— Press release —
For immediate release: 1 October 2020
IFAASA in conjunction with SASREG gain ground in their 7-year battle against cover for infertility treatment
Established in 2013, the Infertility Awareness Association of South Africa (IFAASA) was founded with two main objectives in mind: Firstly, to inform the public of infertility and secondly to tackle the mammoth task of getting medical aids to pay for infertility treatment. After 7 years of countless meetings, presentations, plea’s and pressures, IFAASA in conjunction with the Southern African Society of Reproductive Medicine and Gynaecological Endoscopy (SASREG) have trumped the treatment of infertility by major medical aid scheme Discovery.
IFAASA Founding Member and CEO, Saskia Williams elaborates on the seven year battle;
“Infertility is a prescribed minimum benefit disease meaning that irrespective of the medical aid plan that you are on, you are covered. However, the treatment of infertility is excluded and is the only prescribed minimum benefit disease on the exclusion list of most medical aids. Diagnosis will be paid for by open medical aids, however once you have been diagnosed with infertility, the treatment of such will not be paid for. With our founding members being on Discovery Medical Aid, IFAASA dived straight in at their 2013 AGM, however made no progress. The following year, IFAASA gathered thousands of proxi’s and presented accordingly at the 2014 Discovery AGM who in turn requested a round table discussion. That discussion again hit a brick wall, with the only noteworthy progress being that an individual would be allowed to use his/ her savings for their treatments.”
A host of analytical findings, countless reports, public campaigns and related pressures via social media were then actioned from 2015 onwards.
The IFAASA fertility videos posted on social media proved a hit when going viral as the public applied pressure to their medical aids wanting an explanation as to why it was the only disease on the list that is excluded when it comes to the payment for treatment.
“Credit must go to the public because it wasn’t long until I received a call from Discovery wanting to meet. In partnership with Dr Sulaiman Heylen, President of SASREG as well as Vice President of SASREG Dr Jack Biko, we had countless calls and zoom meetings with Discovery throughout lockdown. Whilst Discovery will announce the exact details regarding the cover of the treatment of infertility, I am delighted with our “win” in this regard and must thank all those who contributed including Meggan Zunckel, Dr Heylen and Dr Biko. This is a huge breakthrough for those who have been on the Discovery Comprehensive and Executive plans for 2 years or more and we are honoured to have played our part. However, it’s is not the end of the road for our battle, as we feel that the benefit should be available on more plans and the other medical aids do need to follow suit or risk possible member decreases. However we have always known that this is a marathon and not a sprint and at last, the 1 in 6 couples who suffer from infertility, are beginning to get the recognition they deserve.”
In short: If members have been on a Comprehensive or Executive plan at Discovery Health for a minimum of 2 years, the medical scheme will cover up to two cycles of Assisted Reproductive Therapy (ART) including In-Vitro Fertilisation (IVF), Intra-Uterine Insemination (IUI), Embryo Transfer (FET) and Intra-Cytoplasmic Sperm Injection (ICSI) starting in 2021. All treatments will have to be done at a SASREG Centre of Excellence. Further T’s & C’s and co-payments do apply, so ensure that you check the full benefit details with Discovery Health Medical Scheme, before embarking on treatment.
—Release ends — Notes for editors:
Break the Silence: Who is IFAASA?
IFAASA, the Infertility Awareness Association of South Africa NPC, established in 2013, is a non-profit organisation with the aim of supporting Southern Africans living with reproductive health issues through education, research and advocacy, and to educate the public about reproductive disease.
Written for and on behalf of IFAASA by Caroline Malan of The PR Machine.
For IFAASA queries: Saskia Williams 072 880 7346 or saskia@ifaasa.co.za
Awesome achievement, however people on these schemes most of the time could probably afford the treatment, but people on lower schemes have a bigger financial stuggle. But I guess this is one step in the right direction.
What about the options of discovery
Fully agree!!! If u can afford exec /comp plan then u most certainly have the money to pay for fertility cash!!! This should be open for all plans
We agree too! We are currently fundraising to go to court to try to get the exclusion of fertility treatment overturned, check out all the information here: https://www.backabuddy.co.za/champion/project/ifaasa-campaign
Please can you confirm that Discovery will not pay for assisted reproductive therapy if you upgrade your plan
Will not pay or, will pay?
This is great news, however once again this will only benefit those with lots of money because wing on Executive or Comprehensive plans in extremely expensive for an average employee.
