Many High Deductible Policies only cover 50% for MRI Imaging

High Deductible Policies Have Lower Premiums
but MRI Scan costs are High

Many of the high deductible policies cover medical imaging at only 50% after the deductible is met, leaving the other 50% payable by the patient. With the average cost of an MRI at $2400, 50% of the cost can be a significant out-of-pocket expense, even with insurance. Once your health care policy deductible is met, 50% of $2400 is not an easy amount to come up with.

At Northwest MRI, we realize health care should be more affordable. That is why we’ve built our business model centered on low fixed costs (low overhead). We have also developed business systems and processes that allow us to keep costs to our patients down.

Why Should I Pay Upfront If I Have Health Insurance?

Today, individuals and families are increasingly transitioning to a high deductible health plan, either by choice or due to employer options, to lower the monthly cost of their insurance coverage. A high deductible health plan (also known as an HDHP) means exactly what the name implies. You will pay out a high amount of money (deductible) before the insurance plan starts paying for your medical bills.

If you have an individual plan with a deductible of $4,000 and you receive a medical bill in the amount of $1,200 for an MRI, the insurance company will not pay anything until you reach your deductible. Therefore, you will pay the entire amount out-of-pocket.  Would you rather pay $1,200 for an MRI or would you rather pay $599 for an MRI?  In other words, would you like to keep $601 in your pocket or give it to a hospital?  This is a considerable savings by most accounts.

Keep in mind, if you go to a hospital you will pay an additional fee for the radiologist report at an average cost of $265.  We use the same imaging technology, the same professionally trained staff and board certified radiologist who interprets your exam with no additional cost to you.

The bottom line: we will save you money if you have not met your annual deductible.  Why pay more?

This is a “typical scenario” each situation is different. We will gladly create a personal cost savings estimate for you by talking with your insurance company, and you can make the best decision for yourself.

Example: LydiaNW MRI-Lydia personna

Lydia  has a high deductible policy to save costs, but her son needs an MRI.  They have not met their individual or family deductible for the year.  Their individual deductible is $1000 per family member.

Lydia’s son has only paid down $200 of his $1000 deductible on a previous doctor’s visit this year.

Typical High Deductible             Northwest MRI Cash

$1300                                              $599

Lydia saves $700 and pays down her deductible.

Payment with High Deductible Insurance:   $1300 Net out of Pocket

Jane schedules an MRI from XYZ imaging center. They are an “in-network” provider, and and their charge is $2200 for an MRI plus $200 for a radiology report.

$2000 List Price for a Scan PLUS $200 for the Radiology Report

Lydia’s insurance company has negotiated a discount price with XYZ imaging center of $1600, with $200 radiology fee.

Her insurance company will only cover 50% of all medical imaging, whether in network or out of network.

Lydia pays the $800 remaining on the deductible first.  Then she pays 50% of the negotiated price of 1800, minus the 800 deductible ($1000), which is $500.

$800 Deductible + $500 Co-pay = $1300

Even with Insurance Lydia Pays $1300 !!

Even after you’ve met your deductible, many policies only cover medical imaging at 50%. That leaves you to cover the remaining 50% out of pocket. Be careful not to wait till after you’ve received the final bill to find this out.

Northwest MRI Cash Payment: Lydia Pays  $599 after insurance

Lydia pays Northwest MRI $599, and sends a copy of the bill to her insurance company for reimbursement.

They apply the $599 to her son’s $800 deductible and do not reimburse.  Her deductible remaining is $201.

$599 cash price

The average cost for an MRI nationwide is upwards of $2600, plus the additional costs of expensive radiology reports. Many current medical insurance policies only cover medical imaging at 50%, which means your out-of-pocket cost can still be substantial.

This is a “typical scenario” each situation is different. We will gladly create a personal cost savings estimate for you by talking with your insurance company, and you can make the best decision for yourself.