Does Medicare cover MRI scans?
MRI stands for “magnetic resonance imaging” according to the Mayo Clinic. MRI scans can be used to take detailed images of your organs and tissues and help your doctor diagnose a variety of health conditions. An MRI machine is a long narrow tube that you lie inside and have a strong magnetic field surround you. Some MRI machines can produce 3-D images.
Why would I need an MRI scan?
According to the Mayo Clinic:
- An MRI scan of the brain and spinal cord can help diagnose stroke, tumors, aneurysms and more.
- An MRI scan of the heart and blood vessels can show if there are any damages caused by heart attack or heart disease and assess inflammation or blockages in the blood vessels.
- An MRI of the uterus, kidneys, liver and other organs can check for abnormalities.
- An MRI scan of the bones and joints can help evaluate bone infections and bone tumors.
An MRI scan may also be used to help detect breast cancer.
How much is an MRI scan?
Like most medical procedures, the cost of an MRI scan depends on a variety of factors. Some factors that may affect how much is an MRI scan include:
- The cost of the MRI machine itself (some MRI machines can reach $3 million according to Time money)
- The room that houses the machine which has safety features to protect those outside from the magnetic field
- Whether or not you are injected with a contrast dye to enhance the appearance of certain details
- How long the MRI lasts (anywhere between 15 minutes and an hour according to the Mayo Clinic)
- The technologist’s fees
How much do I pay for an MRI under Medicare?
How much you pay for an MRI depends on the type of Medicare coverage you have. There are different types of Medicare coverage, such as Original Medicare (includes Part A and B), Medicare Advantage and Medicare Supplement plans. Read on for more details about each plan.
If your doctor orders an MRI scan as part of your inpatient hospital treatment, Medicare Part A may cover the scan, but your Part A coinsurance and deductible may apply.
Medicare Part B will generally cover an MRI scan if it is medically necessary. However, since an MRI is not a laboratory test, you may be responsible for a copayment and deductible. Medicare Part B generally covers 80 percent of allowable charges, leaving you with you a 20 percent responsibility. For example, if the allowable charges are $2,600 for an MRI scan, you may pay $520 out of pocket after you meet your Medicare Part B deductible.
A Medicare Advantage is Medicare hospital and medical insurance coverage offered by a private insurance company. Medicare Advantage plans are required to cover at a minimum, everything that Original Medicare (Part A and Part B) covers. This means that Medicare Advantage plans must cover MRI scans in the same way or better than Original Medicare covers them.
A Medicare Supplement (Medigap) plan may cover some or all of the Medicare Part B coinsurance or copayment and all of the Medicare Part A coinsurance. Medicare Supplement plans go alongside Original Medicare (Part A and Part B) but can NOT be used along with Medicare Advantage plans.
To find a Medicare plan that covers MRI scans, enter your zip code on this page.