Endometriosis diagnosis costs trigger plea for better Medicare coverage

Doctors and endometriosis sufferers want more subsidies for life-changing ultrasounds and specialist appointments, as patients are still left hundreds of dollars out of pocket seeking diagnoses and treatments.

Doctors and endometriosis sufferers want more subsidies for life-changing ultrasounds and specialist appointments, as patients are still left hundreds of dollars out of pocket seeking diagnoses and treatments.

The state’s endometriosis peak body, QENDO, was pushing for new Medicare item numbers for endometriosis-related ultrasounds and more funding to support access to physiotherapists, psychologists, and other allied health professionals.

For many endometriosis sufferers, like Tahlia Keirs, multiple ultrasounds were required to gain an understanding of the level of disease.

In 2022-23, a patient with private health insurance typically forked out nearly $300 out-of-pocket for a pelvic ultrasound of the endometrial cavity.

Meanwhile, a laparoscopy for a patient covered by private health insurance typically costs $520 out-of-pocket.

Patients are being left hundreds of dollars out of pocket seeking diagnoses and treatments.

National Association of Specialist Obstetricians and Gynaecologists president and associate professor Gino Pecoraro said while it was encouraging that the Albanese government had invested money to raise awareness, further funding was needed to increase access to endometriosis-related scans and laparoscopies.

“A laparoscopy is currently the only way to diagnose it. It is a very expensive process and a drain on Australians. If these young, productive members of the community are missing time off school or work because of their disease it comes at a cost,” he said.

“We want to emphasise the profound mental health impact of living with endometriosis, particularly for young people,” QENDO CEO Jess Taylor said.

“This highlights the urgent need for improved access to care, mental health support, and understanding from health professionals and society as a whole.”

In May the federal government announced $49.1m in funding to help Australians with complex conditions like endometriosis access longer specialist consultations, lasting 45 minutes or more. From July 1, these consultations would be covered under Medicare.

In the 2024-25 federal budget, a review of potential gendered differences in Medicare Benefits Schedule (MBS) diagnostic imaging services evaluated the fee relativities and clinical usefulness of breast imaging and various ultrasound items, including pelvic ultrasound.

The availability of ultrasound services for endometriosis was identified as an issue during the review and was being considered by the federal government.

Assistant Minister for Women’s Health Ged Kearney said the government prioritised improving the health and wellbeing of women and girls.

“As a former nurse, and in fact as a woman, I’ve seen medical misogyny up close and personal. Improving the health and wellbeing of women and girls is the utmost priority of the Albanese Labor government,” Ms Kearney said.

Originally published as Endometriosis diagnosis costs trigger plea for better Medicare coverage