Gastrointestinal Endoscopy

What is covered under Gastrointestinal Endoscopy?

Hospital Cover for Gastrointestinal Endoscopy includes hospital treatment to diagnose, investigate and treat the internal gastrointestinal system using a device called an endoscope. 

Examples include:

• colonoscopy
• endoscopy
• gastroscopy
• investigation of the oesophagus. 

This clinical category includes these treatments listed in the Medicare Benefits Schedule (MBS).

Some treatments you might expect to be in the Gastrointestinal Endoscopy clinical category are in other clinical categories. For example, procedures for the digestive system that do not use an endoscope are under Digestive System.

Which Hospital Cover tiers include Gastrointestinal Endoscopy?

What does it mean if cover is ‘optional’?

‘Optional’ means that the Australian Government allows insurers to choose whether or not to cover the clinical category under that Hospital Cover tier.

What does ‘restricted cover’ mean? 

Restricted cover means the insurer pays only limited benefits. 

If insurers offer cover for Gastrointestinal Endoscopy under Basic Hospital Cover, they can do so on a ‘restricted’ basis If you are admitted as a private patient in a private hospital for treatments under this clinical category, you will face considerable out-of-pocket costs.

You should check with your insurer before agreeing to be treated as a private patient in a private hospital if you have restricted cover for Gastrointestinal Endoscopy. 

Does Medicare cover Gastrointestinal Endoscopy?

Yes. Medicare includes all treatments under the Gastrointestinal Endoscopy clinical category.

If there is an MBS item number for the treatment, Medicare covers it. 

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