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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D. Gilson is a writer and author of essays, poetry, and scholarship that explore the relationship between popular culture, literature, sexuality, and memoir. His latest book is Jesus Freak, with Will Stockton, part of Bloomsbury’s 33 1/3 Series. His other books include I Will Say This Exactly One Time and Crush. His first chapbook, Catch & Release, won the 2012 Robin Becker Prize from Seve...

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Leslie Kasperowicz holds a BA in Social Sciences from the University of Winnipeg. She spent several years as a Farmers Insurance CSR, gaining a solid understanding of insurance products including home, life, auto, and commercial and working directly with insurance customers to understand their needs. She has since used that knowledge in her more than ten years as a writer, largely in the insuranc...

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Reviewed by Leslie Kasperowicz
Farmers CSR for 4 Years

UPDATED: Dec 26, 2020

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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 generally 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 generally 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.

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 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 surrounding the testing.

After your premiums and health care deductible, you may have a copayment 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.

The Bottom Line

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 copayment or coinsurance.

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

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References:

    1. https://www.medicare.gov/coverage/diagnostic-non-laboratory-tests

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