LGBTQIA+ couples and single women may face discrimination depending on their specialist when accessing rebates for assisted reproductive technology treatments, prompting advocates to call for more equitable access.
Medical rebates for people undergoing treatments such as IVF or intrauterine insemination are available for people experiencing infertility.
The rebate is available for people who are deemed to have "clinically relevant medical infertility" but it is ultimately up to the doctor's discretion as to whether it applies to same-sex couples or individuals.
Genea Fertility chief executive Tim Yeoh said Medicare definitions needed to be updated to better regulate who was eligible for rebates.
"I think the challenge is that when it comes to things like Medicare, certain rules would have been put in place many decades ago was a more common community understanding of how things should work," he said.
"It's not a bad time for Medicare, Services Australia and some of the state governments just to take a bit of a proactive stance on inclusiveness in terms of funding for alternative family types."
People can be placed in two categories by doctors, being "medically infertile" or "socially infertile", and some won't consider the latter to be eligible. Rainbow Families executive officer Ashley Scott said leaving it to a doctor's discretion could lead to discrimination.
"That really does discriminate against our community. LGBTQ+ people wanting to become parents as well as single people that may not have any medical reasons why they're infertile it's more about social infertility, which is the phrase that's used," he said.
Some fertility treatment companies have made it clear about who they will give rebates to.
Genea's position on rebates is that anyone who needs assisted reproductive technology is entitled to a Medicare rebate.
"We take pride in advocating for inclusivity and removing the exclusion of part of our community to start a family," Mr Yeoh said.
"Removing financial pressure that is not encountered by heteronormative families will allow more equitable access to treatment for all our patients."
Phoebe Wallner did not think her wife, also called Phoebe, would be eligible for a rebate when she underwent intrauterine insemination a few years ago but they were left pleasantly surprised.
"We had the expectation going into it, from other people, that we wouldn't qualify for a Medicare rebate unless there was a medical infertility," she said.
"We went through it and at the end we ended up getting the rebate. It was all completely non-transparent as to why or how. It sort of seemed to be at the discretion of the doctor."
The couple have had two children. Ms Wallner carried the second child but was eligible as she has endometriosis and polycystic ovary syndrome.
She has heard from friends who have had a much harder time accessing rebates.
"It's sort of this non-transparent process that seems to be at the discretion of the practitioner or the provider of the fertility clinic," she said.
"It's really vague and it's a really hard process to navigate and if you're a same-sex couple who also has a little bit of distrust of the medical fraternity, it's a really hard thing."
The Department of Health was asked whether treatment was available for same-sex couples or individuals who had not undergone any fertility treatment.
"Assisted reproductive technology items are available under the MBS where a patient's fertility specialist has determined that patient has clinically relevant medical infertility and the requirements of the applicable item descriptor and any associated notes can be met," a spokesman said.
But the spokesman said the responsibility was on the clinician to ensure it was clinically relevant.
"It is the responsibility of the health care professional providing the service to ensure that the service is clinically relevant, performed in accordance with state and territory laws and ensuring all item requirements and the requirements of any associated notes are met," the spokesman said.
"The Australian government relies on the medical practitioner to determine the appropriate treatment for specific conditions and whether there is an appropriate Medicare Benefit that can be billed."
The ACT's opposition unveiled a policy in April to provide $2000 rebates for Canberrans undergoing IVF or other assisted reproductive technology treatments.
This rebate will only be available to women who are deemed medically infertile but again the onus will be on the treating fertility doctor to determine whether an individual is eligible.
Both Labor and the Greens have promised to put forward their own policies ahead of the October election. Both parties have said it will be open to same-sex couples and individuals.
