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by n8henrie 1492 days ago
Did you offer to pay for the MRI cash (roughly $5k I would bet)?

Because to me this sounds more like "your insurance won't pay for it because it is not an indicated study by ACR criteria."

I hear that spending hours on the phone trying to justify a test to an insurance company is no fun, and I bet the task is not made any easier if you don't actually believe that the study will help the patient.

2 comments

For anyone looking at self pay for an MRI in the US, there's an organization that offers that and other imaging services for the uninsured at $325 or less. https://radiologyassist.com/MRI.html
HMO so yes, costs are a factor. But it was a small cost relative to repeated doctor visits, hospital costs, etc… MRI for massive HMO are not $5000 due to economies of scale. The dr in this case was angry because the MRI revealed brain tumors which needed to be monitored.
$5k would be the estimated outside-of-insurance cost to you, to avoid spending hours of the MD trying to justify the study with the insurance.

Meningiomas by chance?

Has the monitoring improved your health? I'm not sure whether I would be more or less troubled if I had symptoms with an unclear cause vs a possible cause but unclear management plan. I suppose this will be highly variable.