Does Medicare Supplement Plan G Cover MRI Scans?

Yes, Medicare Supplement Plan G will typically cover MRI scans.

Original Medicare Part B, which covers outpatient services, will usually cover 80% of the approved cost of an MRI scan. Medicare Supplement Plan G can help cover the remaining 20%.

However, it’s important to remember that coverage only applies if the MRI is deemed medically necessary for the Medicare beneficiary by a doctor, and your doctor must order the scan.

Does Medicare Require Prior Authorization for MRIs?

Prior authorization is often required for an MRI scan to be covered by Medicare. This means that your healthcare provider must obtain approval from Medicare before the scan.

To request prior authorization, your provider must explain why the scan is medically necessary and submit relevant medical records or test results to support their request.

How Does Plan G Coverage Work?

If you receive an MRI, Medicare will cover certain costs. Here’s what you can expect.

Original Medicare Coverage:

• Part B Coverage: Original Medicare under Part B will cover 80% of the approved cost of the MRI, provided it’s deemed medically necessary by a doctor. Your doctor must order the scan.

Medicare Supplement Plan G Coverage:

• Gap Coverage and Out-Of-Pocket Costs: Medicare Supplement Plan G covers the gaps left by traditional Medicare insurance. So, if an MRI is covered by Part A or Part B, then Plan G also applies. The 20% you typically pay under Part B would be covered with Plan G.

Bottom Line

Medicare Supplement Plan G typically covers the costs of MRI scans. This is because Plan G is designed to cover Medicare Part B excess charges, encompassing a wide range of diagnostic radiology services, including but not limited to MRI scans.

However, it is essential to note that coverage may vary depending on individual circumstances. We always recommend contacting your insurance provider to inquire about the exact coverage details of MRI scans under your Medicare Supplement Plan G.

Sources: HealthLine  |  Procedure Price Lookup  |  Compare Medigap Plans

FAQs

• When does Plan G typically cover MRI scans?

  If an MRI is covered by Part A or Part B of traditional Medicare, then Plan G would also cover it. This means that you can expect 80% coverage for the approved cost of the MRI, with your Plan G contributing to the remaining 20%.

• Is there a limit to how often I can get an MRI?

  Yes, there is a limit to how often you can get an MRI. Medicare typically only covers medically necessary MRI scans; your doctor will consider frequency when determining medical necessity.