If a patient needs a colonoscopy because of a medical condition that is covered by his or her health insurance policy, the cost of the colonoscopy can be reimbursed through the health insurance. However, if the patient undergoes colonoscopy only for health checkups and not for therapeutic purposes, this may not be reimbursed by the health insurance in this case. In addition, health insurance reimbursement is usually limited to a certain amount, and only expenses above a certain amount may be reimbursed.
Expenses that can be reimbursed by the health insurance card include the following:
Outpatient expenses: including registration fees, consultation fees, examination fees, laboratory fees and so on.
Hospitalization expenses: including hospital deposit, bed fee, surgery fee, medicine fee and so on. If hospitalization is required, the medical insurance card can help reimburse a portion of the hospitalization costs.
Medicine costs: The medical insurance card can reimburse part of the medicine costs.
Special Disease Expenses: for some special diseases, such as AIDS, tumors and so on.
In summary, whether the health insurance can reimburse the cost of colonoscopy depends on whether the reason for the visit is eligible for reimbursement by the health insurance and whether the cost exceeds the limit of reimbursement.
Legal basis:
The Law of the People's Republic of China on Social Insurance
Article 28
Medical expenses that are in accordance with the basic medical insurance drug directory, diagnostic and therapeutic items, standards of medical services and facilities, as well as those for emergency and rescue, shall be paid out of the basic medical insurance fund in accordance with state regulations.