Tip For Free MRI
A little known loophole in some PPO health plans grants the ability to receive a free MRI when prescribed by a doctor. Yes, it is possible.
When prescribed to get an MRI from your doctor, most likely s/he will recommend you to the hospital system in which s/he practices. Here's the catch: Hospitals bill differently than a doctor's office. The hospital will bill your health insurance and in turn, you will be responsible for the portion that your health insurance does not cover. Most plans cover 70-90% of this type of expense and you are responsible for the remaining balance of the percentage not covered.
However, if you go to an MRI imaging center that is a part of your plan coverage (your health insurance provider will provide a list if you ask), they will bill the health insurance company as a doctor's office would. Therefore, you will be responsible for your co-pay (if applicable) and that's it. The remaining balance is paid by your provider.
You may want to check out this type of billing situation with other types of hospital services, such as x-rays and bloodwork.
Comments
I wish I new this about 2 months ago.
Damn it! That is not a tip for a "free" MRI, it is a tip on how to use your health insurance more wisely. As much as I would like money not to have to enter into my relationship with my doctor, it simply must nowadays.
Nice tip. The health care system has become so complicated that it is difficult for the average person to know how to get the best deal and quality care with their physician. They'll probably have to begin introducing college courses on how to best manage your health care money.
"However, if you go to an MRI imaging center that is a part of your plan coverage (your health insurance provider will provide a list if you ask), they will bill the health insurance company as a doctor’s office would. Therefore, you will be responsible for your co-pay (if applicable) and that’s it. The remaining balance is paid by your provider. "
This is not true for my insurance.. They have specific copays ($75) and a 10% of the bill charge in the benefits for our policy.. Last year it was just a $75 copay.. More of the "make them pay" if they use it stuff.
What if your ins. carrier does not have an imaging center (I don't live in a UTOPIAN country! What if they flat out don't allow an MRI based on their presumption that MRIs are "EXPERIMENTAL"? I have MID WEST NATIONAL LIFE INS. CO. OF TENNESSEE. It is a PPO. I live in California and I am thinking of going HMO !
thanks for the tip, but it won't work for my health insurance plan either. xrays, injections, etc. are covered in a same-day office visit, but MRI's are not.
I am a college student, on my own, with no health insurance. I have had chronic headaches for the 7 days now and no migraine, headache, or tension medication has helped. I would like an MRI to check for something more serious. The doctors don't know what is wrong, yet I can't afford to pay $2000 to have my head scanned. What do I do? I'm worried that the pain may not be serious now but could lead to something more serious.