NHS funded IVF for a couple(IHS payee and British Citizen)

[fuschia1]

Due to our inability to conceive (ongoing issue with husband for which is yet to receive any treatment from NHS from past one year), my GP referred me for an initial consultant (July) to a Gynaecologist Department. We were recommended IVF treatment. Subsequently we were referred to the IVF clinic of choice and the IVF clinic scheduled our first appointment this week. In meantime, I received a letter from hospital of Gynaecologist Department cancelling of all fertility appointments/treatment and also charging me for initial consultant in July because I am an IHS payee. No indication was given that an initial consultant would be chargeable. The IVF clinic also cancelled my upcoming appointment as no one around had any clarity in my situation where one spouse is a British Citizen and another is an IHS payee.
Guidance on implementing the overseas visitor charging regulations January 2019 states:
5.23 Where two people are seeking assisted conception services with NHS funding, and one of the two people is covered by health surcharge arrangements and the other is ordinarily resident in the UK and therefore not subject to charge, the services required by the health surcharge payer will be chargeable. Any services required by the ordinarily resident person will continue to be freely available, subject to the established local or national commissioning arrangement.

We will be receiving treatment as couple. The guidance clearly states that as IHS payee, I am eligible for the fertility treatment for a cost and my spouse can receive for free.
Has anyone been in similar situation? Does anyone know about the charges applicable in my scenario? Would both of us be treated as private patient or would be entitle to some funding? Would it matter that the IVF treatment is due to lack treatment given to my husband who is a British citizen?
This has emotionally taken a toll on me. Just feels that I have been treated unfairly without being given an option and being denied a chance to be parent. (Please don't be judgemental , I am not asking for a free treatment just what is fair)

I read it that your DH treatment is free yours is not.....you're in the unfortunate situation that it's the woman who has 99% of the IVF treatment has to take all the drugs, have the scans etc - all the man has to do is give a sample in a cup

Private IVF costs in the region of £6k+ (often more than this) - during my last cycle i saw my doctor for appointments/scans/egg collection/transfer probably about 15 times - husband only had to go once for 10mins to do his sample so you can see that it's the woman who receives the most expensive part of the treatment

I guess the question is if you are planning on having a child here couldn't you have become a British Citizen - do you pay Income Tax and National Insurance etc? If not then the rule is being fairly applied

What treatment was your husband waiting for? If it's vasectomy reversal you wouldn't get IVF on the NHS anyway

Thanks itwasalovelydreamwhileitlasted for your message.
DH has due to his inability to ejaculation inside has been suggested psychosexual therapy.
I have been in UK since 2015 . I pay my taxes, NI beside my visa fees and IHS surcharge. I have all the intention to stay and my indefinite to remain is due next year.

Hi fuschia1. Besides having an interest in infertility (having gone through it), I am also quite active in the realm of immigration, having immigrated to the UK quite awhile back.

www.gov.uk/guidance/nhs-entitlements-migrant-health-guide
Might be a helpful guide. It seems you have found the other pertinant document. Your husband should definitely be eligible for his treatment of therapy on the NHS. However, 'assisted conception services' where you are involved (as you should and are treated as a couple) will likely be charged. This would seem to include consultations and any other treatment that you are to recieve, even if recieved jointly with your British husband.

With this in mind, it is well-worth him pursuing the treatment (quoting what you have quoted above), but it seems to me that until you have ILR (sometime next year), you have to pursue treatment privately. If you want to pursue treatment with this gynaecology department, are they willing to take you on as a private patient? Seems a bit strange they cancelled all appointments and didn't discuss your recourse to treatment first....

@fuschia1 so sorry! This happened to us too. We have male factor, DH is a UK citizen but he didn't receive any treatment as I'm on IHS as well. It's so unfair, we pay our taxes, work full time, pay for NHS surcharges but get treated like this.. I was very angry and tried writing them back, no luck. No I think it was a blessing in disguise as NHS technology is 7 years behind and the waiting list is huge. We ended up trying one cycle in the UK with egg sharing and then went to Czech Republic for further treatment as it's cheaper and better. Also went to Mr Ramsay for consultations on MFI, he is worth the money as no one else in the UK will look into MFI in such detail! Good luck

We should start a petition really!

@Viletta it's sad but the NHS can't pay for everything especially if you haven't committed to being a British citizen

@itwasalovelydreamwhileitlasted it's true, I am committed though to live all my life here. There is a free IVF in the country where I am from but I'm not eligible as I am no longer a resident.

I do appreciate NHS and all it does, don't get me wrong. Its just in this thread we are talking about UK citizens not getting any help just because their partners are not eligible for the fertility treatment under NHS. My DH who is British feels betrayed.

Not really the point, but dh and I are both British citizens, and we were ineligible for ivf on the nhs courtesy of the good old postcode lottery. We ended up going to Poland for ivf, no waiting time and much better success rates.

I’m sorry that you’re going through this, it isn’t fair.

@Viletta
I think it's because the British citizens are your husbands - they aren't actually the ones being treated even if it is male factor as 99% of the treatment is received by us women

If it had been the other way round and your husbands were the foreign citizens then likely you would be eligible for more funding?

