Coverage

Are MRIs Covered by Medicare?

MRI scans can leave you with high out-of-pocket Medicare costs. Compare Medicare plans in your area and learn how you may be able to save money on your MRI scan.

Yes, Medicare covers MRI Scans that are deemed medically necessary by your doctor, when the doctor and MRI provider accept Medicare. An MRI is typically used in order to diagnose an illness or condition.

Medicare Advantage plans (Medicare Part C) cover eligible MRI scans in the same way that Original Medicare (Part A and Part B) does.

Many Medicare Advantage plans also offer benefits not covered by Original Medicare, such as prescription drug coverage and certain home health care services.

Find a $0 premium Medicare Advantage plan today.

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1-800-557-6059

Doctors review results of an MRI

When does Medicare cover MRI scans?

In order for an MRI (magnetic resonance imaging) scan to be covered by Medicare, it must be ordered by your doctor or other health care provider who determines the procedure to be medically necessary as part of your treatment plan.

Additionally, the doctor prescribing the MRI and the health care provider administering the procedure must both accept Medicare assignment in order to ensure maximum coverage from Medicare.

If they do not accept Medicare assignment, you may be charged for up to 15 percent more than the Medicare-approved amount. This is called an excess Medicare charge.

How much does an MRI cost with Medicare?

Your MRI will typically be covered by Medicare Part B medical insurance. The cost of your MRI (and your cost for other similar scans, such as CT scans, EKGs, X-rays and PET scans) will depend on whether or not you have met your annual Medicare Part B deductible.

The Medicare Part B deductible is $203 per year in 2021. Once you meet your Part B deductible, you will be responsible for paying the Part B coinsurance, which is typically 20 percent of the Medicare-approved amount of your MRI cost.

The cost of an MRI can vary depending on the provider or facility you visit.

Medicare Advantage plans also cover qualified MRI scans

One coverage option Medicare beneficiaries can consider is a Medicare Advantage (Medicare Part C) plan. Medicare Advantage plans are required by law to provide coverage for the same benefits as Medicare Part A and Part B (also called Original Medicare).

Some Medicare Advantage plans may also offer additional benefits not covered by Original Medicare, such as prescription drug coverage, vision, dental and hearing benefits.

Did you know that some Medicare Advantage plans feature $0 monthly premiums? $0 premium plans may not be available in all locations, so it may help to speak with a licensed insurance agent who can help you compare plans that are available where you live, including plans that cover MRI scans.

Find Medicare Advantage plans that cover MRI scans

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Or call 1-800-557-6059 (TTY: 711) to speak with a licensed insurance agent. We accept calls 24/7!

Christian

About the author

Christian Worstell is a senior Medicare and health insurance writer with MedicareAdvantage.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.

Christian’s work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.

Christian has written hundreds of articles for MedicareAvantage.com that teach Medicare beneficiaries the best practices for navigating Medicare. His articles are read by thousands of older Americans each month. By better understanding their health care coverage, readers may hopefully learn how to limit their out-of-pocket Medicare spending and access quality medical care.

Christian’s passion for his role stems from his desire to make a difference in the senior community. He strongly believes that the more beneficiaries know about their Medicare coverage, the better their overall health and wellness is as a result.

A current resident of Raleigh, Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism.

If you’re a member of the media looking to connect with Christian, please don’t hesitate to email our public relations team at Mike@tzhealthmedia.com.

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