Private health insurance for gastroscopy

As you get older, it’s not unusual to experience problems with your oesophagus, stomach, or duodenum (also known as your gut area). If left unchecked, gut symptoms can worsen and lead to more severe conditions like gastritis, coeliac disease, oesophageal stricture, or even stomach cancer. 

If you’ve noticed recent issues with your upper digestive tract, it’s best to have this checked through a gastrointestinal endoscopy (gastroscopy). This helps diagnose the causes behind any symptoms and prevent the development of more serious conditions.

In this guide, we’ll answer your questions about this diagnostic procedure including what a gastroscopy is, what it can do for you, how much it costs, and where to get cover for this.

What is a gastroscopy?

A gastroscopy is a diagnostic test used to examine your oesophagus, stomach, small bowel and duodenum (top part of the small intestine). A throat spray or sedative is usually administered to manage any discomfort.

Your doctor passes a thin tube with a small camera, called a gastroscope, from your mouth down to your oesophagus, stomach, and duodenum. Images from the camera can be seen from a monitor. During the examination, your doctor uses small biopsy forceps to take tissue samples for diagnosis.

Endoscopy vs gastroscopy - Is there a difference?

No. Although they sound different, they are basically the same thing and involve diagnosis with a flexible tube attached to a camera. Endoscopy is just another word for gastroscopy. 

What is a gastroscopy looking for?

A gastroscopy looks for upper digestive tract problems so a doctor can determine whether treatment is necessary. Some common reasons for undergoing this procedure include the following:

• Abdominal bloating

• Abdominal or chest pain

• Abnormal findings from blood or imaging tests

• Difficulty swallowing

• Indigestion

• Nausea and vomiting

• Reflux

• Stomach ulcers

The abovementioned symptoms may be caused by the following medical disorders (also diagnosed via the gastroscopy procedure):

• Coeliac disease

• Gastritis

• Hiatal hernia

• Lactose intolerance

• Oesophageal stricture

• Stomach or duodenum bleeding

• Stomach or oesophagus cancer

• Stomach polyps

• Ulcer

How long does a gastroscopy take?

A gastroscopy usually takes about 15 minutes. However, your gastroscopy preparation takes longer because your stomach needs to be empty for at least 5 hours before the diagnostic test begins.

How much does a gastroscopy cost?

It costs around $2,000 to $3,000 if you include all out-of-pocket expenses, doctor fees and hospital costs. The actual procedure costs around $1100*.

Does Medicare cover gastroscopy?

Yes. As a Medicare patient in a public hospital, the service may be provided at no cost to you - however there may be lengthy wait times.  If treated as a private patient, the Medicare Benefits Schedule (MBS) code for this procedure is 30473 and 30478.

The MBS fee is $249.50, but with additional fees such as anaesthesia fees, hospital fees, consultations, and nursing fees, your gastroscopy will likely cost more. While there are some instances where Medicare covers the majority of these costs, this isn't always the case.

How is gastroscopy covered by health insurance?

The good news is gastroscopy is one of the services most commonly covered by basic private health policies. All bronze hospital policies can cover you for this as well. Generally, a bronze cover costs around $20 weekly. Find out more about private health cover here.

As always, it pays to do your research and avoid assuming that you’re automatically covered. Fortunately, you don’t have to do all your health fund research on your own.

Our experts at Compare Club can take care of the heavy lifting and help you find a suitable policy across our panel of trusted health insurers#.

*Gastroscopy costs summary Surgery cost calculator for gastroscopy Preparing for your gastroscopy Endoscopy, gastroscopy, colonoscopy Gastroscopy and your health

Chris Stanley is the sales & operations manager of health insurance at Compare Club. With extensive experience and expertise, Chris is a trusted leader known for his deep understanding of health insurance markets, policies, and coverage options. As the sales & operations manager of health insurance, Chris leads a team of dedicated professionals committed to helping individuals and families make informed decisions about their health insurance needs.

Meet our health insurance expert, Chris Stanley

Chris's top health insurance tips

• 1

  Australia’s public health system is world-class, but wait times for public hospitals can be long, inconvenient - and leave you living in constant pain while you wait.

• 2

  An appropriate private health insurance policy can speed up your surgery, relieving your pain sooner.

• 3

  Family health cover means your children are covered under the same policy as you.

• 4

  Many health insurance policies come with a 12-month waiting period for pregnancy-related cover, so it’s a good idea to get a family policy organized well before starting your family. This means your child will be covered from birth until at least their early twenties (depending on which health fund you select).