I think the problem is that the NHS has no way of knowing if you are committed to staying in the UK or not - you could receive treatment tomorrow and move home within a year so they have to apply the policy to everyone

There is at least 5 NHS groups in the country that don't find ANY IVF and that is likely to increase- doesn't matter if you've paid 1 year or 20 years of national insurance contributions. I think the fairest situation is to not fund IVF at all but it should be made significantly cheaper and more accessible for everyone (if ABC clinic can charge £2500 for a full cycle with drugs etc why can't they all?)

@itwasalovelydreamwhileitlasted another problem is that NHS doesn't treat male factor, they send couple straight to IVF route. In many countries they have Andrology department treating male factor and trying to achieve natural conception first if possible.

@MuchTooTired post code lottery is even more ridiculous! There a petition online about it at the moment created by one of the Mumsnet members.. how was your treatment in Poland? We went to Czech and lived it there.

It is one of those unfortunate ones with IVF - although it may be male factor and you need the IVF because of your partner, the IVF patient is classed as the woman. If you were the other way around and you were British and your OH was IHS you would probably find you do not get charged or at least not charged as much.

It is the unfair part of, whatever the reason, the woman is the IVF patient having treatment.

If it’s due to your husbands inability to ejaculate, you may not need full blown IVF. IUI may well be enough, which is way cheaper and less invasive

Thank you all for your comments.We were not even aware that we would get help from the NHS but one of the private clinics suggested that we should wait for NHS appointment and explore our options. However this path has been made redundant because of the unfortunate turns of events.
At the moment we have contacted the various clinics that are in our CCG. Only one of them responded so far and suggested that the only free treatment will be DH's sperm analysis. We had already got this done abroad which is all good such.We have written to the Hospital referring the IHS policy and asked as to why we were charged and they have now said the charges will be reversed. A senior manager will call to discuss the situation (its been 10 days and we have no update). My GP has also said this is the first time she has seen a letter similar to what I received and is saying I will have to deal with the Hospital and the CCG.We plan to write to the CCG but are not hoping for much at the moment.

@itwasalovelydreamwhileitlasted I hear what you are saying, but I feel I have been treated unfairly by the hospital.

They without giving any recourse cancelled my future fertility treatment. I waited for my appointment for seven months

Had I known that this is what is going to happen I would have gone private at first place and not wasted my time.

In an ACS situation don't you think rather than denying or charging a full price for IVF they should reduce the cost as we are getting the treatment as a couple or CCG should decide on case to case basis rather than a blanket ban.

I satisfy the criteria for IVF at ABC. As I got my scans done at Create, ABC is ready to accept my reports and go with the IVF treatment.
I am confused - should I give IUI a try at a clinic (preferably create) or straight away go ahead with IVF at ABC?

IUI has much lower success rates - they say you need to factor in at least 10 rounds oF IUI to have same success as one cycle of ivf - ABC is so cheap id go straight to IVF whilst you still meet their criteria

My treatment has not started and its already taking a toll on me. With the confusion of what to go ahead for the first attempt - IUI clinic or IVF, I got an job interview call for tomorrow morning. This is making things difficult for me to focus - I do want a new job but should I try for new job whilst going with treatment??

Of course. Go for the job. I did.

If the treatment doesn't work out, you'll kick yourself.

@fuschia1
IVF does impact your work no matter how hard you try for it not to. Especially if you aren't local to your clinic - ABC are cheap because a lot of scans are not done at their office (so I've heard) so you might not be able to get scans done before work (incidentally I'm with Create and they start scans st 730) also time off egg collection and transfer - my employer is very very understanding but I can't imagine a new employer being like that (especially if they think you'll be disappearing off on maternity leave within a few months) and would feel too vulnerable attempting treatment during a probation period

Either start treatment and delay the job or take the job and delay treatment....depends which is more of a priority

Would you please advise me whether I would be entitled to free IVF treatment as I am a british citizen and my husband is on spouse visa paid IHS charge on his visa.He being here in the UK for last 2.5 years and paying all taxes and National Insurance.

@fuschia1 Hi! I am currently in a similar situation. My GP referred me to a fertility specialist at an NHS hospital and I have been to 3 appointments. The hospital just found out that I’m not eligible for IVF treatment when I mentioned that I’m on a spouse visa and now asking for payment for my previous visits. Had I known that the treatment is payable, I would have gone elsewhere and avoided some of the costs. The hospital is saying that the onus is on the patient to know whether treatment is free. May I know whether you ended up having to pay for your initial consultation?

@mrswsw Hi ! Sorry to hear your about situation. I got an invoice for my initial consultation which I disputed and contacted the hospital overseas department/fertility dept numerous times. Few people were helpful in terms of listening, while others were extremely rude to the extent of saying that had I been able to conceive I would never needed the consultation (forgetting that it's not the female who might always need help with fertility) which shattered me . I contacted my GP they said they have thousands of patients to deal and they can't keep a track who is eligible and who is not? I would suggest try disputing the letter as you have been there 3 times and hospital is bound to be aware of regulations. Try to see if you could draw any help from the guidelines. Good luck and hope for the best outcome for you!

@fuschia1 thanks for the response.
I’m speechless, how can these people be so rude.. i thought people would be more understanding. I hope things will work for you as well