Hi guys,
Living in Sydney here.
Unfortunately, due to joint issues, I had to do a couple of non-rebatable MRI. Each of them cost me $250. I was wondering I can get anything cheaper as I might have to do another couple to my knees. Opinions welcome.
I am with Bupa, but I doubt it makes any difference.
Why doesn't medicare cover it all, don't you need your pancreas?
medicare computer says "no"
Apparently it's not fully covered even though its coming from a Specialist for a a specific investigation/follow up not just some random scan.
I went through this a month ago for an abdomen MRI+MRCP in Sydney. There was a price difference between imaging providers due to the gap fee charged over the Medicare schedule fee and even a provider's different locations due to individual machine Medicare eligibility (what providers refer to as licensed/unlicensed machines).
I rang around and got the following out-of-pocket quotes:
$495 from my closest provider - unlicensed machine.
$185 from same provider's closest location with a full Medicare eligible machine.
$295 from local hospital - unlicensed machine.
$0 from a different local provider - full Medicare eligible machine.
I went with the last option, didn't have to pay anything and my Medicare claim history shows $405.20 was paid for MBS item 63482.
For pancreas imaging (presuming Subgroup 21: MBS item 63482) requested by a specialist, you'll need a full or partial Medicare eligible machine to get the rebate. health.gov.au have a list of Medicare eligible machines for each state.
Something that would have been good to know beforehand: I was given a thigh-length gown to change into and the choice to keep my dacks on but warned about burns if they contained metallic fibres. Fancy undies (eg, antibacterial and odor-fighting) are being made with metal-impregnated (eg silver or copper) textiles that aren't disclosed on the labeling. I wasn't sure so I played it safe and went free.
Are you an international worker/student?
If so, they sometimes have preferred mri services.
For mris to be covered make sure they comply with your health mobs requirements. Usually
1. Is the referral from a registered gp?
2. Does the mri provider have a fully registered service that will be convered by your healthmob?
3. Can't remember.
Either way, shop around and obtain an informed consent form, with itemised costs, as well as item numbers. Check this with your health mob, if and how much will be covered. There will be oope, and you must likely need to pay up front, unless your provider has an agreement with the mri provider.
I worked in private health for 3 months, and mris were not always covered, as some were not registered with the Australian government.
Heres a tip, you can always check how much you get back on a service by looking up the item number on the aus govt health site, but best to confirm with your insurer. All calls are recorded so if they give you wrong advice, it can be disputed. ;)
$250 is a bargain, I paid $340 last month to have my knee done. I called a few places around the area (Hills) and they were all around the same. If you're aged under 49 I believe Medicare will cover it, may need something from your GP.
Agree. $250 is a bargain. OP should be happy, not complaining!
I'm in the industry.
If your between 16-49 you can try to get an GP request and find a partial licensed magnet to get it BB.
If your over 50 then youll need specialist request for BB.
Note most places don't actually BB they GAP even if their magnet is partial/full licensed.
For reference my place is 225$ per region and Im in Brisbane.
If you go out to MM2 region and beyond youll find more licensed magnets. Ie. rural
Even for registered machines, GPs' referrals can be bulk billed ONLY for certain suspected conditions. For suspected meniscal tear for 16-49 and ACL tear for all ages.
https://www.health.gov.au/topics/diagnostic-imaging/MRI-and-…
I had a back problem a few years back and I was surprised to find that CT scans of your spine are free (bulk billed), whereas MRI scans cost a few hundred, potentially even $400-$500. The same for hip joints. Weird seeing as CT scans consume radioactive substances and, depending on the body part, they can irradiate your body with quite a bit of radiation.
Since MRI scans don't consume radioactive substances, I would have thought MRI scans are cheaper for the hospital to perform, and safer than CT scans. Why do they cost the patient more than free CT scans?
CT scans consume radioactive substances
CT scans don't consume radioactive substances. They generate radiation from electricity. MRI scanners are more expensive to make as they have big ass magnets.
People get confused about the types of imaging a lot!
CT: X-rays taken from all around, combined into image by computer.
MRI: Uses magnets and radio waves, combined by computer. Can't use if you have metal implants.
Nucleur Imaging: Injected radioactive drugs + "Gamma camera". This is the one that uses Radioisotopes ("radioactive material").
People see a big humming tube and reckon they're all the same thing.
MRI techs gets paid more than CT techs, and MRI scans are also typically longer than CT scans so the cost reflects that.
I actually thought that was pretty cheap.
MRI's for me have typically been about $400-$800 in the past (fingers, or chest).
You can always ring around different clinics and ask them directly to tell you how much it'll cost, but as far as I'm aware the only time it's free if it's an MRI of your back or the head - everything else is deemed not serious enough.
Each of them cost me $250.
Do you mind sharing which imaging provider & location ?
I've had them for about that much from IMED providers in Victoria.
I'm not familiar with the bulk billing system/codes etc, but when my under 18 son needed a MRI on a knee, it was fully covered by bulk billing.
I was surprised as I've heard there was and was expecting quite a large out of pocket.
I also suggest, you call up a few different imaging places as prices can vary. I got it done at Lumus Imaging. Of course YMMV
The price depends on the item number used, i.e. this one and how much they decide to charge untop. Consider yourself lucky they've chosen to bulk instead. I've only ever been bulk billed when they've struggled to get my vein.
Thanks.. I must thank the GP.
The radiologists at the MRI rather.
@Clear: When I emailed them the referral letter (when making the appointment) they said no charge, so wasn't sure if it if was the GP or radiologist.
@JimB: Radiologists decide. GP is simply sending them a referral and have no decision on how much you get charged. Any specialist will receive more money from Medicare with a referral than no referral.
My MRI right knee cost $225 at Qscan Chatswood Aug last year. Neither Medicare or private health funds cover the cost. Qcscan was the cheapest compared to Macquarie medical imaging & PRP.
I needed MRI of head, rang local public hospital but they had waiting list. Rang around private businesses and went with cheapest. GP and specialist both said it wasn't a good one and go to the hospital next time. It was pretty expensive so not happy, didn't realise you could take quality shortcuts.
MRI machines have different magnetic field strengths. 1.5T, 2T and 3T. A lot of smaller clinics will have a 1.5T or 2T MRI instead of 3T due to the size, infrastructure and cost requirements.
The other gotcha is how skilled the radiologists are. Many clinics (Xray included) outsource. This isn't always a bad thing as it's costly having a radiologist onsite and there are shortages.
Second this comment. At the basis of my inertia into looking for alternatives from my current reference point (Medscan). Broke a shoulder two years ago. Radiologist did a wonderful anamnesis, to the extent I was able after some work and 3D model analysis to conversate with surgeons and physioterapists, eventually picking a couple that looked more versed into tackling problems out-of-the-box.
In Adelaide and about to get an MRI done for Pancreas. Charge is $563 with Medicare rebate of $363. Gap $200.
Doubt there's anything cheaper unless inpatient services.