VHIS

Bowtie VHIS + BowtieCash for Gastroscopy: full claim is possible!

Many Hong Kong people suffer from gastrointestinal problems. Doctors may recommend a gastroscopy depending on the patient’s conditions. Gastroscopy at a daycare center normally takes only 10 to 15 minutes, but if you assume full claim from medical insurance for such a simple procedure, you might be wrong. You may not even be covered if your medical insurance protection excludes outpatient surgery (refer to the source for more details). However, Insureds from Bowtie VHIS have made full claims for their gastroscopy costs before! Let’s see how it works!
Author Bowtie Team
Reviewed By Bowtie Team
Date 2021-10-06
Updated on 2021-10-06
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Is gastroscopy a medical necessity?Costs varies with different situationsHow to make a full claim for gastroscopy?What is BowtieCash?Case Study of Insurance claim for endoscopy

Is gastroscopy a medical necessity?

No one will rashly take a gastroscopy. Gastroscopy, also known as endoscopy, is a procedure using a bendable, lens-attached, tube-like instrument that enters the esophagus through the mouth, in order to observe the stomach’s conditions. Any abnormalities, such as inflammation, ulcers, polyps, and cancer cells could be detected immediately.

If you have a history/prolonged history of the following symptoms, you should take gastroscopy according to the referral or recommendation from a doctor: 

  • Constant discomfort, pain, and even swelling in the upper abdomen
  • Frequent indigestion
  • Acid reflux
  • Difficulty in swallowing
  • Previous bleeding in the stomach and black stools

Costs varies with different situations

Generally, there are two types of situations that may occur during a gastroscopy examination. Each with different treatment methods and possibility of involving other specialists, and the cost will be adjusted accordingly:

  1. In case of abnormalities, the doctor will evaluate the need for additional tests or surgery, such as removal of the polyps, or extraction of tissue for pathological analysis
  2. If no abnormal tissue is found, the doctor will explain the results to the patient after the examination

How to make a full claim for gastroscopy?

Generally speaking, the price of gastroscopy in private hospitals or endoscopy centers ranges from HK$5,000 to over HK$10,000. If further tissue extraction or removal of polyps is required, there will be additional charges. Although it may not be an astronomical amount of money, it is always good to claim the full amount! Bowtie VHIS covers inpatient or outpatient procedures. If a Bowtie client arranges for a gastroscopy in our medical network, then he/she can use BowtieCash to cover the difference (if any), there is a pretty great chance that nothing will be charged!

What is BowtieCash?

BowtieCash# is a reward program that provides policyholders of Bowtie VHIS with an additional coverage. It can be used to pay for eligible medical costs that exceed the policyholder’s insurance plan coverage^. With BowtieCash, clients have the opportunity to pay at zero cost, just like the following case!

  • ^BowtieCash Program applies to Bowtie VHIS plans only. BowtieCash can only be redeemed through the insurance and claim services of Bowtie and cannot be redeemed for cash.
  • #The promotion is subject to the terms of BowtieCash.

We have designed a case, with reference to the price of a gastroscopy examination at The Grand HD Endoscopy Centre, and the $2,000 BowtieCash in the policy to explain how a Bowtie VHIS insured may help you obtain full claim.

Case Study of Insurance claim for endoscopy

No abnormality found

Ms. Lee underwent a gastroscopy at The Grand HD Endoscopy Centre (Mongkok). There is no abnormality found and thus no extra surgery or treatment is needed. Whether Ms. Lee is enrolled in the Bowtie VHIS Standard or the Flexible Regular, she can get more than 90% of the medical expenses reimbursed. By using BowtieCash to pay the remaining 3% to 7% of the medical expenses, she may have a chance to pay it at zero price!

Item Price The benefits provided by Bowtie VHIS Standard Plan The benefits provided by Bowtie VHIS Flexi Regular Plan
Surgeon’s fee HK$3600* HK$3600 (Full claim!) HK$3600 (Full claim!)
Operating theatre  charge HK$1620* HK$1260 HK$1260
Additional coverage / No additional coverage for this plan HK$288
Total HK$5220* HK$4860 HK$5148
Difference / HK$360 HK$72
BowtieCash / $360 $72
Actual Payment / HK$0 HK$0
  • *The prices in the table are exclusive outpatient fees for the Bowtie customers.
  • *The above expenses include include Dormicum 5mg/5ml, Pethidine 50mg/1ml & 1 biopsy forceps, 1 photo report, Surgeon’s Fee, Intravenous (IV) Sedation Fee, Instrument Fee, Pathology Fee, Operation Theatre Fee, Pre-Consultation Fee, Post-operative Report Interpretation and all miscellaneous charges during the procedure. For OGD include one CLO-test.
  • All of the above examples are for reference only. Actual medical costs will depend on the recommendations and decisions of the doctors regarding the patient's medical condition.
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