Does Medicare cover an MRI?

Does Medicare cover an MRI? Original Medicare will generally cover them if they are medically necessary. Medicare Advantage will also usually cover them, but you should contact your policyholder for details. Learn more below about your Medicare MRI coverage options and how to handle out-of-pocket expenses.

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The Highlights

  • Original Medicare generally covers medically necessary MRI testing
  • Medicare Advantage will most likely cover an MRI, but you should contact your policyholder to make sure
  • A Medigap plan can help cover the out-of-pocket expenses associated with original Medicare

An MRI is magnetic resonance imaging that takes an image of your organs and internal tissues. This can help your healthcare provider diagnose important disorders.

Does Medicare cover an MRI? Original Medicare will mostly cover an MRI as part of a medically necessary diagnostic and treatment plan.

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Does Medicare cover an MRI?

Original Medicare will largely cover MRIs as a part of diagnostic testing for reasons that are medically necessary. Medicare Part A would cover inpatient MRIs, while Medicare Part B would cover outpatient MRIs.

Since Medicare Advantage must be at least the same as original Medicare, these plans will also generally cover MRIs, but you should check with your policyholder for details.

Is an MRI covered by insurance? Medicare must be accepted by both the doctor that orders the MRI and the facility in which the MRI is conducted for it to be covered.

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How much will an MRI scan cost under Medicare?

The average out-of-pocket cost for an outpatient MRI is $12, while the average for an inpatient MRI is $6. However, these costs may vary depending on the cost of living in the area, the facility that conducts the MRI, and any special circumstances of the testing.

After your premiums and health care deductible, you may have a co-payment or coinsurance. Original Medicare usually covers 80 percent of the cost, meaning you will have to pay the other 20 percent. If you have a Medigap plan, you can use it to help cover these out-of-pocket expenses.

Do I have to go to a hospital to receive an MRI scan?

No. Other facilities outside the hospital typically offer the same scan services that hospitals offer. One example would be an imaging center, a place that offers a wide variety of services including x-rays and MRI scans. They also typically cost less and often have early and late hours, as well as free parking. Just make sure to do a little research beforehand so that you go somewhere that provides decent service.

Why would I need an MRI?

According to the NIH, an MRI scan could be good for imaging non-bony body parts or soft tissues. The brain, spinal cord, muscles, ligaments and tendons may be seen more clearly through an MRI than with an x-ray or CT scan.

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What is the average cost of an MRI?

When it comes to Medicare coverage, however, Medicare generally pays for 80 percent of the Medicare-approved amount. The patient is responsible for the remaining 20 percent. The total costs will depend on where the MRI is performed, meaning whether it is outpatient or in-patient.

The Bottom Line: Does Medicare cover an MRI?

Original Medicare will most likely cover an MRI that is medically necessary, although you may have out-of-pocket expenses depending on your premiums, deductible, and co-payment or coinsurance.

Medicare Advantage may also cover MRIs, but you should contact your plan provider to make sure.

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