Guiding consumers since 2009

Does any insurance cover infertility?

By Jessica Anne Wood

Infertility is a challenge that many couples face, with approximately one in every six struggling with infertility issues. But do any medical aids cover infertility treatments?

According to the Infertility Awareness Association of South Africa (IFAASA) website, “infertility is not a well-covered disease by medical aids in South Africa. IFAASA intends to help more people expand their family by increasing access to fertility treatments. To achieve this IFAASA is in the process of advocating for acceptable cover from medical aids but until this is realised it is important to know your rights and what you can claim for.”

Dr Nozipho Sangweni, the principal officer of Discovery Health Medical Scheme (DHMS), notes that the scheme does cover some infertility services. She explained that DHMS will cover “those medical and surgical services, as prescribed by the Medical Schemes Act of 1998, as amended, as part of Prescribed Minimum Benefit (PMB) entitlements for diagnosis and treatment of infertility.”

In other words, if there is a medical reason as to the infertility issue, this will be treated as a medical condition/procedure by the medical scheme. Furthermore, Sangweni highlighted that DHMS members are able to access infertility investigations and treatment from their available medical savings account, as well as from the above threshold benefit (ATB) where applicable.

However, not all aspects of infertility treatment are covered by medical aids. “In Vitro Fertilisation (IVF) is not covered by the scheme from the ATB, but is covered from the Medical Savings Account (MSA) for members with a positive MSA balance,” pointed out Sangweni.

She added: “DHMS continues to work with representatives of the South African Society of Reproductive Surgery and Science (SASREG), the IFAASA as well as various healthcare professionals to define a sustainable funding solution to IVF treatment.”

Sangweni stressed that a medical aid scheme has a responsibility to balance the various healthcare needs of its members with ensuring that premiums remain affordable in the long term. “Unfortunately, like all other medical schemes, it cannot afford to meet all demands at all times.”

For more information on infertility treatments see:

Other medical aids were contacted for comment, but could not respond in time for publication.

Recent Articles

Featured Are you entitled to your spouse’s pension after divorce?

Divorce means more than just parting ways with your partner. It may also involve parting ways with your assets. The Divorce Act states that your retirement fund forms part of your assets. This means that it will be considered when dividing up your assets.

Retrenched – what payments are you entitled to?

In the current struggling economic climate, retrenchments are a regular occurrence and not everyone survives the cut. If you find yourself on the receiving end of retrenchment you may have questions about the payments that are due to you.

Do you want to settle your debt?

You may be considering settling your credit account, whether it’s a credit card or various store accounts, now may be as good a time as any. This especially if you have saved, or you received a tax return or salary bonus. 

Can you afford a personal loan?

Taking out new debt is not always a choice. However, if you’re not pressed by a medical emergency or an unforeseen disaster, it’s worthwhile considering whether you can actually afford it. But what does it mean to “be able to afford a personal loan”? What percentage of your income should you not exceed dedicating to it? 

Deals

Eat for less on Tuesdays at Panarotti’s

Price: R59.99
When: Tuesdays
Where: Nationwide

Get discounts with Clicks ClubCard Seniors Programme

Price: Available on request
When: Daily
Where: Nationwide

Amani Spa Voucher Special

Price: R1000
When: Daily
Where: Cape Town, Jhb, and Port Elizabeth