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Yes, Medicare does cover MRI scans, but the details of coverage depend on several factors, including the type of Medicare plan you have, whether the scan is performed in a hospital or outpatient setting, and whether additional medications are needed during the procedure. Inpatient MRIs fall under Medicare Part A, while outpatient scans are covered by Medicare Part B. Medicare Advantage (Part C) provides the same baseline coverage but involves prior authorization, in-network restrictions, or copay-based costs.
For related medications such as sedatives or contrast dye, Medicare Part D applies. Ultimately, the cost of an MRI with Medicare varies from minimal coinsurance under Original Medicare to plan-specific charges under Medicare Advantage, with Medigap offering additional protection against out-of-pocket expenses.
What Factors Determine Medicare Coverage for MRI Scans?
Medicare coverage for MRI scans is determined by medical necessity, the type of Medicare plan, and the setting where the scan is performed. Original Medicare (Parts A and B) covers MRIs if they are deemed medically necessary by a Medicare-approved provider. Part A applies when the scan takes place during an inpatient hospital stay, while Part B applies to outpatient MRIs performed at approved imaging centers or hospital outpatient departments. Medicare Advantage (Part C) plans also cover MRIs, but patients may need to use in-network providers and obtain prior authorization, depending on the plan’s rules.
How Medicare Part A (Hospital Insurance) Helps Cover the Cost of an MRI?
Medicare Part A helps cover the cost of MRI scans if you are admitted to the hospital. In 2025, the Part A deductible is $1,676. Once this deductible is met, inpatient MRIs are fully covered for the first 60 days of your hospital stay. After day 60, daily coinsurance costs apply depending on the length of your stay.
When Medicare Part B (Medical Insurance) Applies?
Medicare Part B applies when an MRI is performed in an outpatient setting, such as an imaging center or a hospital outpatient department. Under Part B, you are responsible for meeting the $257 deductible in 2025. After that, Medicare pays 80% of the Medicare-approved amount, while you pay the remaining 20% coinsurance.
Do Medicare Advantage (Part C) Plans Cover MRIs?
Yes, Medicare Advantage (Part C) plans cover MRIs. These plans are required to provide at least the same level of coverage as Original Medicare, but since they are administered by private insurers, the specific costs and rules differ. Some Medicare Advantage plans require prior authorization before approving an MRI, and out-of-pocket expenses are often structured as fixed copayments rather than coinsurance.
Additionally, most plans require patients to use in-network imaging centers or hospitals to avoid higher costs. Because of these variations, it is important to confirm coverage details and potential expenses with your Medicare Advantage provider before scheduling an MRI.
Does Medicare Part D Cover MRI-Related Medications?
Yes, in some instances, Medicare Part D covers MRI-related medications. Medicare Part D does not cover the MRI itself, but it may cover medicines that are needed as part of the procedure. This includes sedatives prescribed to help patients manage claustrophobia during an MRI, as well as medications required if contrast dye is used for more precise imaging. However, coverage depends on the specific plan’s formulary, so it is important to check whether these medications are included before your appointment.
How Much Does an MRI Cost with Medicare?
An MRI cost with Medicare depends on whether you are covered under Original Medicare, Medicare Advantage, or have supplemental insurance. Without insurance, MRI scans range from $400 to $4,000 depending on the type of scan, the facility, and the location.
With Original Medicare, patients are responsible for 20% coinsurance after meeting the deductible. In 2025, the average outpatient MRI cost was $9 in ambulatory surgical centers and $17 in hospital outpatient departments, while brain MRI scans averaged $58 in separate facilities and $91 in hospital outpatient settings.
Medicare Advantage plans also cover MRIs, but costs differ since private insurers use flat copays or their own coinsurance structures. For patients with Medigap, supplemental insurance helps cover deductibles, copayments, and coinsurance under Parts A and B, significantly reducing out-of-pocket expenses.
Do You Need Prior Authorization for an MRI Under Medicare?
No, prior authorization is usually not required for an MRI under Original Medicare (Parts A and B). However, Medicare Advantage (Part C) plans require prior approval from the insurer before the scans are performed.
Are All Types of MRIs Covered by Medicare?
Yes, all types of MRIs are covered by Medicare if they are medically necessary and ordered by a Medicare-approved physician. This includes brain MRIs, spinal MRIs, joint MRIs, and vascular MRIs when used to diagnose or guide treatment for specific conditions.
Does Medicare Cover a Full-Body MRI Scan?
No, Medicare does not cover a full-body MRI scan for general screening purposes. Medicare only covers MRIs that are deemed medically necessary and ordered by a Medicare-approved physician to diagnose or treat a specific condition.
Can You Get a Full-Body MRI With Medicare if You Have No Symptoms?
No, you cannot get a full-body MRI with Medicare if you have no symptoms. Medicare does not pay for preventive or screening MRIs without a documented medical reason, as these scans are considered elective and not medically necessary.
How Much Does a Full-Body MRI Cost if Medicare Does Not Cover It?
The cost of a full-body MRI if Medicare does not cover it ranges from $1,000 to $5,000, depending on the facility, location, and whether contrast dye is used. Since Medicare does not reimburse for elective full-body MRIs, patients must pay the full amount out of pocket.
