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MRI Scans: Costs and Coverage with Medicare

MRI scans are pricey, but an MRI might be necessary to detect and diagnose certain medical conditions. 

What is an MRI?

A magnetic resonance imaging (MRI) scan produces three-dimensional images of your body to detect certain abnormalities. Unlike x-rays and CT scans, this type of machine does not use radiation and instead relies upon powerful magnetic waves. This specialized scan allows doctors to differentiate between types of soft tissue of the brain, spinal cord, muscles, tendons, and ligaments. 

Most MRI machines are “closed,” meaning you lie on your back and slide into a large, cylindrical machine. This may make some people claustrophobic, but you may be able to ask your doctor for sedatives beforehand. Other MRI machines are “open” and may be a better option for those with intense claustrophobia if one is available. 

MRI machines also emit loud banging sounds during a scan, so ask your MRI technician if they have earplugs available or headphones for music.  

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What does Medicare cover?

MRI scans are expensive, averaging about $2,600 for a single scan in the United States. Depending on the type of scan you need, the cost can run between $500-$3,000. An MRI of the brain or spinal cord will likely be more expensive than an MRI of the knee. 

Most MRI scans will be covered by Part B as long as they are deemed medically necessary, ordered by your doctor, and performed by a provider who accepts Medicare assignment. The scan will likely be subject to an 80 percent copay as well as the Part B deductible. 

For example, if your hospital charges $2,000 for an MRI, Medicare will pick up $1,600, and you will be responsible for the remaining $400. You may also have to pay the Part B deductible if you have not already paid it in the year in which you receive your scan. In 2019, the Part B deductible is $185. 

Some Medicare Advantage plans may differ in how much they pay for an MRI scan, but they must pay at least the same amount as Original Medicare. 

If you have a Medigap policy, it may be able to pick up the MRI copay and Part B deductible. 

An MRI scan as part of an inpatient stay will be picked up by Part A, but you may have to pay the Part A deductible. 

Additional charges could include:

  • Sedatives for claustrophobia
  • Additional readings by radiologists 
  • Injectable contrast or dye

It would be wise to request an itemized bill if you have an MRI so you can know exactly what your charges are.

What do MRI scans diagnose?

MRI scans can be used to diagnose health conditions like:

  • Brain tumors
  • Multiple sclerosis
  • Stroke
  • Dementia
  • Traumatic brain injury
  • Aneurysms
  • Infections

infographic showing what MRI scans diagnose

When should I avoid an MRI?

Although MRI machines do not emit harmful radiation, a scan still may not be right for some patients.

You may need to avoid an MRI if you have:

  • A pacemaker
  • An implantable cardioverter defibrillator (ICD)
  • An implanted insulin pump
  • Artificial body parts, like joints, limbs, or heart valves
  • Cochlear implants
  • Surgical pins, clips, screws, mesh, or plates
  • Metal fragments, bullets, or shrapnel 
  • Body piercings
  • Tattoos with ink that contains metal 

You may also need to avoid an MRI scan if you have kidney problems, are within the first three months of pregnancy, or are currently breastfeeding. 

MRI scans are complex, so be sure to voice any concerns or questions to your doctor before your scan. 

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