Infertile couples can use super to fund IVF, if there is mental illness

Couples will still be granted early access to retirement savings to pay for IVF — but only if they have a diagnosed mental illness.

Fertility specialist David Molloy.

Infertile couples will still be able to use their superannuation to pay for IVF but only if they have a diagnosed mental illness, under a Treasury proposal to lift the threshold for early access to ­retirement savings.

The growing use of superannuation to pay medical bills has prompted a long-running review and led to questions over the type of conditions that should qualify on compassionate grounds.

The number of early release applications approved for medical treatment jumped from 15,132 in 2016-17 to 19,060 last year, when almost $278 million was released. Rising demand has been blamed on public hospital waiting lists and high out-of-pocket costs in the private sector.

Based on a previous Treasury sample, more than half of those approvals may have been for weight loss surgery and about 7 per cent for IVF — or an estimated 1300 superannuation-funded fertility treatments each year.

The rules administered by the Australian Taxation Office currently require evidence that treatment is “necessary to treat a life-threatening illness or injury, or alleviate acute or chronic pain, or alleviate an acute or chronic mental disturbance”.

IVF cases have long been funded on the basis of the patient having a “mental disturbance”, but Treasury has now conceded this is a “grey area” that should be clarified. Treasury acknowledged health sector concerns that “mental disturbance” was not a clinically recognised term and could cover a much broader range of scenarios and potential treatments than intended.

It has proposed a diagnosed mental illness be required for ­future IVF cases, providing a “higher but appropriate threshold for release” under the rules.

The Department of Health gave internal advice to Treasury on the IVF issue but it was redacted in a Freedom of Information release to The Australian because it was still under consideration.

The released documents state that “despite generous (Medicare) rebates and the introduction of low-cost providers to the market, patients can still be ­subject to out-of-pocket costs which can increase significantly when patients undertake ­multiple IVF cycles”.

Fertility Society of Australia president Michael Chapman said yesterday that of the 200 or so cycles he performed every year, about three were funded through superannuation.

“They go through a very ­prolonged process of form-filling and justifying the use of their funds,” Professor Chapman said.

From his experience, tightening the rules would have little impact on demand, as people with infertility already had a higher rate of mental illness, particularly depression.

“The couples that are doing it through superannuation are often seriously desperate and in a precarious financial situation,” Professor Chapman said.

The Australian Medical Association told the Health Department that treatments should be better funded through Medicare, without people ­having to resort to using their superannuation.

“Earlier access to super to continue funding IVF has potential for downstream social and economic hardships that are only exacerbated by child-­rearing,” the AMA told the department.

Fertility specialist David Molloy, who already needs a ­psychiatrist’s diagnosis for his superannuation-funded pat­ients, said it could be a wise use of retirement funds.

“If everything goes well, then an investment in a child is also an extremely good investment in having someone to help look after you in your old age,” Dr Molloy said.

Treasury will consult on the proposed changes for another month but has deemed the ­option of using superannuation to pay for medical bills “bene­ficial in a world of finite government resources”.

It has also proposed that a second doctor be required to sign off on the medical treatment: one must be the ­applicant’s regular doctor and one must be a specialist in the field related to his or her condition.

Despite concerns from the health sector that people could be ripped off or put at risk by ­brokers, Treasury has not proposed any crackdown on such third parties, but has sought to restrict overseas medical treatment to cases of life-threatening illness or injury or where the individual lives abroad.

Asked about the proposed rule changes this week, Health Minister Greg Hunt said: “This is about critical concerns that can and should be addressed, but non-absolutely critical concerns have never been the ­intention of the early access to super program”.