colonoscopy changes Health Insurance

In November 2019, Medicare announced changes to the way some colonoscopy services are categorised and billed. These changes will have an impact on the circumstances in which all private health insurers are able to pay benefits for these services.

As with any medically necessary hospital admission, you will continue to be eligible for colonoscopy benefits with your private hospital cover if the procedure is recognised by Medicare and included on your Phoenix Health cover.

Why have they made changes?

The Australian Government changes have been made with the intention of improving access to Medicare-funded colonoscopy services for those who need it, to ensure alignment with contemporary evidence and practice and to improve health outcomes for patients.

How will I know if the procedure is recognised by Medicare?

This is an important question to ask your doctor before you are admitted to hospital for the procedure. It’s also a good idea to ask for an itemised quote so you’re aware of any possible out-of-pocket expenses in advance.

Where can I find more information about the changes?

The Australian Government has prepared a factsheet outlining the changes in more detail, including any affected item numbers. Learn more about the changes and download a copy of the factsheet here.

Planning a hospital admission?

We understand not all hospital admissions are planned but if you learn in advance that you’ll need to be admitted to hospital, contact the Phoenix Health team on 1800 028 817 so we can guide you through your hospital journey.