Is this only for certain plans on discovery. I feel this is so unfair as many of us has been struggling with infertility for many years. Why only comprehensive and executive plans on Discovery Health. Should there not be a qualifying criteria does not matter on what plan you are. Certain people have that plan with discovery but does not require the need for infertility treatment. I was so happy when I saw discovery is Covering infertility treatment but sad to see that it’s only on certain plans of discovery. We have been struggling for ten years and can not afford ivf but we on discovery the classic saver Delta plan. I think once you have been diagnosed with infertility your docter can motivate to your medical aid to cover the infertility treatment. I hope for 2021 discovery would make more options available.
Wow!!!
Can I back claim my 13 Gift procedures- 22-30years ago🙊🙊🙊 I do have 3 kids thanks to the treatment😀
I have been with discovery for 2 years but not on comprehensive or executive…. Does that mean l will be excluded from benefiting from this even if l only change my option next year. This is a slap in the face as one who had problems with infertility would be cautious as to how one uses their money so being on comprehensive or executive plans would not have been affordable as one would have needed to save the money for the treatment.
Once again this is a huge achievement for SA but the ones already on Executive or Comprehensive plans are 100% the ones who can afford ivf.
This really shows how out of date Discovery is regarding affordability and offering of services to individuals who out right will be excluded and who need it the most.
(Secondary infertility + failed ivf+ x3 Laparoscopies + Stage 4 Endometriosis)
This is a big win!!! Well done for lobbying and never giving up🙌🏼 Now to get more plans covered.😊
This is so exciting! It is just unfortunate that the financial support is really only for the elite. Both the Comprehensive and Executive plans have exuberant monthly contribution fees and I am sure that members on these specific plans would be older and therefore not necessarily of child bearing age. The latter means that Discovery is assisting a handful of its members to gain access to the dream of parenthood. I have been with Discovery for many years, on the classic priority plan and have forked out for 7 IVF procedures. I will be giving birth in November this year.
So although a huge step in the right directions (one that IFAASA should be congratulated for) there is still much to be done.
I am interested to know why medical aids have never been taken to Court if the prescribed minimum benefit has been so blatantly excluded? Surely there would be legal recourse for this exclusion?
Congratulations on your pregnancy and wishing you all the best for the next month or so! We have got a legal team on board but, the cost of a case like this would be around R500k and, we don’t have that kind of funding available. If you have any ideas re getting funding, please let me know!
Thank you so much for the information. The doctor diagnosed me with primary infertility so I still need to do Hsg test to see if my fallopian tubes are blocked this test costs about R3400 at netcare hospital. I am on the keycare plus cover, I am hoping that one day they we also over us for the treatments like IUI which cost between R5000 to R10000
What will be my waiting period if I join now..I am on an existing for more than 2 years
If you need to upgrade to the Comprehensive or Executive Plans, the waiting period will be 2 years.
Does bankmed also cover this as they are underwritten by discovery?
Hi There. I am afraid you would need to contact Bankmed to check that with them. All T’s and C’s haven’t been announced yet.
I hope they do. It would be amazing!
Does Classic Saver qualify for this:
If members have been on a Comprehensive or Executive plan at Discovery Health for a minimum of 2 years, the medical scheme will cover up to two cycles of Assisted Reproductive Therapy (ART) including In-Vitro Fertilisation (IVF), Intra-Uterine Insemination (IUI), Embryo Transfer (FET) and Intra-Cytoplasmic Sperm Injection (ICSI) starting in 2021. All treatments will have to be done at a SASREG Centre of Excellence. Further T’s & C’s and co-payments do apply, so ensure that you check the full benefit details with Discovery Health Medical Scheme, before embarking on treatment.
Unfortunately Classic Saver doesn’t qualify for the benefit as it stands.
I am on keycare plus I wanna find out if they will cover for my HSG test?
An HSG should be covered on all plans. Did you come right?
As mentioned by others, clients who can afford to be on the comprehensive plan and executive plan can pay cash for IVF. We the people who cannot afford the higher plans are the clients who actually need medical aid to cover the treatment. This is so unfair. Its basically saying only the rich will benefit from this. I have been struggling for 7 years.
Hi Jo. As mentioned in all our posts, including this one that you have commented on, it’s only a start, we are working hard to get fair cover for ALL.
Hi. Does this also cover for delta essential saver plan?
Unfortunately not at this time.
