Is an MRI covered by Medicare?

Does Medicare cover an MRI? Usually, the answer is yes. MRIs are generally considered medically necessary diagnostic tests because they can evaluate the body for a wide variety of ailments. There are several types of MRI exams, including MRIs to examine your brain, organs, and bones. When a doctor requests an MRI, Medicare Parts A and B usually cover it.

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Chris Tepedino is a feature writer that has written extensively about home, life, and car insurance for numerous websites. He has a college degree in communication from the University of Tennessee and has experience reporting, researching investigative pieces, and crafting detailed, data-driven features. His works have been featured on CB Blog Nation, Flow Words, Healing Law, WIBW Kansas, and C...

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Laura Walker graduated college with a BS in Criminal Justice with a minor in Political Science. She married her husband and began working in the family insurance business in 2005. She became a licensed agent and wrote P&C business focusing on personal lines insurance for 10 years. Laura serviced existing business and wrote new business. She now uses her insurance background to help educate...

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UPDATED: Nov 24, 2021

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The Rundown

  • Medicare generally covers MRIs because doctors typically only request them when they are medically necessary
  • There are several types of MRIs, each that looks into a different part of your body
  • If you’re worried about Medicare coverage, you can purchase additional insurance through Medicare Advantage or Medigap to cover MRIs

Doctors use magnetic resonance imaging (MRI) scans to diagnose various problems. However, hearing that you need one is never a good feeling.

When you do need an MRI scan, you want to focus on your health. The last thing you want to worry about is the cost. Fortunately, an MRI scan cost with insurance isn’t always outrageously high — it all depends on the type of insurance you have.

A common question for this type of diagnostic test is if an MRI is covered by Medicare. Since MRIs are typically requested when you have an abnormality or symptom your doctor is worried about, health insurance usually covers scans.

So, does Medicare cover an MRI? Probably, but if you’re worried about coverage, you can purchase additional insurance with Medicare Advantage or Medigap. If you’re interested in seeing what quotes might look like for you, enter your ZIP code into our free tool.

Does Medicare cover an MRI?

The short answer to the question, “Does Medicare cover MRIs?” is usually yes. Medicare does pay for MRIs when they are considered medically necessary.

What typically covers MRIs is Medicare Part B. Medicare Part B covers outpatient services, such as doctor appointments, preventative services, and diagnostic tests (including MRIs).

If you happen to need an MRI while you’re in the hospital, Medicare Part A will cover your treatment. Medicare Part A includes inpatient treatment at hospitals and other approved facilities.

MRIs diagnose a range of internal complications. These scans are more powerful than X-rays and CT scans, so they are usually reserved for more complex issues.

There are several types of MRIs. Each type looks at different body parts and searches for different health complications.

Type of MRIPart of the bodyUsed to evaluate
Breast MRIBreastsCancers and other abnormalities
Bone and Joint MRIBones, joints, tendons, ligaments, muscles, and cartilageInjuries, cancer, masses, and infections
Brain MRIThe brain and brain stemHeadaches, strokes, aneurysms, seizures, blurry vision, and injuries
Magnetic Resonance AngiographyVascular systemBlockages in veins and arteries
Spine MRISpineHerniated or bulging discs, injuries, and other spinal diseases
Cardiac MRIHeartHeart attack damage, blood flow, heart defects, and tumors
Pelvic MRIFemale reproductive system, Prostate glandAbnormalities in the uterus or ovaries and cancer
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While they may seem intimidating, MRI scans with insurance can help save your life. If your doctor orders one, it’s crucial that you go through with it.

Medicare Advantage insurance does cover MRIs, as well. If Original Medicare isn’t enough, Medicare Advantage is a great place to start.

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How much does a Medicare MRI cost?

Many Americans assume that healthcare services are free under Medicare, but that isn’t correct. Like any other test or treatment, you will still have to pay for an MRI.

First, there is the cost of your deductible. In 2021, the price of Medicare Part B’s deductible is $203 per benefit period. In 2022, that number will rise to $217.

After you’ve met your deductible, you’re responsible for paying your coinsurance fee. Medicare Part B covers 80% of services, like MRIs. That leaves you with the remaining 20%.

The average price of an MRI in America is $2,611. How much does Medicare pay for an MRI? It depends on the type of MRI you receive, where you receive it, and how much your doctor charges, but you can expect to pay much less than you would without insurance.

The good news is that Medicare does cover MRI scans very well. How much does an MRI scan costs with Medicare? According to Medicare.gov, the average price for an MRI brain scan without contrast is $60 in an outpatient setting.

Medicare MRI Guidelines

When you need an MRI, Medicare can help, but only if you meet specific guidelines. Like all other healthcare services, Medicare MRI coverage depends on three criteria:

  • Your doctor must request the procedure as medically necessary
  • You must have the procedure done at a Medicare-approved facility
  • Your doctor must accept Medicare and Medicare assignment

If you meet those criteria, it’s likely that Medicare will cover MRI scans for you.

Medicare Does Cover MRI Scans — Find the Best Option for You

Because insurance covers MRIs, people with Medicare should feel at ease with this diagnostic test. If the price is still too high, you can also look into Medicare Advantage or Medigap to gain additional coverage.

The good news is that the answer to, “Does Medicare cover an MRI” is usually yes. However, if you think you need additional coverage, you should shop around to find the best rates.

If you’re ready to see what quotes might look like for you, then enter your ZIP code into our free tool.

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