VHIS

Bowtie Voluntary Health Insurance Scheme + BowtieCash for colonoscopy: a chance of full claim!

Colorectal cancer is the most common type of fatal cancer in Hong Kong, and colorectal polyps are one of the important causes of the disease. Abnormal cells and polyps could be detected via regular colonoscopy as early as possible to reduce the risk of developing colorectal cancer. With the advanced medical technology nowadays, colonoscopy can be done in about 30 minutes by day surgeries. However, if your health insurance does not cover day surgery, you may not get a claim (see source 1 for more information). Yet in Bowtie, insureds of VHIS can possibly make full claims for the colonoscopy medical expense! Let’s have a look at the following example to see how it is possible!
Author Bowtie Team
Date 2021-08-18
Updated on 2021-08-19
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When do we need to have a colonoscopy?How much does a colonoscopy cost? Can insurance cover the colonoscopy fully?What is BowtieCash?Insurance claim for colonoscopy

When do we need to have a colonoscopy?

Colonoscopy, commonly known as endoscopy, is the procedure using a flexible tube with a light and camera at the end, to enter the colon through the anus to examine the intestinal condition. During the examination, other treatments such as hemostasis, removal of polyps, hemorrhoid ligation and extraction of tissue for pathological tests may also be performed.

If you suffered from any of the following symptoms for a long time, you should seek medical help and get a colonoscopy as referred or recommended:

  • Unknown weight loss or anemia
  • Frequent feeling of bowel urgency after defecating
  • Unstable bowel habits, often constipated, and sometimes diarrhea
  • Persistent diarrhea
  • Unexplained abdominal pain
  • Blood or mucus in the stool

In addition, people aged 50 or older and those at high risk (immediate family members with colorectal cancer) should also undergo regular screening. It is important to note that regular examinations performed without a practitioner’s referral may not be eligible for coverage (See Sources 2, 3 for more information).

How much does a colonoscopy cost?

How much does a colonoscopy cost in general? Bowtie has compared the costs of different private hospitals and colonoscopy centers, ranging from HK$8,000 to over HK$20,000. It is worth noting that if other treatments or other specialists are required during the examination, the costs will be adjusted accordingly.

  1. If abnormal cells/ tissues are found during the examination and, after evaluation by the doctor, the polyps need to be removed or tissues need to be extracted for pathology analysis, additional medical expenses will be incurred.
  2. If no abnormalities are found, the doctor will explain the results to the patient after the examination.

Can insurance cover the colonoscopy fully?

The cost of the colonoscopy depends upon the exact procedure(s) that are done in the surgery, such as tissue extraction or removal of polyps. If your health insurance can cover the full amount, it will indeed reduce the financial burden. Bowtie VHIS covers both inpatient or outpatient procedures. To avoid spending too much at once, customers may schedule a colonoscopy through our medical network and use BowtieCash to make up the difference.

What is BowtieCash?

BowtieCash# is a reward program created by Bowtie for Bowtie VHIS Policyholder to pay for eligible medical costs that exceed the policyholder’s insurance plan coverage.

#Promotion subjects to the terms of the BowtieCash.

We have designed 1 case with the price of endoscopy of The Grand HD Endoscopy Centre, and the $2,000 BowtieCash in the policy as a reference to explain how a Bowtie insured can make a full claim to the cost of the examination. 

Insurance claim for colonoscopy

Abnormal cells found in the intestine

Ms. Lee underwent endoscopy at The Grand HD Endoscopy Centre (Mongkok). During the examination, 3 polyps were found (the cost of 1 – 3 polyps is the same), which required removal surgery and involved pathology analysis. 

To avoid bleeding after polyps removal, the doctor used additional medical tools such as Snare and Biopsy Forceps to perform the surgery resulting in a charge of HK$2700^. However, Bowtie VHIS plans consider this as “miscellaneous” and can fully reimburse this additional cost. Together with BowtieCash, Ms. Lee was fully reimbursed.

Item Price The benefits provided by Bowtie VHIS Standard Plan The benefits provided by Bowtie VHIS Flexi Regular Plan
Surgeon’s fee HK$5,220^ HK$5,000 HK$5,000
Operating room charge HK$1,800^ HK$1,750 HK$1,750
Pathological analysis HK$1,890^ HK$2,700 (taken as “miscellaneous” for reimbursement) HK$2,700 (taken as “miscellaneous” for reimbursement)
Snare HK$630^
Biopsy Forceps HK$180^
Additional coverage / No additional coverage for this plan HK$216
TOTAL HK$9,720^ HK$9,450 HK$9,666
Difference / HK$270 HK$54
BowtieCash / HK$270 HK$54
Actual payment / HK$0 HK$0
  • ^The prices in the table are exclusive outpatient fees for Bowtie customers.
  • ^The above expenses include intravenous sedation, biopsy forceps, medical report with image, doctor's fee, operating room charge, laboratory examination, equipment fee, medication, pre-surgical consultation fee, and endoscopic test for H. pylori.
  • 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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