OBJECTIVES:  This study attempted to examine the changes in costs and the use of capsule endoscopy after the medical service became a selective health benefit. METHODS:  This study investigated the changes in costs and use of capsule endoscopy since September 2015, when the National Health Insurance began to cover it as a selective health benefit (with a coinsurance rate of 80%). As such, this study examined the results of a 2014 survey on the prevailing charges for medical services at five major hospitals to extract the costs of capsule endoscopy before it became a selective health benefit. As for demand for the service, the study reviewed sales of companies that manufacture devices for endoscopy.Finally, it utilized the HIRA Service’s data on claims to measure the use of capsule endoscopy. RESULTS:  Patients, who undergo capsule endoscopy, are now charged 555,910 won, which is about 43% less than the lowest cost of the service at 971,000 won before it became a selective health benefit. Since the shift, patients’ deductible expenditure has reduced by approximately 54% from 971,000 won to 444,728 won. In the use of capsule endoscopy in two years after the shift, it grew about twofold from 1,120 cases to 3,250 cases. Meanwhile, cases of small bowel radiological special study, conducted on patients, as an alternative to capsule endoscopy, reduced from 13,212 to 10,654, marking a decrease of about 20%. CONCLUSIONS:  This study performed the first analysis of costs, coinsurance rate, and use of a medical service that has become a selective health benefit. However, this study showed that the listing of the service as a selective health benefit has reduced patient burden considerably and made it easier to manage the use of the service within the National Health Insurance program, indicating that the new system is successfully achieving its purpose.