astronomical cost of brain mri

[someqs17]

hi all,

i am at a complete loss right now and think yall would know the most about this. i went for my second brain mri a couple months ago for ms symptoms and i just got the bill. i had it done on a 3t machine at a hospital. the cost before insurance was $10,000. thats right, $10,000. with my insurance i owe $1,828.

now, i had a brain mri done at an mri place a year ago on a 1t machine and the cost before insurance was $1,400 and i paid $300.

i called my insurance and they cant help...they said id need to check w the hospital on the cost. how could this be soooo much money!?????? it seems complelteyl insane.

would love to hear what u all think

could this be? could 3t cost like 10x a regular machine? this seems unbelievable to me and im hoping its a mistake but i tend not to think so. meanwhile i had a lumbar puncture whixh was only 3k before insurance.

[Mike_Shuswap]

I recal older discussions re- 1.5T vs 3T MRI machines. Seems to me those in the know said the program running the machine is as important as the magnet strength, as well as making sure they are imaging using MS protocal.

I hate to say, and I'm only going by memory here, but I think it was stated that the 1.5T has better resolution or something, and it may be prefered for finding MS lesions.

I think Cobob may have been the poster with a background in the imaging field, and it's my recolection of his posts that I'm trying to get accross (sorry Bob if I'm misinterpreting some of your old posts)

Mike

[Maks322]

Hi
I am getting an 3T MRI on my brain with and without contrast (at a hospital)on the 12th - I have not been told the cost, but plan to call Monday or Tuesday to ask the cost.  I had already been told a 1.5T on my brain with and without contrast (at an imaging center) would cost me $173.00, out of pocket.  It will be interesting to know the difference.  I do expect it to be more - hoping not to much.  hope it's worth it
Maureen

[JaneK1975]

I so feel your pain. I was diagnosed late last year, and at the time I had an HMO insurance plan. I couldn't believe how little I paid for multiple MRI's throughout the diagnostic process. Earlier this year I quit my job to go to  grad school, and made some pretty big life changes. I lost my access to the HMO insurance plan I had, but like a good little girl I made sure I never had a lapse in insurance and researched my best alternative option, which is an Aetna PPO.

I recently got a bill for my 6-month follow up MRI, and it was for over $1,300! I couldn't believe my fricking eyeballs! I called the imaging center and negotiated the bill down to $1,200. For my next MRI, I will be sure to apply for assistance with the MSAA BEFORE I have the MRI done. http://www.msassociation.org/programs/mri_institute/

Just wanted you to know you are not alone in being surprised at the astronomical cost!

Best wishes,
Jane

[Guitar_grrrl]

A 3T will certainly show more.  The resolution is much better in these machines.

[PastorDan]

How much more are you being told the 3T will cost?

[Maks322]

Do you think a #T machine is worth the extra cost?
I am going for a brain with and without contrast -
I am considering asking to try the 3T

Maureen

[PastorDan]

I can see how that could be a factor, dv.  In addition, most have annual deductibles, which might (or might not) have been all or partially met already for the year.  It really gets confusing when the "family" deductible comes into play, if you ask me.  I really don't know how that works into the equation.  I will be very interested in seeing if my MRI turns out to cost me anything near the figures I was quoted, when all's said and done.  I certainly pray it's no more; we're not really what I would call flush these days.

[doublevision1]

So Dan....this is why patients don't know until after the fact what they be charged for co-pay?  

[PastorDan]

Lulu's right.

One more potential complication: PPO's.  Many insurance companies have negotiated a specific contract amount with each area facility for each procedure (with exceptions, no doubt).

My insurance company told me that the facility could tell me what that figure was, but that the contract prohibited the insurance company from telling me.

Therefore, I had to call around to different facilities, try to find someone who was willing to admit that they had a clue about what I was asking, and try to wrestle the information out of them for the procedure I would have and the insurance plan covering it.

Seems it would have been much simpler for the insurance company to tell me who's high and who's low priced, but the hospitals don't want them to be able to do that.

Very frustrating, but once again, it sounds like the insurance company is not the bad guy -- or at least not the only bad guy.

Actually, the disease is the real bad guy; whatever it is, that's what I'm mad at!

[Lulu54]

Hi.  To add just one thing here - before you pay anything to the hospital, be sure to see the EOB (explanation of benefits) from your insurance company for this test. This EOB will tell you exactly what the hospital did bill, what the insurance company did pay and then what you owe.  Be sure you are paying your percentage off of what the insurance company paid and not what the hospital billed for the MRI.

good luck-
Laura

[KatCaughtABigFish]

Sometimes the hospital will write it off if you can really show them that you are on the lower income for your area.  You will have better luck actually going to their offices.  Bring your tax return in for the previous year, pay check stubs, if you can show that you don't own any boats or other property.

[meg321]

I had my last brain MRI and it cost $6,300.00 and I only paid $141.59 of that.
I also have good insurance with medicare.

I remember when I had both the brain and spine mri...of course it was double in price.

meg

[LilMinnie]

Alex explained it pretty well. Yes, there is an understanding that, for example, once you meet your deductible you as the insured will pay a predetermined percentage. Mine is ten percent. The question becomes ten percent of what amount? Medicare and Medicaid don't pay much, so the rest of us make up the difference. The cost for those of us with private insurance is not the same as for those with Medicare and Medicaid because the government will not pay much. In this case, it isn't the fault of the insurance companies.

