Insurance Coverage for Gastroscopy Reports in Taiwan - Gastroenterology and Hepatology

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Issues with Health Insurance Coverage for Gastroscopy Reports


Hello doctor, I recently had an upper gastrointestinal endoscopy in Changhua.
The doctor mentioned that my stomach shows signs of redness and inflammation, and I also have gastroesophageal reflux.
The doctor prescribed Omeprazole and Simethicone to be taken before breakfast and dinner.
However, I feel that my symptoms have worsened; I experience increased bloating after meals and have difficulty digesting, along with constipation.
I would like to ask if I can bring my report to your hospital to get better medication.
I know that Esomeprazole is considered the best; are there any better options available? I feel that Simethicone hasn't improved my digestion.
Are there any better digestive aids? Additionally, if I have another endoscopy on February 22 and bring the report to consult with you for medication, how would that work? For example, if I receive a one-month supply of medication and it doesn't help, how long can I continue to get medication after consulting with you? Thank you for your assistance.

Awei, 30~39 year old female. Ask Date: 2016/02/24

Dr. Cai Anshun reply Gastroenterology and Hepatology


Hello: In principle, you just received a one-month supply of medication on February 22.
Even if you bring a report to our hospital for a prescription for gastric medication, there will still be an issue of duplicate medication under the National Health Insurance.
Based on the gastroscopy report you described, the combination of Omeprazole and Sucralfate should be sufficient for treatment, rather than switching to another medication of the same class.
You may also want to review your diet for any components that could be causing gastric discomfort, such as tea leaves, coffee, soda, chocolate, sweets, glutinous rice products, high-fat/high-protein foods, habits of overeating, smoking, drinking alcohol, chewing betel nut/gum, emotional stress, or being overweight.
Additionally, it is possible that abdominal bloating could be caused by constipation.
There may also be other abdominal conditions.
If necessary, you can come in for a consultation.
Changhua Hospital cares about your health.
Dr.
Tsai An-shun

Reply Date: 2016/02/24

More Info


When it comes to understanding insurance coverage for gastroscopy reports in Taiwan, there are several important factors to consider. First, it is essential to understand that the National Health Insurance (NHI) system in Taiwan provides coverage for a variety of medical procedures, including gastroscopy, but the specifics can vary based on individual circumstances and the nature of the medical condition being treated.

In your case, you mentioned undergoing a gastroscopy that revealed inflammation and gastroesophageal reflux disease (GERD). The medications prescribed, such as Omeprazole (瘍寧) and other digestive aids, are commonly used to manage these conditions. However, if you are experiencing worsening symptoms, it is crucial to communicate this to your healthcare provider. They may need to reassess your treatment plan and consider alternative medications or additional diagnostic tests.

Regarding your question about obtaining a better medication, it is advisable to consult with your physician about your current symptoms and the effectiveness of the prescribed medications. They can provide insights into whether a different medication, such as a stronger proton pump inhibitor or a different class of drugs, might be more effective for your condition. For instance, medications like Esomeprazole (Nexium) or Rabeprazole (AcipHex) may be options worth discussing, as they can sometimes offer better symptom relief for certain patients.

As for the insurance aspect, if you plan to take your gastroscopy report to another hospital for further consultation or to obtain a different medication, you should ensure that the new healthcare provider is within the NHI network to maximize your coverage. Generally, you can present your gastroscopy report to the new physician, and they will evaluate your condition based on the findings. If they prescribe new medications, the coverage will depend on whether those medications are included in the NHI formulary.

If you have a follow-up appointment scheduled for February 22nd, you can bring your gastroscopy report to that consultation. Typically, if you receive a prescription for a month’s supply of medication, you can return for a follow-up visit to discuss your progress. If the medication is not effective, your doctor may adjust the dosage or switch to a different medication. The duration for which you can receive medication after your follow-up visit will depend on your physician's assessment of your condition and the treatment plan they establish.

In summary, it is essential to maintain open communication with your healthcare provider regarding your symptoms and treatment effectiveness. They can guide you on the best course of action, including medication adjustments and insurance coverage for any new prescriptions. Always ensure that you are aware of the NHI policies and how they apply to your specific situation, as this will help you navigate your healthcare needs more effectively.

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