People who are lucky enough to have full medical coverage may only have to contribute a small co-payment, assuming that a doctor has prescribed the need for an MRI, the insurance company approves the procedure and the patient meets pre-qualifications criteria.
In the best cases, out-of-pocket expenses may be minimal.
Considering, however, that there are millions of Americans who may still be uninsured or whose plans simply do not cover the full cost of an MRI (if they cover them at all), it is in everyone’s interest to shop around before getting an MRI.
MRI "Cost Related Anxiety"-Reducing Facts
1). Most people don’t necessarily have to pay advertised/reported prices for these procedures. In some cases, prices may be negotiated downwardly, or payment options can be worked out which may allow even people without health coverage and on a tight budget to get an MRI. Though they may not go out of their way to advertise this fact, most imaging facilities are able to negotiate on prices—within reason.
2). Independent/private imaging centers usually offer lower prices (than hospitals) for imaging procedures, especially for the uninsured. It is also more likely that you'll be able to negotiate lower rates with these facilities since hospitals tend to use a one-price-fits-all pricing mentality. Also, hospitals’ overhead expenses are usually much heftier than these private imaging facilities—thus their need to charge more.
3). You need to have a good understanding of the factors that determine the actual cost of an MRI—these include:
- location of the facility;
- the center’s overhead expenses;
- what type of MRI is needed (a brain MRI, for example, would be costlier than one for a knee);
- how many sessions/tests are needed;
- and whether the test will require a contrast agent/dye.
4). It may require lots of patience and time to get quotes for MRI services. This is due to the fact that “shopping around” is, relatively speaking, a new concept to American healthcare. Such shopping around has been done in the past, but mostly by insurances companies.
5). Make sure you obtain codes for the MRI procedure you want priced. Healthcare facilities are used to dealing with a “code” for everything they charge for—by knowing the code(s), you can save time and, possibly, your sanity.
6). Understand that there may be additional charges for an MRI, beyond the quoted fee. Doctor’s fees, for example, are usually billed separately.
7). Be ready for a huge disparity between what different independent facilities charge, even for the exact same type of MRI. There may be even larger differences between what hospitals and these private centers charge.
8). Even if they may not advertise it, most facilities may be open to special payment plans or, in some cases, special rates for people who fall below the government’s poverty line. This may be especially important for hospitals which receive subsidies/grants to cover the cost of some indigent patients’ care.
9). Expect the cost of an MRI to be relatively high. The incredible differences in prices, though, has inspired some experts to suggest that maybe pricing of such services should be controlled or regulated by the government—either that, or a true capitalistic paradigm can be introduced into the US’s healthcare system, one that will introduce actual competition among providers.
Ironically, it’s the insurance companies’ willingness to pay industry-set prices that has hampered such efforts on the part of consumers.
10). MRI procedures may be tax deductible or qualify for medical tax credits. This may be especially important for retirees, the disabled, the self-employed and those receiving public assistance. By all means, keep your receipts in case reimbursements or tax credits may apply in the future.
The cost of an MRI should not preclude anyone who really needs it from getting one. The bottom line is that, by shopping around, you can save hundreds of dollars. For those whose finances are stretched to the limit, special payment plans, or unique, not-generally-advertised options may be available.
Copyright, 2018. Fred Fletcher. All rights reserved.
“Here’s to your health and wellness!”
REFERENCES & RESOURCES