Under most circumstances, Medicare will cover MRI scans. MRI (Magnetic Resonance Imaging) scans are used under varying medical contexts, so your specific circumstances may vary. However, in most situations, you’ll have nothing to worry about.

We’ll discuss everything you need to know about who may need to get an MRI, differences in coverage depending on where you get the MRI scan done, and additional options you may have beyond traditional Medicare coverage.

What Are MRIs For?

An MRI can be useful for a wide variety of conditions. MRIs are unique in that they can create images of your soft tissue, whereas X-Ray scans are only able to provide detailed images of bones. This means that while X -Rays and CT scans are useful for understanding fractures and related types of injuries, MRIs have a much wider realm of applicability.

You may need to get an MRI scan to examine your condition after a stroke, aneurysm, or brain injury, or to look at finer structures like your blood vessels. MRIs are also commonly used to evaluate muscle damage and joint abnormalities. They can also be used to screen for various cancers.

Unless you are in a hospital, you will probably get your MRI done at a radiologist’s office, at the recommendation of your physician or specialist.

MRI scans usually take about 45 minutes and involve being almost completely immobile in a small, cramped space for the entirety of that duration. This can make MRIs difficult for some patients, and your physician may be able to find an alternative option for you if that’s the case.

How Do MRIs Work?

MRI works by using strong magnets and radio waves to create an image of the inside of your body. The use of strong magnets prohibits people with certain implants, such as pacemakers and cochlear implants, from getting an MRI under certain conditions. Your doctor will be able to find another suitable option for you if you are unable to get an MRI for some reason.

Getting an MRI Scan in a Hospital

Getting an MRI scan in a hospital will be a fairly straightforward process. If you have been admitted to a hospital, then your services will be covered by Part A of Medicare. Part A will usually cover 80 percent of the approved amount of your procedures, and MRI scans are no exception.

If your doctor has ordered an MRI in a hospital, then it should be covered just like any other procedure under Medicare Part A.

MRI Scans and Part B Coverage

Part B covers your outpatient health services. Most people who get an MRI scan will do so under conditions that apply to Part B. If you get a referral to go to a radiologist’s office and aren’t part of an inpatient program, then Part B will apply to your care.

Medicare Part B only covers services that are “medically necessary”. Without getting into too much detail, this means that you will have to get an MRI ordered by your doctor, rather than deciding to get one on your own.

Part B will function more or less like Part A when it comes to getting an MRI. Part B covers 80 percent of your healthcare costs after your deductible has been paid and leaves you responsible for the remaining 20 percent as a coinsurance fee.

MRIs and Excess Charges: When do They Apply?

If the radiologist that you visit doesn’t accept Medicare assignment, then you may have to pay an additional “excess charge”. This refers to an amount that your healthcare provider charged, which Medicare did not agree to pay.

If you want to avoid excess charges, you should make sure to ask your radiologist or other healthcare provider whether or not they accept Medicare assignment -- they should be able to provide this information easily.

Does Medicare Part C Cover MRIs?

Part C of Medicare is often referred to as Medicare Advantage. Medicare Advantage plans are Medicare plans that are offered by private insurance companies, rather than the federal government. Original Medicare (Parts A and B) is offered by the U.S. Government as one standardized plan for everyone, while Part C plans have a bit more variety.

Part C plans vary in a few key ways when compared to Original Medicare. First, the cost can vary quite a lot. This can be both in terms of the premiums and the out-of-pocket costs. This means that your Part C plan could end up covering more, or less, than the 80 percent that Medicare will cover for your MRI scans.

Second, these private insurance plans also vary to some degree in coverage. However, they all must cover at least what Original Medicare covers. This means that your plan can only provide more coverage than Original Medicare does, not less. For this reason, some plans may end up covering more than 80 percent of the cost of your MRI.

Part C plans also sometimes come bundled with prescription drug coverage.

Medicare Supplement Plans: Can They Help?

Medicare Supplement plans, also known as Medigap plans, are plans that help supplement your Original Medicare coverage. Rather than covering your healthcare costs directly, these plans help cover your out-of-pocket costs, like your deductible and coinsurance fees.

Medigap plans only cover fees associated with Original Medicare, which means that they cannot help cover your costs if you have a Part C plan.

The federal government standardizes Medigap plans, which means they can vary in price, but not in coverage. A full comparison of the coverage offered by each plan is available at medicare.gov.

Supplement plans can help cover your costs in two major categories: coinsurance fees and excess charges. While only two Medigap plans (Plan F and Plan G) cover excess charges, almost every plan covers some amount of your Part B coinsurance. This is that 20 percent that you will have to pay out of pocket, so a Medigap plan can certainly help here.

What's the Cost of an MRI?

The usual cost for an MRI will fall between around $500 to $3,000. This will vary depending on how many scans are taken, which body part is being scanned, and many other factors. Remember that this is the total billed cost, not the cost that you will pay.

This procedure price comparison tool shows that patients will usually pay $60-100 for an MRI brain scan under Original Medicare. While this will vary compared to MRIs for other body parts, it can give you a rough estimate of what to expect to pay with your Medicare coverage.

Key Things to Keep in Mind

For most people, getting an MRI will be just like getting any other medical care done under Original Medicare. Your out-of-pocket costs will be minimal, and coverage should be uniform and easy to access. The main things to keep in mind are that you need to get your MRI under doctor orders and that the MRI coverage may be distinct from the rest of the care you are getting. Otherwise, it should be an easy process.