My doctor has ordered an upper endoscopy. Is this covered? What will my out of pocket cost be? Thank you for your assistance!
Thank you for reaching out to us today, I would be happy to provide more information regarding your benefit plan coverage.
According to your specific benefit plan, endoscopic services performed for preventive purposes (no medical concern warranting it to be rendered), it is payable 100% when received in network.
If there is a medical issue/concern warranting it to be performed, benefits are payable at a 70% coinsurance level following a $1500 deductible being met. There is a maximum out of pocket of $6500.
This also applies to those performed in network.
The following threads will also help provide additional guidance.
How do I find out my benefit information?
What providers are in my network?
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