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Does Medicare cover Endoscopy?

Original Medicare Part B does cover 80% of your endoscopy procedure under certain qualifying conditions. Learn more!

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Does Medicare Part B Cover Endoscopy?

Original Medicare Part B may cover 80% of your endoscopy procedure. For Part B coverage, your doctor needs to determine it’s medically necessary. Furthermore, Medicare must approve the endoscopy, and a Medicare-approved doctor who accepts assignment must perform it.

If the endoscopy meets the above conditions, you pay only 20%. However, some Medicare Supplement Plans cover your 20% coinsurance cost. For example, Plan G pays 100% of Medicare-approved Part B outpatient costs. Please call Senior Healthcare Direct at 1-833-463-3262, TTY 711 to shop for a Medigap plan.

What is Endoscopy?

A doctor performs an endoscopy by inserting a tiny camera on the end of a long, flexible tube down your throat (MayoClinic.org ). The procedure allows your doctor to visually examine your esophagus, stomach, and beginning of your small intestine. Your doctor may recommend an endoscopy procedure for the following reasons:

  • Investigate the cause of digestive issues such as nausea, vomiting, or difficulty swallowing.

  • Diagnose medical conditions, which may include collecting tissue samples (biopsy) to test for diseases.

  • Treat your digestive system, such as burning a bleeding vessel to stop bleeding, widening a narrow esophagus, or removing a foreign object.

In the video, Robert Bache’s digestive issue was difficulty swallowing. During Robert’s endoscopy, his doctor treated a narrow esophagus by putting a balloon down his throat to stretch it out.

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