In Canada, healthcare coverage for infertility treatments varies considerably by each province.  That’s why it is critically important to understand what is covered under your plan and what you may have to pay out of pocket when pursuing fertility treatments.  By having a financial plan in place, you will ease the burden of an already difficult process whereas every patient’s treatment plan is different and may require treatments not covered by insurance.  The information below briefly explains the coverage in both Quebec and Ontario provinces.

Quebec Overview

On November 10, 2015, a new law called Bill 20 was passed to terminate coverage for almost all services related to IVF that was previously covered by RAMQ.  Except in cases of egg/embryo freezing for cancer patients, RAMQ no longer provides coverage for IVF.  See below for more coverage information.

Fertility Treatments Covered by RAMQ

  • Initial consultation with fertility specialist
  • Intrauterine insemination (IUI)
  • Ovarian stimulation medications for assisted reproductive techniques (IVF and IUI)
  • Egg/embryo freezing for cancer patients (for a 5-year period)

Fertility Treatments Not Covered by RAMQ

  • Diagnostic examinations requested for the man or woman (semen, karyotype, hysterosonograhy)
  • Evaluation of the ovarian reserve (ultrasound, FSH, AMH, estradiol, preconception blood profile)
  • In-vitro Fertilisation (IVF)

*Under the new bill, tax assistance granted for expenses incurred after November 10, 2015 cover only a limited number of IVF cycles and only for those who do not already have children and who did not choose voluntary sterilization for contraceptive purposes.  The tax credit also takes into account the financial ability of each individual household with a scale that ranges from 80% of costs being reimbursed for couples with a family income of less than $50,000 to 20% of costs for families who earn more than $120,000 per year. 

Ontario Overview

Fertility Treatments Covered by the Ontario Health Insurance Plan (OHIP) *Procrea Fertility has been approved by the Ontario Ministry of Health to provide OHIP-funded fertility treatments.

  • Initial consultations with fertility specialists
  • Infertility testing
  • Minor surgical procedures
  • Artificial insemination
  • One IVF cycle per eligible patient per lifetime
  • One additional IVF cycle if the woman is acting as a surrogate
  • Basic infertility testing and surgeries
  • One cycle of fertility preservation (sperm and egg freezing) per patient per lifetime and only for medical reasons

Fertility Treatments Not Covered by OHIP

  • Repeated IVF treatments
  • Fertility drugs

*Ontario places significant restrictions on who qualifies for financial assistance, and there are no tax breaks or one-time tax credits. 

 

At Procrea Fertility, we understand the financial burden fertility treatments may cause.  That is why we are pleased to offer patients access to financing using Health Smart financing where you can finance any treatment, service, or product over $300.  For information or to schedule a consultation at one of our fertility treatment centers, please click here to submit a request.

As part of our Patient Education Series, Procrea is proud to offer webinars on a range of topics, including Affording Fertility.  We have sessions coming up in both October and November.  Please visit https://procrea.ca/webinars to learn more and register for this informative and interactive event.    

 

Resource: http://globalnews.ca/news/3059988/paying-to-treat-infertility-coverage-varies-widely-across-canada/