 # Hepatitis B Surface Antigen Yes $0.00 $15.65 ^ Hepatitis C Yes $0.00 $15.65 ^ HIV Ag/Ab Yes $0.00 $15.65 % LH (Luteinising Hormone) Yes $0.00 $30.50 # Progesterone Yes $0.00 $30.50 # Prolactin Yes $0.00 $30.50 # Rubella IgG Yes $0.00 $15.65 % SHBG (Sex Hormone Binding Globulin) Yes $0.00 $30.50 # Syphilis Antibody Yes $0.00 $15.65 % Testosterone Yes $0.00 $30.50 # Total BhCG Yes $0.00 $10.00 TSH (Thyroid Stimulating Hormone) Yes $0.00 $25.05 Varicella IgG Yes $0.00 $15.65 % Vitamin D Yes $0.00 $30.05 First Trimester Screen (Free BhCG, PAPP-A, Placental Growth Factor) No $95.00 & $95.00 * If ordered in combination, a total charge of $47.45 for both tests. # When multiple hormones are ordered, the first is charged at $ Subsequent are charged at $ Capped at a total of $83.35 for 5 or more. ^ If ordered in combination, a total charge of $29.25 for both tests. % When multiple serology tests are ordered, the first is charged at $15.65 and subsequent are charged at $ & Patient can claim rebate of $33.80 from Medicare. 3

6 Ovulation Tracking Costs Ovulation Tracking OUT-OF-POCKET COSTS 7 ADDITIONAL INFORMATION 3 CYCLES MAXIMUM $0.00 (for Medicare eligible patients) Cycle monitoring includes: *All blood tests *Pregnancy tests * Reports back to the referring doctor either after 3 cycles of Ovulation Tracking or when pregnancy occurs. * Please note that the no out-of-pocket service is only guaranteed at a Genea Pathology Collection Centre 4

7 Ovulation Induction (OI) Costs Ovulation Induction Cycle $ OUT-OF-POCKET COSTS ADDITIONAL INFORMATION This fee is for monitoring and administration costs only. Please see below for any additional charges payable. Ultrasounds Dependent on the provider Blood Tests During Cycle Generally Bulk Billed Any non-bulk billed tests will be payable by the patient. Medications (if applicable) Dependent on drug and dose Doctor As per the doctor 5

8 IVF/ICSI/IUI Cycle Costs TREATMENT COST ESTIMATED OUT-OF-POCKET COSTS: 1ST CYCLE 5 (Safety net not met) ESTIMATED OUT-OF-POCKET COSTS: SUBSEQUENT CYCLE 5 (Safety net met) Calender year of 2017 CYCLE COSTS INCLUDE IVF Cycle $9,430 $4,292 $3,737 ICSI Cycle $9,975 $4,373 $3,818 IUI Cycle $2,470 $1,941 $1,800 Frozen Embryo Cycle $3,595 $2,575 $2,013 *Planning and management of cycle *Ultrasounds and blood tests *First pregnancy test *Lab and scientist costs * Genea specialist fees for day surgery *Local anaesthetic (if needed) *Counselling Day Surgery Costs 6 Egg Collection (Before Health Fund Rebate) Embryo Transfer (Before Health Fund Rebate) $1,234 $680 $325 IUI GENETIC TESTING OF EMBRYOS PER EMBRYO TESTED 5 OR MORE EMBRYOS TESTED (Capped) PGD $ $3,715 PGS $ $3,715 (Genetic testing of embryos) PGD +PGS $ $4,245 6 PGD PGS Preimplantation Genetic Diagnosis (Single Gene Disorders) Preimplantation Genetic Screening (Chromosome Screening)

9 Donor Cycle Costs TREATMENT COST OUT-OF-POCKET COSTS (Top Contracted Health Fund Cover) OUT-OF-POCKET COSTS (No/Limited Health Fund Cover) INCLUDES Donor IVF (First cycle in calender year) Donor ICSI (First cycle in calender year) $11,079 $4,790 $6,024 $11,624 $4,872 $6,106 *Cycle *Egg Pick Up *Vitrification Donor Recipient $3,110 Safety Net Met $848 Safety Net Not Met $1,561 Safety Net Met $1,528 Safety Net Not Met $2,241 *Cycle *Embryo Transfer 7

10 Surrogacy Cycle Costs TREATMENT COSTS OUT-OF-POCKET COSTS (Top Health Fund Cover) OUT-OF-POCKET COSTS (No/Limited Health Fund Cover) INCLUDES Surrogacy IVF (First cycle) Surrogacy ICSI (First cycle) $11,079 $4,791 $6,025 $11,624 $4,872 $6,106 *Cycle *Egg Pick Up *Vitrification Surrogacy Recipient $4,703 $4,703 $4,703 *Cycle *Embryo Transfer 8

11 Egg Freezing Cycle Costs EGG FREEZING NON-MEDICAL CYCLE COSTS OUT-OF-POCKET COSTS MEDICARE REBATE INCLUDES First Cycle $6,999 $6,999 $0.00 *Cycle Fees *Egg Pick Up *Ultrasound Subsequent Cycles Cycle Medications $5,999 $5,999 $0.00 Pharmacy prices 4 From $1,500 $0.00 *Blood Tests *Counselling *Day Surgery Fees *Local Anaesthetic *Vitrification *Storage (12 Months) EGG FREEZING MEDICAL CYCLE COSTS OUT-OF-POCKET COSTS 4 Safety net not met (Top Health Fund) OUT-OF-POCKET COSTS 4 Safety net not met (No/Limited Health Fund) INCLUDES First Cycle $9,434 $3,781 $5,015 *Cycle Fees *Egg Pick Up *Vitrification 9

