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Health insurance for Colonoscopies
A colonoscopy is an important procedure that helps protect you from cancer. Colonoscopy is covered by Medicare, but private health coverage can help you avoid long waiting times.
Depending on your age, you may be eligible for an
aged-based discount. This is used to estimate your
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Under 65
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$93,001 to $108,000
$108,001 to $144,000
$144,001 and over
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*Prices updated March 2024, in line with Finder's
database of health insurance policies. Prices are based
on a single individual with less than $93,000 income and
living in Sydney with a $750 excess.
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What you need to know
A colonoscopy examines the large bowel. The procedure is covered by Medicare, but you will not be able to choose your own doctor.
If you do not have Medicare and are uninsured, a colonoscopy would cost over $2,000.
Demand for colonoscopies is very high - around 7 months in the public system.
When might you have a colonoscopy?
A colonoscopy is a medical procedure that examines the large bowel. It's the most accurate test for cancer of the colon and rectum. Growths can develop on the lining of the colon and sometimes become cancerous.
Colon or bowel cancer screening usually begins at the age of 50 for most people. If a colonoscopy doesn't find anything abnormal, you shouldn't need a test for another ten years.
It is not just a requirement when you reach a certain age. You may also need a colonoscopy if you have any of the following symptoms:
Bleeding from your rectum.
Blood in your stool.
Pus or mucus in your stool.
Unexplained abdominal pain.
Unusual changes in your bowel habits.
Your family have a history of colon cancer.
You have Crohn's disease.
Finder survey: How many people think hospital insurance is worth it?
Response
Female
Male
Somewhat
38.89%
37.71%
Yes
34.67%
34.79%
No
26.44%
27.5%
Source: Finder survey by Pure Profile of 1006 Australians, December 2023
Cost of a colonoscopy
If you are unregistered or uninsured, a colonoscopy could cost over $2,000. It's a procedure you will have at some point in your life, so it's worth considering whether you'd like to have it done privately or through the public system.
How does Medicare cover colonoscopies?
As a public patient in a public hospital or clinic, you'll generally have little to no out of pocket expenses for treatment, as the procedure is covered by Medicare. Unlike the private system, you will be assigned a specialist for the procedure; you won't be able to choose your own doctor.
You will also go on a waiting list for a colonoscopy. Demand for colonoscopies is very high. The average public waiting time is just under 7 months, far longer than the recommended 30 days for those who need it. Indeed, Bowel Cancer Australia says that less than 20% of us who require a colonoscopy aren't getting it within the recommended 30 days. If you need a colonoscopy urgently, or you want to receive treatment quicker, you could opt to go private for shorter waiting times.
Average public vs private wait times in Australia for colonoscopies
Source: Australian Institute of Health and Welfare (AIHW) Private health insurance use in Australian hospitals 2006–07 to 2016–17
How does private health insurance cover colonoscopies?
One of the perks of being a private patient is greater freedom of choice. You'll be able to select your own doctor, when you want the colonoscopy and book in for any prior consultations to discuss the procedure.
While this isn't necessary for everyone, if you have certain health issues like Crohn's disease or bowel cancer, it's likely to give you greater peace of mind knowing you can choose someone you trust.
Similarly, if you've been living with your condition for some time, or simply want a shorter waiting time, you can choose your own specialist.
With a colonoscopy, your private health insurance policy generally covers most of the cost of your procedure, though you are likely to face a small out of pocket expense, depending on your excess, overnight fee, doctor and hospital price. Most basic policies cover colonoscopies for around $70 a month.
Here are some of the ways you can work out a price estimate:
Call your doctor or specialist to get a price.
Ask if your doctor is in your private health insurance provider's preferred list.
Ask for an extras cost.
Make sure there are no hidden out of pocket expenses.
Ask for a Medicare code.
Call your private health insurance provider and give them your Medicare code.
Find out your doctor's estimated rebate.
Why you can trust Finder's health insurance experts
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You can trust us. We say it like it is. We aren't owned by an insurer and our opinions are our own.
Frequently asked questions
Before the procedure, you'll need to discuss a range of issues with your doctor:
It's not recommended to be on blood thinning tablets like aspirin when the procedure is performed so discuss this with your doctor beforehand.
You need a clean bowel so that the doctor can see the colon lining. You may be told to adjust or change your diet and avoid specific foods before the procedure.
Sometimes you will be given a "bowel preparation kit" and instructions on how to use it. The kit contains substances that help cleanse the bowel.
You may be given laxative tablets to help cleanse your bowel.
You'll be required not to consume food or drink prior to the procedure.
You'll receive sedation intravenously prior to the procedure so that you don't feel anything during the colonoscopy.
The doctor will make sure you are lying on your left-hand side with your knees tucked up to your chest. The colonoscope – a long, thin, flexible instrument connected to a camera – is gently inserted through the anus and up into the colon.
Once the colonoscope has reached the point where the colon joins the small intestine, the doctor will slowly withdraw it while looking carefully at the colon lining. The optics of the colonoscope transmits a video image from inside the bowel to a screen and the design of the colonoscope allows for instruments to pass through the channel of the scope to remove any unwanted tissue.
If any abnormal tissue or lumps are found during the colonoscopy, it's removed and the tissue is sent for analysis to check for cancer.
A colonoscopy doesn't usually require an overnight stay. You can usually return home the same day. The examination generally takes less than half an hour but the sedative can stay in your bloodstream for up to a day. Following the procedure, you'll stay in bed for around two hours until the sedation wears off.
If something abnormal is found, you'll receive a follow-up consultation and a plan will be put into place.
A colonoscopy can take a toll on your body, so you can expect to feel tired for a while following the procedure. It's also common that you'll experience some bloating and wind as air may still be trapped in the bowel, but this is normal. You may have a small amount of bleeding if you had any lumps removed.
While these side effects are common, you should contact your doctor if you have any of the following:
Gary Ross Hunter was an editor at Finder, specialising in insurance. He’s been writing about life, travel, home, car, pet and health insurance for over 6 years and regularly appears as an insurance expert in publications including The Sydney Morning Herald, The Guardian and news.com.au. Gary holds a Kaplan Tier 2 General Advice General Insurance certification which meets the requirements of ASIC Regulatory Guide 146 (RG146). See full bio
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You pay nothing. Finder is free to use. And you pay the same as going direct. No markups, no hidden fees.
You save time. We spend 100s of hours researching health insurance so you can sort the gold from the junk faster.
You can trust us. We say it like it is. We aren't owned by an insurer and our opinions are our own.
