Additional support for members needing fertility treatment
For some, the path to starting or growing a family requires medical support. Fertility treatment can be emotionally demanding and costly, and access to the right care can make an important difference.
From 2027, the MCP will include an Assisted Reproductive Therapy (ART) benefit, providing eligible beneficiaries with greater financial support for approved fertility treatment.
The benefit will cover 75% of the SRR, up to an annual limit of R145 450 per beneficiary. Cover is subject to the Scheme's clinical guidelines and treatment protocols, as well as the use of a facility accredited by the Southern African Society of Reproductive Medicine and Gynaecological Endoscopy (SASREG).
Treatment or procedures that do not form part of the defined basket of care will not be funded from the ART Benefit, unless they qualify for cover as Prescribed Minimum Benefits (PMBs).
Cover based on your age
The treatment available depends on the age of the beneficiary and whether the Scheme's qualifying criteria are met.
|
Age |
Available cover |
|
25 to 39 years |
Up to two IVF cycles per year or two egg donation cycles per year, or one IVF cycle and one egg donation cycle per year |
|
40 to 42 years |
One IVF cycle or one egg donation cycle per year |
|
43 to 50 years |
One egg donation IVF cycle per year |
The donor matching fee is covered for all three age groups. However, the costs charged by egg donor agencies are not covered.
Preserving fertility during cancer treatment
Certain cancer treatments may affect a person's future fertility. Beneficiaries registered on the AMS Oncology Programme who meet the Scheme's clinical entry criteria may therefore qualify for egg or sperm cryopreservation, commonly known as freezing.
The benefit includes storage for up to five years. Cryopreservation and storage are not covered where a beneficiary is not registered on the Oncology Programme or does not meet the clinical entry criteria.
Check your eligibility before starting treatment
If you are considering fertility treatment, contact AMS on 0860 222 633 before starting the process. The Scheme can confirm whether you meet the qualifying criteria, explain the authorisation requirements and help you understand which services will be covered.