Insurance premiums, co-pays, and deductibles can make diagnostic tests like an MRI prohibitively expensive; fortunately, most health plans cover them.
Negotiating with imaging providers to reduce costs may help those without insurance to manage expenses more easily. When making this decision, variables include whether oral, IV conscious sedation or general anesthesia is required and whether an open or closed MRI machine will best meet your costs and locations.
Costs
One of the first questions people ask when seeking medical care is how much it will cost. While costly procedures like an MRI may seem expensive at first glance, most health insurance providers provide some reimbursement. Prices depend on location, scan type, and whether or not patients require sedation for the procedure.
Due to their powerful magnetic fields and cooling with liquid helium, MRI machines consume significant amounts of electricity. According to one recent study, an average MRI machine uses 15 kilowatt hours daily – roughly equivalent to half the energy consumed by an American home daily! As a result, hospital costs for using an MRI may be high due to utility costs being factored into any potential estimates of costs associated with MRI technology.
Hospitals are financially incentivized to keep referring doctors happy, which can result in primary care physicians referring patients for MRIs at hospitals instead of freestanding imaging centers despite whether such referrals are medically necessary and result in higher bills for both the patient and insurers.
As is usually the case, the more details needing scanning, the higher the cost of an MRI exam. For instance, brain MRIs often cost significantly more than elbow ones due to the greater fact needed for diagnosis. Furthermore, patients requiring contrast dye for better image clarity will increase their bills accordingly.
Time can also play a part in the cost of an MRI exam, with longer exams tending to cost more. Patients can often request shorter exams if clinically necessary, though longer exams can sometimes incur higher charges.
The cost of an MRI depends heavily on whether or not a patient has insurance coverage, with those covered often experiencing lower out-of-pocket expenses when visiting an in-network facility for their scan. Patients without health coverage should work closely with their healthcare provider to find cost-effective options.
With rising deductibles and co-pays, understanding the actual cost of an MRI before scheduling one has never been more critical. Luckily, there are ways to minimize costs without compromising quality of service.
Locations
Magnetism, radio waves, and computers produce cross-sectional body images through magnetic resonance imaging (MRI). These pictures can then be used to diagnose and treat diseases, injuries, and conditions using cross-sectional images produced using magnetism and radio waves. Scan sessions usually last less than an hour, depending on which part of your body needs examining, after which your exam results will be evaluated by a radiologist who will send signed reports back to your physician and discuss any findings from the MRI with you directly.
During an MRI examination, you lie on a moveable bed with your head supported on a headrest and arms at your sides. A coil, which is an antenna device used for improving image quality, will be placed over or around the area of your body being scanned; you may listen to music through headphones during your scan, and some facilities allow patients to bring in CDs of their choice; friends or family may accompany you into the room, and some MRI centers offer sedation therapy for those who feel anxious during their examinations.
A radiologist or technologist will closely supervise your scan and ask that you remain as still as possible since any movement could create blurry images. If any twitching sensation or noise from the machine bothers you, please notify them.
Once your MRI scan is over, the technologist will remove the coil. You should feel slightly warm, as this is normal – if this bothers you, please notify a radiologist, who will offer alternatives.
Before an MRI scan, you should wear clothing without metal zippers, fasteners, or buttons that fit loosely around your body. A gown may also be necessary during this examination. Furthermore, pregnant and breastfeeding women must inform their radiologist and nurse if their fetus’ reaction to magnetic fields can alter during an MRI scan and lead to complications during examinations. Furthermore, those suffering from kidney or liver diseases should inform both parties since these diseases could prevent contrast material from being used during an MRI examination.
Sedation
An MRI can often be essential in diagnosing and treating medical conditions. Furthermore, an MRI scan may help prepare for surgery or other procedures by using magnetic fields instead of radiation to create images of the body. While the process requires patients to remain still for extended periods, this can be challenging for those suffering from anxiety or nerves; fortunately, sedation options are available if necessary.
Patients considering sedation must inform their physician and arrange for someone to drive them home after treatment. This person should remain with the patient until they can safely drive. A sedative medication can make patients unsteady on their feet to stay safe and avoid stairs and other places where slipping might occur.
The amount and type of sedation necessary will depend on each exam and an individual patient’s comfort level and pain threshold. For instance, an excruciating orthopedic procedure might necessitate moderate or deep sedation; its choice will also depend on the vital signs and the length of stay in the scanner.
An anesthesiologist or healthcare provider specially trained in administering sedation may administer your medication, including nurses, other healthcare providers, and anesthesiologists. A nurse or health care provider will typically inject their sedative through an arm injection, quickly becoming tired and relaxed as the effects occur.
Minimal sedation allows you to remain awake but relaxed during an exam with our technologist; you can always stay in contact using a two-way intercom and invite friends or family into the room during an examination as companions and distractions.
Moderate sedation typically utilizes midazolam and fentanyl in an effective and safe combination to induce unconsciousness without complete sleepiness during an examination, likely leaving no memory of the experience behind.
Insurance
MRIs are invaluable when diagnosing health issues, providing doctors with in-depth and three-dimensional images of tissues, organs, and bones for diagnosis and treatment planning. Unfortunately, as with any medical procedure, MRIs can be costly; thankfully, most people have health insurance to help cover these costs. Depending on their plan, they may be subject to paying a deductible/copay before insurance begins covering expenses. Individuals may also use health savings or flexible spending accounts to decrease out-of-pocket costs.
A doctor’s choice in ordering an MRI test can impact its cost, such as open or traditional closed MRI being typically less costly and an MRI with contrast being more expensive. Furthermore, anyone suffering from anxiety may need an antianxiety medication before receiving their scan, adding another cost component to this exam.
As MRIs are diagnostic tests, most health insurance plans cover them. Individuals should contact their insurer to ascertain coverage and out-of-pocket expenses associated with an MRI procedure.
Medicare Part B typically covers up to 80% of an authorized MRI procedure; however, Medicare Advantage Plans managed by private insurers may have different payment structures, and thus, individuals need to contact their Medicare Advantage provider to understand what coverage exists for MRIs.
GoHealth can assist if you are considering getting an MRI or need help finding a plan to cover it. Our licensed agents will assess your situation and find you an affordable plan that meets all of your needs. Call or fill out a short online application – Once done, our agents will walk you through all the following steps and answer any questions along the way – We look forward to speaking with you!
