Will Health Insurance Pay for an MRI?

The cost of healthcare in the United States is skyrocketing, and it seems to be getting more and more expensive every day. The cost of a simple non-emergency medical procedure can be astronomical; forget about the expense of medical emergencies, preventative care, and chronic illnesses. Because healthcare is so expensive in the US, having medical insurance coverage is absolutely vital. Without it, you could end up paying thousands, if not tens or even hundreds of thousands of dollars in medical bills.

Thanks to the Obama Administration and the passage of the Affordable Care Act (ACA or often referred to as “Obamacare”), every American now has access to health insurance coverage. However, before purchasing a policy through the health insurance marketplace, fully understanding the details of your policy, including what it covers, is crucial. No health insurance plan will cover everything; however, some policies do cover more than others, including diagnostic imaging, such as an MRI.

What is an MRI?

Magnetic resonance imaging, more commonly referred to as an MRI, is a form of diagnostic imaging, similar to an X-ray or a CT scan. Through the use of a powerful magnetic field and radio waves, an MRI can capture highly detailed images of the tissues and organs inside the body.

Because an MRI can capture such detailed images of crucial parts of the body, and because it is a non-invasive procedure, it is one of the most common forms of diagnostic imaging used in the healthcare industry. MRIs can be used to view all areas of the body to examine and diagnose everything from cancerous and non-cancerous tumors, abnormalities of the heart, injuries and abnormalities within the joints, brain and spinal cord injuries or diseases, complications of the kidneys, liver, and other organs that lie within the abdomen, as well as female and male reproductive organs.

Is an MRI Covered by Health Insurance?

Like most questions that are asked about health insurance, the answer to that question is: it depends. Typically, MRIs are considered outpatient services, which healthcare funds are not permitted to cover, as per regulations of the Federal government. But, that doesn’t mean that your insurance will not cover the cost of an MRI in all situations; there are certain cases where this type of diagnostic imaging will be covered – at least partially – by your health insurance provider.

For example, if you were to be admitted as a private patient in a hospital and you needed to have an MRI, you might be allowed to file a claim for the treatment with your health insurance provider. Additionally, depending on your health insurance company, the specifics of your policy, the symptoms you are experiencing, and the condition that medical professionals are attempting to diagnose, your MRI may be covered, even if the scan is required in an outpatient setting. For instance, if the symptoms that you are presenting and the diagnosis that has been made can justify the need for an MRI, then you may be able to file a claim with your health insurance provider.

Bear in mind, however, that if your health insurance plan does cover the cost of an MRI scan, you still have to consider your deductible. A deductible refers to the amount of money that you are responsible for paying for medical treatment before your health insurance will become effective. For example, if you have a $3,000 deductible, you would have to pay the full $3,000 out of your own pocket before your health care plan would kick in. Like any other medical treatment, if your deductible isn’t met before you have an MRI, you will be required to pay the full or remaining amount that is owed prior to your health insurance covering any of the costs of the scan.

Finding a Policy that Covers an MRI

Since MRIs can be used to diagnose such a wide range of conditions and scans are so commonly ordered, finding a health insurance policy that will cover the cost of this type of diagnostic imaging is important. Even if you are in good health, overall, there’s no way to predict the future; if you’re involved in an accident, sustain an injury, or develop symptoms that need to be assessed, your doctor may order an MRI scan. Therefore, it’s advisable to enroll in a health care plan that will cover at least part of the expense of this type of testing.

Trying to figure out all the intricacies of the myriad of health insurance policies can be difficult. For assistance with selecting a policy that will cover an MRI and meet all of your other medical and monetary needs, contact a reputable agent that specializes in health insurance. Together, you can assess the different options that are available and determine which one will best suit your individual needs.