Medicare and health insurance can cover MRI scans but only if you’re being treated as an inpatient in hospital.
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Medicare and health insurance won't cover MRI scans that are classified as outpatient services. However, both can cover you if you're admitted to hospital and require an MRI scan during the course of your treatment. So long as the reason for the scan is on the MBS list, even a basic hospital policy can ensure that you pay little to nothing.
How does health insurance cover MRI scans?
Inpatient
If you are admitted to hospital as an inpatient and require an MRI scan during the course of your treatment, hospital insurance can cover the gap between what Medicare pays and the total cost of the scan. The scan will need to be for the treatment of a condition that your policy covers, however.
Outpatient
Generally, an MRI is considered an outpatient service, which isn't covered by Medicare or private health insurance. Unfortunately, this means that you'll most likely have to pay the full cost of the MRI yourself.
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Depending on your age, you may be eligible for an
aged-based discount. This is used to estimate your
rebate.
Under 65
65 - 69
70 or older
What's your household's taxable income?
This is the combined income you and your spouse earn before tax. It's needed to calculate the correct Australian government rebate.
$93,000 and under
$93,001 to $108,000
$108,001 to $144,000
$144,001 and over
What kind of health insurance do you need?
Combined (Extras + Hospitals)
Extras
Hospital
What level of hospital coverage would you like?
You can change this at any time later.
Legend
Covered
Restricted cover, You may be partially covered for
this category.
Not covered. Optional for insurer to include.
*Prices updated March 2024, in line with Finder's
database of health insurance policies. Prices are based
on a single individual with less than $93,000 income and
living in Sydney with a $750 excess.
What extras cover do you need? (Optional)
Select as many as you want or move to the next step
Preventative & general dental
Major dental & implants
Optical
Physiotherapy
Podiatry
Non-PBS pharmaceuticals
Chiropractic
Emergency ambulance
Remedial massage
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You'll pay the same price as going direct - we don't
charge fees
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Hang tight - we're fetching policies just for you!
Comparing quotes from 40+ funds...
Who pays for MRI scans?
Medicare
Medicare almost always covers MRI scans as long as it has been ordered by a GP or a recognised medical specialist. They generally cost around $100 to $500 but you might not have any out of pocket expenses because it's often bulk billed.
Private health insurance
If you receive an MRI scan as a public patient in a public hospital you can claim a rebate, providing it was part of a Medicare approved treatment. If you are covered by health insurance and opt to be treated as a private patient in a public or private hospital, Medicare pays 75-85% of the cost, while the remaining amount is paid by your health fund.
What to look for in health insurance policies that cover MRIs
Sections that include MRI. Look for joint investigation, gastroscopy, diagnostic imaging, health screenings and similar terms. Depending on your particular health issues, you might be able to claim the MRI costs against these treatments.
Annual benefit limits. This s the highest dollar amount that can be claimed per year for a certain procedure. They might also be per person, or per family if there are multiple people covered by your policy.
Exclusions. This refers to conditions under which claims won't be paid. Common exclusions include overseas treatment, medically unnecessary scans and scans performed without a doctor's referral.
Pre-existing conditions. This can be a particular concern for seniors, as such conditions may accumulate over the years, slowly limiting your options. You may wish to look at health insurance options for seniors if you're over 65.
What happens during an MRI?
MRI machines pass radio waves through your body, some of which are absorbed by your body’s tissue before being retransmitted. By turning the large magnet in an MRI machine on and off, the machine picks up the radio waves you are giving off and uses these to generate a picture of a particular part of your body.
Before you undergo an MRI procedure, what you can expect will be thoroughly explained to you by the radiographer. After changing into a gown, you will be asked to lie on a table. This table then passes into the “tunnel” inside the MRI machine, where the scan will take place.
You'll then need to lie on the table in the tunnel while the scans are completed, which can take anywhere from 15 minutes to an hour. You’ll hear a range of knocking and buzzing noises during the scan, but you won’t feel anything. You may be given a dye injection that makes the pictures the machine takes easier to examine, or you may need to hold your breath for some pictures.
Treatments
Purpose of the MRI scan
Joint investigations
If you need an MRI for limb joint analysis or preparation for surgery it can be claimed under the joint investigation component of your health insurance policy.
Gastroscopy
An MRI may be recommended by your doctor for diagnosing health issues affecting digestive system, including the bowels and oesophagus.
Diagnostic imaging
A general term for procedures like X-rays, CT scans, MRIs and other imaging techniques, and requires a doctors referral in order to claim.
Health screenings
Health screenings are preventative measures used to identify potential health issues. Some extras cover include MRI health screening benefits.
Why do you have to remove all metallic items?
One of the key things you’re told before undergoing an MRI scan is that you need to remove all metallic items before going into the machine. The reason behind this can be found in the “M” of “MRI”, which of course stands for “magnetic”.
MRI machines use very high-powered magnets to scan your body, so any metallic objects in the vicinity of the machine’s magnetic field can become magnetised and pulled towards the MRI magnet, which can be quite dangerous.
For example, let’s say you were to wear earrings into an MRI machine. Those metallic earrings could be pulled towards the MRI magnet with such force that they could be ripped from your ears.
For this reason, there are very strict measures in place to stop you taking any metallic items into an MRI scanner. Removing earrings, wedding rings, coins and all other jewellery before undergoing an MRI scan is the best way to ensure your safety.
How much does health insurance cost?
We ask hundreds of Australians what they're paying for health insurance every month. Here's what their bill looked like in November 2024.
Extras only: $56
Basic: $105
Bronze: $141
Silver: $193
Gold: $223
Price based on 470+ responses for single hospital or extras insurance.
Gary Ross Hunter was an editor at Finder, specialising in insurance. He’s been writing about life, travel, home, car, pet and health insurance for over 6 years and regularly appears as an insurance expert in publications including The Sydney Morning Herald, The Guardian and news.com.au. Gary holds a Kaplan Tier 2 General Advice General Insurance certification which meets the requirements of ASIC Regulatory Guide 146 (RG146). See full bio
Gary Ross's expertise
Gary Ross has written 646 Finder guides across topics including:
Andrew Munro was the global cryptocurrency editor at Finder. During his time he covered all aspects of cryptocurrency and the blockchain. Before he became cryptocurrency editor, he was a content writer for Finder covering various topics over his nearly 5 years in the role. Prior to joining Finder he was a web copywriter. Andrew has a Bachelor of Arts from the University of New South Wales. See full bio
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Depending on your age, you may be eligible for an
aged-based discount. This is used to estimate your
rebate.
Under 65
65 - 69
70 or older
What's your household's taxable income?
This is the combined income you and your spouse earn before tax. It's needed to calculate the correct Australian government rebate.
$93,000 and under
$93,001 to $108,000
$108,001 to $144,000
$144,001 and over
What kind of health insurance do you need?
Combined (Extras + Hospitals)
Extras
Hospital
What level of hospital coverage would you like?
You can change this at any time later.
Legend
Covered
Restricted cover, You may be partially covered for
this category.
Not covered. Optional for insurer to include.
*Prices updated March 2024, in line with Finder's
database of health insurance policies. Prices are based
on a single individual with less than $93,000 income and
living in Sydney with a $750 excess.
What extras cover do you need? (Optional)
Select as many as you want or move to the next step
Preventative & general dental
Major dental & implants
Optical
Physiotherapy
Podiatry
Non-PBS pharmaceuticals
Chiropractic
Emergency ambulance
Remedial massage
Email me my results (optional)
To get a copy of your results for later, add your email below