Hi Saskia w I would like to know if I’m on my fiance medical aid how long must I wait to be covered since we both struggle with infertility but his been on discovery for more than 8 years. Since they told him he should be married first to put me on his medical aid. Please help
Hi Lucinda
Are you not on your fiance’s cover yet? Has be been on a comprehensive or executive plan for at least 2 years?
Good morning Saskia No I’m not because they told him he should be married first his on the plan B for 10 years now to be exact.
Hi Saskia
This is truly awesome news.
I was wondering, when they refer to 2 years, when do they start counting?
Do you only qualify for the treatment after being on the scheme for 2 years or the benefit would kick in on your 2nd year with the Scheme?
Hi Kabelo, I hope you guys are well? You need to have been on those covers for 2 years so, year 3 the benefit would kick in. If you can, I would suggest using the cover for a sibling and still going for treatment now, as you don’t want to wait any longer than you need to with fertility.
Wonderful news. Just bad it took so long. We had an unsuccessful IVF and took years to save money for it. We are busy with round two. Will discovery pay for round 3 if we do it next year if needed or must it be a new case? It is a surrogacy case because I can’t carry a child. Will you still cover?
Please contact Discovery or your Broker for full information. If you are on a comprehensive or executive plan, it will cover up to the benefit limit.
Almost over the child bearing years of 42, and still cannot afford any treatment. Discovery has really limited the kind of help people desperatly need. Been a member on coastal saver for years, it has not been of much benefit to me.
Hi Delene. We agree it isn’t fair cover, please check out our fundraiser to try and get the exclusion of fertility treatment overturned https://www.backabuddy.co.za/champion/project/ifaasa-campaign
Most people who have been on these plans can afford IVF already. It’s the ones on the lower plans that need the assistance. I have paid for one successful round of IVF in 2014 and have a 6 year old son from it. Could a Dr not motivate for this as time is against me, despite not being on the top 2?
Hi Candice
I am afraid Doctors can only motivate for payment from your MSA. Discovery have now waived their 2 year wait for members on Comprehensive or Executive plans so, if you upgrade now, you can access those benefits in January. We are still fighting for fair cover for all though so, please ensure that you contact Discovery and make your feelings known about the fact that there isn’t cover on the lower plans, public pressure definitely does help.
Hi Saskia!
So no more 3 yr waiting period??? I’m upgrading tomorrow ❤️❤️❤️❤️❤️
Hi, no more waiting period, no but you have to activate the cover before starting treatment.
I had lupus since I was 12yrs old, im 34 now and married for 8 yrs. We really want to have a baby, but because of the lupus and the way it affected my kidneys I wont be able to carry my child. I dont have any fertility problems and was pregnant before but had to terminate. My Dr also advised that if i do have to fall pregnant it would lead to me having to go on dialysis. What happens in a case like that if my only option to having a child of my own will be a surogate?
Hi Chanelle. You would need to check with Discovery what they would cover. As far as I am aware (and I may be wrong), your surrogate would have to have a comprehensive or executive plan to have the cover. Have you started the surrogacy process yet?
I am so happy to hear this! I have just been approved for this benefit and it really takes the Financial burden off this decision – now it doesn’t seem like such a big decision which we have been putting off, what a huge opportunity – I am over the moon this just made what seemed like another tough year a GREAT one!
I have been with Camaf since 2015. If I join one of the Discovery comprehensive plans how long will I have to wait before I can access the fertility treatment option?
There is no waiting period Mesh, you just need to activate the benefit before using it.
Discovery this actually doesn’t help as the members who can afford your most exclusive plan monthly can afford fertility treatments, it those of us who are on the med discovery plans who are struggling with fertility and cannot afford IVF that needs to be supported..I had to take a 2nd bond to help us get IVF, discovery would not even pay some of the charges out of my savings. Great news to those who can afford ifv, not much difference for us and no support from discovery to who can’t afford
Hi Chaney
We agree, which is why we are fundraising to go to court and fight the exclusion of Fertility Treatment. For more information, please look here: https://www.backabuddy.co.za/champion/project/ifaasa-campaign
Hi I had 3 ectopic pregnancy I’m 39 years of age we are on comprehensive scheme how can you help us to consive
Hi There
You are welcome to check out Discovery’s t’s ad c’s and go to a SASREG approved clinic for help to fall pregnant. https://www.discovery.co.za/medical-aid/assisted-reproductive-therapy-benefit
The list of clinics can be found here: https://sasreg.co.za/centres-of-excellence/