This program is designed to provide eligible Medibank members with more choice and transparency on affordable care options when undergoing some endoscopy procedures at participating hospitals with participating surgeons and anaesthetists. There is no change to your quality of care.

An endoscopy procedure is any procedure using an endoscope (a long tube with a camera at one end and a lens at the other) which allows medical specialists to see inside a patient without the need for major surgery. Gastroscopy, colonoscopy and sigmoidoscopy are all kinds of endoscopy procedures.

Medibank members must have resident hospital cover with gastrointestinal endoscopy benefits included in their product and have served all applicable waiting periods. The program must be clinically appropriate. Please contact us on 132 331 to check your product eligibility and level of cover.

The No Gap Endoscopy program is only available at participating hospitals with participating surgeons and anaesthetists. Your participating surgeon and anaesthetist will work with you to decide if the program is right for you and your health needs. Not all anaesthetists at participating hospitals are participants in this program.  If the procedure is provided by a non-participating anaesthetist, the procedure may involve further out of pockets. 

As long as the procedure is fully provided by participating surgeons and anaesthetists at a participating hospital, eligible members will not pay out-of-pocket costs, for the specific procedure, for the following services as part of their participation in the program:

• Hospital admission, if required.
  
• Medical specialist costs.
• Anaesthetist costs.
• Diagnostic tests, including scans and blood tests (provided these are taken on the day of the procedure and are undertaken as part of the procedure).

An excess or per day payment may still be payable, depending on the type of cover you have and whether you are claiming under your hospital cover for the first time in a calendar year. Please contact us on 132 331 to check your product eligibility and level of cover. You will need to speak to the surgeon performing the procedure to ensure that the surgeon and anaesthetist are participating in Medibank’s no gap program.

There may also be out-of-pocket expenses associated with outpatient appointments, such as your initial visit with a participating surgeon and anaesthetist in their consulting rooms. Please speak with your participating surgeon and anaesthetist to find out more.

Fees may apply if there are complications during your hospital admission that require additional care or services beyond what is included in the no gap program. Please speak with the participating surgeon and anaesthetist to confirm and ensure a valid Informed Financial Consent is given.