[doublevision1]

U.S. health care truly baffles me.  Wouldn't / shouldn't the exact amount of the patient's co-pay be understood up front, and agreed to in writing, with patient signing off on the amount in advance?  How is it that insurance companies can spring this on the patient after the fact?

[jensequitur]

Sometimes they'll give you a discount on a cash price - worth checking out.

[xxSamanthaJ]

i meant i had 4 MRI's done, not 2

[xxSamanthaJ]

i had 2 MRI's done. lumbar spine, thoracic, cervical and brain MRI. They were $975 then $102 after insurance. im pretty sure that 10,000 before insurance number is wrong. then hospital would be the one youd want to talk to about it, like the others said.

good luck!

[LilMinnie]

Lol, our posts must have crossed. That's what I said, it's like buying a car! Ugh, and the haggling stinks :(

[someqs17]

And to Pastordan-- Yeah, even the highest in your range is half of what this hospital charged me. Seems like some kind of crazy ripoff!

[someqs17]

I called the hospital this morning and they said they match their prices to other hospitals in the area. This is Philly.

I gave them a huge sob story and told them I can't afford it, and I know what these thigns cost and it's ridiculous, and they said they could offer ME paying $1500 vs $1800. I kept pushing saying that i could afford $1K and they came back again and said $1400. I continued to push and now a supervisor is going to call me. This is like buying a car!!

[LilMinnie]

Alex covered it well. My daughter, who works for a large hospital as a mediator between the patient, hospital, and insurance companies told me the same thing.

It is kind of like buying a new car. No one ever pays the same price and you can't get a straight answer if you just walk in and say, "How much is this car?"

I, too, am paying off tests and the only other one I may have done is the LP. Other than that, if I don't get a diagnosis (the pieces are slowly falling into place) then I believe I will be done for a while until my next flare hits. In the meantime I will see if I can get treatment for the symptoms.

Best to you, I know how stressful it is.

Hugs, Minnie :)

[HVAC]

Usually the formula with MRIs and insurance is the patient pays a third of the cost. This is from my meetings as a health advocate with the National MS Society. You can shop around for MRIs. For example a MRI at a free standing radiology practice is way less than a hospital. The insurance is not paying half of what the hospital is charging if your policy is a PPO. I stopped getting MRIs because of the cost and my neurologist can tell more about my neurological damage from my neurological exams. My Doctors knew I had brain stem damage in 1965 and the MRI did not exist. I am in the biggest group plan in the State with the Largest insurer, it is a PPO. I pay that much for a 1T so I do not get them.

I have to have CT Scans for Cancer all the time and they are that much out of pocket. I have refused breast MRIs because they are wildly expensive and the doctors do not really understand what they are seeing. My Doctor saw something on my CT Scan for cancer and does not know what it is. These are expensive tools nothing more. I think of a MRI as an expensive shadow puppet machine. They do not see the brain they see the shadows and interpret those shadows.

It would be nice if we were told upfront what things cost medically. I owe up to ten thousand I do not have on my cancer. The only arrangement I could make on my MRI is to divide payments over a year. It get 36 months with my CT Scans because my bill is so high. If I make a payment a day late I owe the bill in full.

The secret is we with private insurance are paying more because hospitals are losing money on MRIs for Medicare patients because the government tells hospitals what they can charge for these tests under Medicare  and Medicaid. Hospitals make it up on the co pays from privately insured individuals. It is cost shifting. You sign a paper when you are treated saying you agree to pay anything your insurance will not. Unfortunately it is perfectly legal. The hospital has the law on its side.

Hospitals and Doctors can't tell you what anything costs because they make up the costs according to each person's insurance plan. Your insurance does not even know what your co pay will be most of the time. I always call the hospital and insurance ahead and ask how much something will cost, usually I can't get an answer.

I have three diseases to pay for Ovarian Cancer, Breast Cancer, and MS. I turn down a lot of tests. I have turned down a half a dozen MRIs in the last year because I can't afford them. I have to choose which I can afford to treat aggressively I can't do all three. I do not have enough Credit to make that many payments and I do not have any savings and we barely live pay day to pay day.

If I need these expensive tests I need to shop around or just make payments. Otherwise I say "NO". Health care is very expensive. Unfortunately health care is not a right in this country it is run as a business. I used to fret about costs but I owe way too much to worry about it. I pay a $1000 a month in medical bills every month and it will grow as my balance for all my care grows. I fall through the cracks for all assistance. Worrying about it only makes me more stressed.

Alex

[PastorDan]

I was recently quoted figures ranging from about $1k to almost $5k, for MRI of brain with and without contrast.  These were all "in network" locations, and the one 3T machine I found was among the highest - but they told me that they charge the same amount for their 1.5T as for the 3T.  No comprendo.

[classiechic]

Sounds like a Big Mistake to me. That's Crazy. Call the Hospital. Did you have a scheduled MRI, or did you go through the ER? I can't imagine an MRI costing that much. I've had close to 10 MRI's and have never had to pay close to that.