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Does Medicare Cover MRI Scans?


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What is an MRI?

An MRI scan can produce three-dimensional detailed images of your body without using the more harmful radiation of x-rays. And MRI might help your doctor diagnose or rule out a possible illness or condition. MRI stands for “magnetic resonance imaging” according to the National Institutes of Health (NIH). An MRI allows physicians to tell the difference between various types of tissue based on magnetic properties.

An MRI does not emit the radiation found in x-ray and CT imaging but it does use a strong magnetic field. To have an MRI scan done, you must lie very still within a large magnet. Movement can blur the images being taken. If you have an implant containing iron, such as a pacemaker or cochlear implant, you generally should not enter an MRI machine. A closed MRI machine is tunnel-shaped and from the front looks a little like a donut standing upright. An open MRI machine has no sides and may result in less of a feeling of claustrophobia than a closed MRI.  An MRI scan lasts between 15 minutes to more than an hour, according to the Mayo Clinic.

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. According to the Mayo Clinic, an MRI of the brain and spinal cord can help diagnose:

  • Stroke
  • Tumors
  • Multiple sclerosis
  • Brain injury
  • Aneurysms

An MRI can also detect tumors and abnormalities in the:

  • Ovaries and uterus
  • Prostate
  • Pancreas
  • Spleen
  • Kidneys and liver

An MRI can help evaluate:

  • Bone infections
  • Joint abnormalities
  • Soft tissue and bone tumors
  • Abnormalities in the spine
  • Knee and shoulder injuries

What is an MRI scan cost?

The National Institutes of Health reports that an MRI is more expensive than x-ray imaging or CT scanning. According to Forbes, and MRI scan can cost between $500 and $3,000. However, if you have insurance such as Medicare, this is usually not the amount you will pay out-of-pocket.

Does Medicare Cover an MRI?

Medicare Part B (medical insurance) generally covers diagnostic non-laboratory tests including MRIs under certain conditions. Your doctor or other health care provider must order them and they must be ordered as part of treating a medical problem. MRI scans are subject to copayments and deductibles and Medicare Part B generally covers 80 percent of the allowable charges.

A Medicare Advantage plan is another way to get your Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) benefits from a private insurance company. Medicare Advantage coverage must be at least as good as Original Medicare (Medicare Part A and Part B) meaning Medicare Advantage plans also generally cover MRI scans. With a Medicare Advantage plan you must continue to pay your Part B premium.

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