Health Insurance May Not Cover MRIs In Every Circumstance
Determining whether your health insurance will cover certain procedures can help you control your healthcare costs and make financially sound decisions regarding the services you obtain. While MRIs are generally covered by health insurance, it is left to the discretion of your health insurance company to decide whether the test is medically necessary. If your provider determines that it is not, then you may pay for the procedure out-of-pocket.
What is an MRI?
Magnetic Resonance Imaging
An MRI, is a noninvasive medical imaging test that produces detailed images of almost every internal structure in the human body, including the organs, bones, muscles and blood vessels. MRI scanners create images of the body using a large magnet and radio waves.
How Much Do MRIs Cost?
Medical imaging is expensive, but how much you pay for a test ranges widely depending on the healthcare provider and health care prices in your region. On average, fees typically range between $500 and $3,000, but your bills may be even higher.
If your health insurance company determines that an MRI is medically necessary, then the test is typically covered. However, this does not necessarily mean that it will cost you nothing. Depending on your health insurance plan, you may have to meet a deductible before your policy pays for anything while some insurance plans you will pay a co-pay. If you do not have a co-pay, and you have already met your deductible, you would pay a percentage of the price, called coinsurance. If you have met your “out of pocket maximum” this means you are not required to pay anything for the remainder of the calendar year. The “out of pocket maximum” is the most you will pay for anything medically necessary for the remainder of the year, and this includes prescriptions. You would want to look at your policy’s “Summary of Benefits” for further information regarding your plan.
The portion of the cost your health insurance pays also depends on whether you see an in-network provider. Many health insurance plans have network providers that agree to the plan’s payment terms. If you have an HMO, your health insurance usually only pays for care you get from an in-network provider. If you get services from an out-of-network provider, you generally pay the entire bill, because HMO plans do not have coverage out of their network. If you have a PPO, your policy covers care from out-of-network providers, but you pay much less if you stay in-network.
How to Find Out If Your MRI Is Covered
The best way to determine whether your MRI is covered is to call the number on the back of your insurance card under “member services” to discuss your portion of payment that may be necessary. It is important to remember that your health insurance company will usually tell you how much your co-pay, deductible, and/or co-insurance would be. They most likely will not be able to discuss the contracted rate before the procedure. Your member services department can give you an idea as to how much you’ll pay so you can plan accordingly.
What To Do If Your MRI Is Not Covered
If you have to pay for an MRI out of pocket, your best option is to call around and get quotes from local providers. Your city’s cost of living significantly influences the affordability of healthcare services, but even within a single city, costs can range drastically. Many providers have sliding fee schedules or flexible payment plans for self-paying clients.
Getting Great Health Insurance with Nevada Insurance Enrollment
Comprehensive health insurance can help you obtain necessary medical services without financial hardship. At Nevada Insurance Enrollment, our health insurance agents help you assess your needs and budget and enroll in the best policy for you.
Recent Posts
Are Fertility Services Covered by Health Insurance?
Even if you live in a state that requires health insurance coverage for fertility treatments, there may be certain requirements that you have to meet to have services covered. For example, if you have unexplained infertility, you might only qualify for in vitro fertilization after a period of time or a specified number of in-vitro cycles.
Affordable Care Act Pros and Cons: Will It Last?
While a lot of good has come from the law, there have been serious downsides as well, leaving many to wonder whether the ACA will stand the test of time or be repealed and replaced.
What is Covered By Obamacare?
Preventive services are covered under the Affordable Care Act at no cost to the insured. This means there is no co-payment or deductible. There are specific services provided for all adults and specific benefits provided to women and children.
Search This Website
Most Popular Pages
By page visits (this month)
#1) Health Insurance Subsidy Chart
#2) Health Insurance
#3) Health Insurance WITH a Subsidy
#4) Insurance Blog
#5) Request a Quote
Top 5 Most Popular
By page visits (this month)
#1) Health Insurance Subsidy Chart
#2) Health Insurance
#3) Health Insurance WITH a Subsidy
#4) Insurance Blog Posts
#5) Request a Quote
Recent Posts
Telemedicine Benefits
Telemedicine puts healthcare within reach of those who would otherwise have a difficult time visiting a doctor. If you have a severe sinus infection, the last thing you want to do is spend the afternoon in the doctor’s office.
Health Insurance: What is a Single Payer System?
A single-payer health care system is one in which there is one party that collects all healthcare fees and covers all health care costs. In theory, this could reduce medical costs because there would be significantly fewer entities involved in the system, thus cutting down on administrative costs.
What Is A State Based Health Insurance Exchange?
In most cases, when someone is talking about state-based health insurance, they’re referring to a health insurance plan that is regulated by the Department of Insurance in that state. These plans are sold through state health insurance exchanges.
Health Insurance Options For Laid-Off Workers
If you rely on employer-based health insurance and you lose your job, you may wonder what happens if you need medical care before you are able to get new coverage. Fortunately, there is COBRA, a law passed in 1986 gives many workers and their families the right to retain their health insurance even if they quit or lose their jobs.