Endoscopies
What are endoscopies?
Endoscopies – also called scopes – are used to investigate certain medical and surgical conditions such as gastric ulcers, reflux and infections. When we refer to endoscopies and how we cover them, we only refer to four diagnostic endoscopies which include gastroscopy, colonoscopy, sigmoidoscopy and proctoscopy. These are all used to investigate the digestive system. Scopes may also be used to investigate other body systems. All such endoscopies/scopes fall outside of this benefit.
Cover for gastroscopy, colonoscopy, sigmoidoscopy and proctoscopy.
Please Note: Please call us to confirm your benefits at least 48 hours before having this procedure.
Where the scope is performed in your doctor’s rooms we refer to this as “out-of-hospital”
Where the scope is performed in hospital, payment for this healthcare service is based on your health plan
In-hospital
In-hospital with authorisation:
Hospital and related accounts paid from the Hospital Benefit
In-hospital without authorisation:
Scope codes will be funded from IPB, subject to available scopes IPB limit, all other accounts (hospital and related) will be paid from MSA.
Out-of-hospital
In doctor's rooms with authorisation:
Scope codes will be funded from your Insured Procedures Benefit (IPB), subject to available scopes IPB limit, all other accounts (hospital and related) will be paid from MSA.