Lesbians TTC – Will Medicare pay for it?

Trying to conceive with the help of a fertility clinic is an expensive process. Even if you happen to be one of the lucky few who conceive in the first cycle, you’re still looking at thousands of dollars. So when Jay and I first made an appointment to see our fertility specialist, one of our first questions was “but how much does it cost, and will Medicare help us?”

To be entitled to a Medicare benefit, that is able to make a Medicare claim, you will need to have incurred medical expenses in respect of a “professional service” (see section 10 of the Health Insurance Act). While you might have paid to see a doctor, whether you can make a Medicare claim depends on whether that appointment was for a professional service

Under section 3 of the Health Insurance Act a professional service means a service:

  • with a “Medicare Benefits Schedule” (MBS) item number;
  • provided by a medical practitioner; and
  • is “clinically relevant.

There is an MBS item number for both IUI and IVF (see items 13203, 13221 and 13200 in the Health Insurance (General Medical Services Table) Regulations), which in most cases will be provided by a medical practitioner; this means points one and two of the definition are sorted. The issue which might trip up lesbian couples, is whether the service is clinically relevant.

A clinically relevant service is a service that is generally accepted in the medical profession as being necessary for the appropriate treatment of the patient (see section 3 of the Health Insurance Act).  

The legislation doesn’t get much more specific than that unfortunately, so the payment of Medicare benefits for IUI or IVF largely depends on the medical practitioner’s decision that he or she is providing a clinically relevant service. This decision will vary between clinicians, and may be influenced by your background, medical history, age and other factors.

if you have no known cause of infertility, you can contact your fertility clinic to ask what their policy is regard same-sex couples and Medicare claiming. Anecdotally, many fertility specialists will regard a service as clinically relevant once the patient has paid for two IUIs out of pocket.

Another question for the fertility clinic I’m afraid – don’t forget to add it to your list!

What more information?

Visit the Department of Human Services’ website. Feel free to make a comment below, or visit me on Facebook for any other questions.

Separation and rainbow families: what happens when it ends?

In my last post, we looked at whether same-sex couples can have both mothers’ names listed on their child’s birth certificate. Just to recap, the legislation is slightly different in each state and territory, but in general two women can be listed on a birth certificate provided they are in a de-facto, or ‘marriage-like’ relationship and the child is conceived by artificial insemination with the consent of both parties.

But what happens if the couple separates? If both parties are listed on the birth certificate, do they have the same legal rights and responsibilities?

Parental responsibility

When a couple separates, the Family Law Act presumes that it is in the best interests of the child for both parents to have equal shared parental responsibility for the child (see section 61DA of the Act). This presumption applies to parents living all Australian states and territories. 

Parental responsibility means the duties, powers, responsibilities and authority which, by law, parents have in relation to their children. In practice, this involves decisions about what school your child goes to, where they will live, whether they will be brought up a particular faith.

Assuming both parents are the child’s ‘legal parents’, the presumption of equal parental responsibility is not affected by whether they are or are not biologically related to the child.

Parenting Orders

The presumption of equal parental responsibility does not relate to the amount of time the child spends with each of the parents. If the couple were unable to decide this matter between them, they can apply to the Family Court for a Parenting Order (see section 65D(1) of the Act).

In these matters, the Court’s paramount consideration is the best interests of the child. It will also consider whether the child spending equal time, or ‘substantial and significant time’, with each of the parents is reasonably practicable. The Court will have regard to matters such as:

  • how far apart the parties live from each other;
  • their capacity to communicate effectively; and
  • any other relevant matter.

Getting help

Separation is a stressful time for any family, and often involves complex legal issues. If you need legal assistance, you can get advice from:

The Family Court of Australia provides general information and referrals to the public, but cannot provide legal advice. It has also published a brochure containing information for people considering, or affected by separation or divorce.