Forum Discussion
Cost of MRI
I just need to vent. My oncologist suggested I do an MRI to see why I am getting numbness in my arms & legs. I have also been suffering a lot more headaches. Well the MRI cost me $1000. How much do I get back from Medicare? You guessed it ZERO! What about private health insurance? ZERO.... Why isn't this test covered? I don't understand. I have metastatic breast cancer. So an MRI is the only way to definitively test the progress of my mets. Can anyone explain to me why this is not covered. BCNA is this on your radar?
16 Replies
- Being diagnosed at 45 in 2011 & having had a family history of BC I had MRI bulk billed every year by our favourite radiologist for 4 years. But when I turned 50 I was no longer eligible to have them for free...Clearly according to Medicare I'm no longer at risk !!! who knew Medicare was soooo psychic !......not sure if the wording on the referrals up to that point were worded a certain way, but my date of birth is a dead give away now. All my imaging is done (read) by the same guy & he suggested I alternate two yearly MRI & U/S with Mammo & U/S because now I have to pay. I do place all my trust in him but I know he is very thorough, when I had to have a lump looked at late on the Friday before christmas he was closed , so the place I had the U/S sent him everything to double check he was happy. He rang me between Christmas & New Year to confirm that he was happy there was nothing nasty.
Medicare needs to come into the real world.
Carmel - I paid $500 for each of my MRI's in Queensland last year at South Coast Radiology. I have no insurance and was travelling as a public patient. Usually when I get an invoice it has the medicare rebate, what I paid in cash and what the final invoice total is. I have just gone to look at my invoice from South Coast Radiology and it contains no information at all about medicare rebates or their charges. I paid in advance and was a diagnosed cancer patient both times.
- I had an MRI following my bc diagnosis in 2016 to check if my other breast tissue was normal and to confirm the size and location of my cancer. This helped my surgeon and I make a decision re my treatment and was the decider in my having a single and not double mastectomy. It cost $550, no rebate. Surely there should be some subsidy given for tests which will provide a clearer diagnosis and ultimately save the the health system money?? It’s ridiculous when so many other scans are bulk billed. Thank you BCNA, we need all the advocates we can get.
Jane x - Hey there ang66,
I was in hospital last year for rads to bony Mets and had an MRI while in hospital Received a bill later for the MRI for $750, not covered by Medicare or my health insurance. It is a big shock, especially when you need these investigations to assist with your treatment. Just know that there are people batting on your behalf.
Cuddles, Trace - I have had two brain MRI's and they have both been bulk billed. I went to have it checked for serious brain fog and poor memory from what I was sure was Tamoxifen but just to make sure it was nothing nastier. Luckily my gp was on the ball with what wording to use. Whoever is referring must say "headaches" in the referral even if that's not why you are going. It's the only way at the moment.
- Thank you @Kathy_BCNA & @Marianne_BCNA for your responses. It is fantastic that BCNA is working on this issue. Good luck with the fight. While we focus on our health, it is great to have the BCNA advocate on our behalf the issues that matter for people with breast cancer. Keep me updated on any progress with the bureacrats!
Ange xxx Hello everyone
This is Kathy from BCNA's policy team. Ang, I am sorry to hear about your situation. We know MRIs can be expensive, but $1,000 is really up there. I know you had a brain MRI rather than a breast MRI and I am not sure what they usually cost. I know breast MRI can be up to around $600. I think you have already had the MRI, but if not it would be worth letting the doctor who referred you for the MRI know this and asking him/her if there is another clinic which could do the MRI more cheaply.
The cost of breast MRIs is certainly on our radar. We have ben advocating for a number of years to have a Medicare rebate for women diagnosed with breast cancer. At the moment, a rebate is only available to women under the age of 50 who are at increased risk of developing breast cancer - as a screening tool because mammograms are often not a good screening tool for younger women. This is clearly not acceptable as more and more women diagnosed with breast cancer are being recommended a breast MRI by their medical team.
BCNA has been working with a team of breast surgeons to have the Medicare rebate extended to include some women with breast cancer. An application was made to the Medical Services Advisory Committee (MSAC), which is the committee that makes recommendations to the Government on items that should receive a Medicare rebate. Unfortunately the MSAC recommended an extension to the rebate for only two particular situations, and these did not include the situation you are in Ang. You can read our submission and about the outcomes on our website. Another application has been made to MSAC and we have written in support of that. We are waiting on the outcome from MSAC.
We also take every other opportunity to raise the importance of a Medicare rebate for breast MRI. For example, we recently made a submission to an inquiry into the availability of diagnostic imaging equipment in Australia and discussed MRI in that. We also discussed it in our submission to a major review of Medicare.
Ang, this doesn't help you, but hopefully it helps others to know we are working hard on this issue.
It is always a good idea to talk to your referring doctor, and the imaging clinic, if you are having trouble meeting the costs. There may be some solutions they can offer.
Best wishes
Kathy
- Get it done the same day as in patient for infusion services. When booking tell them your an in patient by getting your Dr to give you a referral to like MIA that may do it at the Hospital you get your infusion done at the same day. Could possibly save $$
- It's absurd. And ageist. I'm 51. My mother had breast cancer at my age. My sister died from it at 47. I'm being treated for it now. For me, being told you're too old and not high risk enough to qualify for assistance is insulting and downright offensive. IMHO...
