Does job-based or Marketplace insurance cover MRI?

MRIs are usually covered when medically necessary, but they are rarely free. A clinician’s order and a covered medical reason make diagnostic imaging eligible. MRIs are among the services most likely to need prior authorization, and the deductible and coinsurance usually apply. Cost: Expect your deductible, then a copay or coinsurance. Ask the plan for a negotiated estimate before care.

Does Original Medicare cover MRI?

Yes, Medicare covers medically necessary MRIs. Part B covers diagnostic MRIs ordered by your doctor. Original Medicare rarely requires prior authorization for imaging. Cost: Generally 20% after the Part B deductible; hospital outpatient settings may add a facility copay.

Does Medicare Advantage cover MRI?

Yes, Medicare covers medically necessary MRIs. Part B covers diagnostic MRIs ordered by your doctor. Original Medicare rarely requires prior authorization for imaging. Medicare Advantage plans must cover this too, but set their own copays and often require in-network providers and prior authorization. Cost: Your plan’s copay or coinsurance: check the Evidence of Coverage.

Does Medicaid cover MRI?

Covered when medically necessary, often with prior authorization. Medicaid health plans often use an outside company to approve scans like MRIs.

Is MRI covered by insurance?

Magnetic resonance imaging (including MRA). Here’s how each kind of plan usually handles it.

Ask a specific question Plan a visit: cost and doctors Check it against my plan

Employer or MarketplaceCovered with conditions
MRIs are usually covered when medically necessary, but they are rarely free.
More details
A clinician’s order and a covered medical reason make diagnostic imaging eligible. MRIs are among the services most likely to need , and the and coinsurance usually apply.
Cost: Expect your deductible, then a copay or coinsurance. Ask the plan for a negotiated estimate before care.
Original MedicareCovered with conditions
Yes, Medicare covers medically necessary MRIs.
More details
covers diagnostic MRIs ordered by your doctor. rarely requires prior authorization for imaging.
Cost: Generally 20% after the Part B deductible; hospital outpatient settings may add a facility copay.
Medicare AdvantageCovered with conditions
Yes, Medicare covers medically necessary MRIs.
More details
covers diagnostic MRIs ordered by your doctor. rarely requires prior authorization for imaging. Medicare Advantage plans must cover this too, but set their own copays and often require in-network providers and prior authorization.
Cost: Your plan’s copay or coinsurance: check the Evidence of Coverage.
MedicaidCovered with conditions
Covered when medically necessary, often with prior authorization.
More details
Medicaid health plans often use an outside company to approve scans like MRIs.

Plan type	How it’s usually covered
Employer or MarketplaceCovered with conditions	MRIs are usually covered when medically necessary, but they are rarely free. A clinician’s order and a covered medical reason make diagnostic imaging eligible. MRIs are among the services most likely to need , and the and coinsurance usually apply. Cost: Expect your deductible, then a copay or coinsurance. Ask the plan for a negotiated estimate before care.
Original MedicareCovered with conditions	Yes, Medicare covers medically necessary MRIs. covers diagnostic MRIs ordered by your doctor. rarely requires prior authorization for imaging. Cost: Generally 20% after the Part B deductible; hospital outpatient settings may add a facility copay.
Medicare AdvantageCovered with conditions	Yes, Medicare covers medically necessary MRIs. covers diagnostic MRIs ordered by your doctor. rarely requires prior authorization for imaging. Medicare Advantage plans must cover this too, but set their own copays and often require in-network providers and prior authorization. Cost: Your plan’s copay or coinsurance: check the Evidence of Coverage.
MedicaidCovered with conditions	Covered when medically necessary, often with prior authorization. Medicaid health plans often use an outside company to approve scans like MRIs.

What usually has to be true

Your doctor must put the medical reason in writing.
MRI and CT commonly require prior authorization before the appointment.
You can get two bills: one from the imaging center and one from the doctor who reads the scan.

Good to know

Covered does not mean free.
MRI and CT commonly need prior authorization.
The facility setting can change the price substantially.

CT scan · Computed tomography (CAT scan) imaging.
X-ray · Standard radiographs.
PET scan · Nuclear imaging, often used for cancer staging.

Sources

Typical rules for 2026 plans, checked against these sources on October 20, 2026. Your plan’s own documents decide.

1
What Marketplace plans cover
HealthCare.gov
Marketplace plans cover outpatient care, hospitalization, mental health care, prescription drugs, rehabilitation, laboratory services, preventive services, and other essential benefit categories.
2
Prior authorization
HealthCare.gov
Prior authorization is a decision by the plan that a service, treatment, drug, or equipment is medically necessary; it is not a promise to pay.
3
Diagnostic non-laboratory tests
Medicare.gov
Part B covers diagnostic tests such as CT scans, MRIs, EKGs, X-rays, and PET scans when a doctor orders them to treat a medical problem; you generally pay 20% after the deductible.
4
Medicare costs
Medicare.gov
Original Medicare commonly charges 20% for covered Part B services after the deductible; covered clinical laboratory services generally cost $0.
5
Compare Original Medicare and Medicare Advantage
Medicare.gov
Medicare Advantage plans cover everything Original Medicare covers (except hospice, which Original Medicare continues to pay), usually use provider networks, often require referrals or prior authorization, and may offer extra benefits such as dental, vision, and hearing.
6
Mandatory and optional Medicaid benefits
Medicaid.gov
States must cover mandatory benefits such as inpatient and outpatient hospital care, physician services, laboratory and X-ray services, home health, and nursing facility care; many other benefits, including adult dental, vision, and prescription drugs coverage details, are state options.

General information about how coverage usually works, not a decision about your plan. Your plan documents and insurer have the final word.

Prior authorization: Commonly required; MRI and CT commonly require prior authorization before the appointment: ask whether the ordering office or the imaging center obtains it.
Typical total price: $400 to $3,500; per service, rough national range before insurance
Where to look in your SBC: Imaging (CT/PET scans, MRIs)
Network: Choose an in-network freestanding imaging center when appropriate; hospital outpatient departments often cost much more.
Pay with HSA or FSA: Eligible; A qualified medical expense: you can pay with an HSA, FSA, or HRA.

What you’d likely pay

For MRI, typically $400 to $3,500

Example: you might pay

$1,590

You $1,590Plan $360

$1,500 toward your deductible, plus $90 (20% of the rest).

Based on a $1,950 bill, $1,500 left on your deductible and 20% coinsurance.

These are typical numbers, not your plan’s. Many plans charge a flat copay for visits instead. Use the numbers on your card or plan summary for a real estimate.

Was MRI denied?Build an appeal with the right deadlines.

Is MRI covered by insurance?

What usually has to be true

Good to know

Related

Sources