We are often asked whether fertility treatments cannot be claimed from a Medical Aid. Unfortunately they are not covered by Medical Aid and a couple will need to fund the cost of it on their own. Undergoing treatment is a big decision to make because it involves a lot of emotions and costs.
If you are infertile due to circumstances that were beyond your control, then why won’t the Medical Aid cover the costs of fertility treatments?
These companies will state that fertility treatments are not a life threatening illness. It is an elective treatment you choose to undergo unlike an ailment that threatens your life like heart disease. Some Medical Aids may cover the fixing of an issue that caused the infertility such as surgery for unblocking the fallopian tubes or blood tests. However, you have to speak to a consultant to advise you on what is covered by your Medical Aid scheme. Some restricted plans may cover up to a selected amount related to the fertility treatment. This will depend on your plan and the limits specified thereby. In such cases you may need to pay the fertility clinic first and then send the invoice to the Medical Aid company for compensation.
When you choose to undergo any type of fertility treatment you need to consider the costs of radiology, pathology, blood tests, hospitalisation and other additional costs involved. Fertility clinics are quite transparent when it comes to providing the full costs upfront. This is beneficial to the couple because you go into the situation fully aware of what needs to be paid. This allows you, as the couple, to budget accordingly and plan ahead. If your Medical Aid doesn’t cover any part of the fertility treatment that your fertility doctor has recommended, you can still make a plan. Open a separate savings account and, each month, you and your partner can save an agreed amount. Between the two of you, you will need to agree that these funds will remain untouched and serve as funding only for the fertility treatments. Although the fertility clinic gives you the full breakdown of the costs, add an additional 10% to 20% for inflation and contingencies. Rather save more than less. If you don’t use the additional 10% to 20% and the fertility treatment is successful then you will have some spending money to use on baby items.
On the bright side, Medical Aids do cover the gynaecological visits and the birthing costs if you fall pregnant. Given that you have surpassed the waiting period as stated by the company providing you with this medical cover.