12 Freezing & Storage Costs COST ADDITIONAL INFORMATION Embryo Freezing $ Includes 12 months complimentary storage. Embryo Storage $444.00/Year Once complimentary storage period expires. Egg Freezing Non-Medical $6,999 $5,999 First Cycle (Includes 12 months complimentary storage) Subsequent Cycles (Includes 12 months complimentary storage) Egg Freezing Storage $40.70/Month Once complimentary storage expires. Sperm Banking *Collection *Freeze Sperm Banking-Additional Freeze $ $ Includes 6 months complimentary storage. Once the initial 6 month period has expired, a storage invoice will be sent. No semen analysis involved. Sperm freezing includes 6 months complimentary storage. Once the initial 6 month period has expired, a storage invoice will be sent. 6 Months Cryo Storage $

13 GeneSyte (NIPS) Costs GENESYTE COST ADDITIONAL INFORMATION Detects autosomal abnormalities: Trisomy 21 (Down Syndrome) Trisomy 18 (Edwards Syndrome) Trisomy 13 (Patau Syndrome) $ Detection of foetal sex: XX or XY Detects foetal sex chromosomal abnormalities: Monosomy X (Turner Syndrome) XXX (Triple X) XXY (Klinefelter Syndrome) XYY (Jacobs Syndrome) Genetic Counselling available at NO charge for patients with positive results. No Medicare Rebate Available 11

14 Genea Day Surgery Contracted Health Funds BELOW IS A LIST OF THE PRIVATE HEALTH FUNDS THAT GENEA DAY SURGERY CONTRACTS WITH: ACA Health Benefits Fund Australian Health Service Alliance Australian Health Unity Budget Direct Health Insurance CBHS Friendly Society Central West Cover Credicare Health Fund CUA Health Defence Health Emergency Services Health Pty Ltd Frank Health Insurance GMF Health GMHBA GU Health HBF Health.com.au Health Care Insurance Health Insurance Fund of Australia Ltd Health Partners HCF IOOF NSW Manchester Unity Navy Health Ltd NIB Nurses and Midwives Health Pty Ltd Onemedifund Peoplecare Health Insurance Phoenix Health Fund Police Health Queensland Country Health RACT Health Insurance Railway and Transport Health Reserve Bank Health Society Ltd Teachers Health Fund Teachers Union Health The Doctors' Health Fund Transport Health UniHealth Insurance Westfund 12

15 Taking the Pain Out of Payment NO upfront payments. FAST Medicare reimbursements (5 days not 5 weeks). Opportunity to access Superfund. Tailored personal loan if needed. Availability of a Patient Relationship Coordinator for support to answer any questions regarding costs. Did you know that at Genea there are options available to assist your patients with the cost of their IVF treatment? PAYMENT USING PATIENT S SUPER FUND PAYMENT USING TAILORED PERSONAL LOAN Patients may be able to access their super fund to pay for their IVF cycles through SuperCare. SuperCare is the only company in Australia specifically established to assist individuals to access their Super to fund IVF treatment. SuperCare consultants are able to assist your patients every step of the way, facilitating and taking the hassle out of the entire application process. SuperCare pride themselves on their personal approach and work with your patient to ensure an easy, efficient and stress free result. p A tailored personal loan through MacCredit to help ease the financial costs for your patients. A loan to suit your patient s individual circumstances with flexible payment plans. No upfront fees or service charges. The only minimum criteria is that the patient must be able to show proof of income and have no adverse credit history. Approval within hours once proof of income is received. p

16 Footnotes: 1. This fee is for the lab tests associated with testicular biopsy or aspiration. It does not include any Day Surgery or Doctor fees. These tests are inpatient services that should also attract private health fund rebates. 2. Sperm freezing includes 6 months complimentary storage. Once the initial 6 month period has expired, a storage invoice will be sent every 6 month of cryo storage. 3. Medication costs are indicative prices only. They are issued and dispensed by pharmacies independent to Genea. 4. Based on reaching the relevant threshold on the Medicare safety net for Costs for the calender year of The actual out of pocket for Day Surgery will be lower than this if the patient has full private health insurance cover for IVF and/or holds a policy with a contracted health fund. 7. The no out-of-pocket service is only guaranteed at a Genea pathology collection centre. Should the patient present to have their blood tests at another provider,the patient may be out of pocket for those tests. The costs in this brochure are an indication of the fees and out of pocket expenses a patient can expect. The fees are current as at January 2017 and the fees are subject to Genea price changes and Medicare rebate adjustments. The patient s particular circumstances (Medicare,health fund and cycle of the calender year) will determine the actual costs and out of pocket expenses. A Genea Patient Relationship Coordinator will provide your patient with a personalised quote once they have attended the nurse consultation. For the most current version of Genea s fees, please visit our website: For more information about SuperCare or Mac Credit, visit: Genea Level 2, 321 Kent Street, Sydney, NSW 2000 p (02) f (02) genea.com.au 14