Will My Insurance Cover An Open MRI

Open magnetic resonance imaging or MRI is a great alternative to traditional closed MRIs. They are designed to provide more space to reduce MRI claustrophobia and so that claustrophobic or overweight patients can feel more comfortable during the procedure. 

There are two main open MRI designs. The first is the donut, which consists of two round areas separated by a space: 

The second open MRI design is called the stand-up, which allows patients to either sit or stand during the scan. The stand-up MRI can also scan the body in specific positions – which may be helpful to get detailed scans for issues that only occur when standing, such as back pain.

Open MRIs are great for claustrophobic patients. Unlike closed machines, which are infamous for their narrow enclosures, these machines let patients see freely to both sides. 

While most insurance carriers will cover a traditional MRI scan if it is deemed medically necessary, coverage for open MRI depends largely on your insurance plan. If you are planning on using insurance to pay for your MRI, it is important to ask the following questions before shopping for a diagnostic procedure:

Do you have a high-deductible plan?

MRI pricing varies but averages around $500. If you have a high-deductible insurance plan, coverage won’t start until you meet that deductible, no matter what type of procedure your doctor orders. Please call to confirm how much your deductible is and how close you are to meeting it. It is also good to shop around for the lowest price on an open MRI exam— as long as you know you’re getting the best value for your expense. 

Does your insurance plan require pre-qualification for diagnostic tests?

We hate to refer you to the fine print, but some insurers won’t pay for certain procedures unless you have prior authorization. Just like imaging centers, a primary care provider’s referral or prescription is necessary for insurance to approve the procedure. There are different types of primary care providers (PCPs). Some insurance companies and imaging facilities will only accept referrals for certain ones so it’s important to clarify if this is something that might affect you. 

Is the procedure “medically necessary” under your insurer’s definition of that term?

For an MRI, insurance companies usually cover MRIs of all types, but only if they’re “medically necessary.” The best way to find out if your insurer will cover medical imaging is to call your insurance agent directly. Just be sure to place the call before you go in for the procedure.

Even if your insurance company refuses to cover an open MRI, there are still options for low-cost, high-quality imaging. Many centers offer discounted cash pay rates for the same imaging services as insurance but at much more affordable prices. At Medmo, cash MRI can save you up to 80% on your scan. It’s important to note that cash payments will most likely NOT count towards your deductible but it varies between companies and health plans. 

Medmo’s Customer Success Managers have years of experience in prioritizing patients’ needs, especially when it comes to their finances. Contact us through our chatbox or through email for more information on cost and scans.To book a scan, visit us at Medmo.com. Medmo helps people schedule radiology imaging tests – such as MRI, CT scans, PET, and more – at nearby accredited centers and identify the payment solution that works best for them.