I'm on a supplemental Plan N, and I'm curious if my recent MRI is covered or if I'll get stuck with a big bill.
Answered by 23 licensed agents
With your Medicare Supplement Plan N, your recent MRI is covered under Medicare Part B as long as it’s deemed medically necessary, but you’ll need to meet the 2025 Part B deductible of $257 first, and then Plan N picks up the 20% coinsurance—though you might face a small copay, up to $20, if it’s done in a doctor’s office. Unlike Plan G, which also covers the Part B coinsurance but skips those copays and fully handles excess charges if a provider bills above Medicare’s rate, Plan N leaves you responsible for any excess, though that’s rare with MRIs since most imaging centers stick to Medicare-approved amounts. I’ve seen beneficiaries caught off guard by these details, so double-check your provider’s billing with your Explanation of Benefits to avoid surprises—either way, your bill should stay manageable compared to having no supplement at all.
Plan N makes you Part B deductible ($254 per year in 2025) your responsibility. It depends if you have had other outpatient services that would have required the deductible already. So the most it would cost is $254 in 2025 but it may cost nothing.
The MRI must be deemed medically necessary by either Medicare or your supplemental plan. You may be responsible for 20% of the original amount, as well as any applicable deductibles, until your deductible is met. Currently, the part B deductible for a Plan N is $257.00
There will be some charges because with a plan N you are subject to a $257 plan b deductible, potential co-pays and potential excess doctor fees. The best thing to do is contact the facility, let them know what plan you have and have their billing/claims person give you an estimate.
You will need to pay the Part B medical deductible which is $257 in 2025 before the MRI is covered. If there are Part B excess charges you may need to pay those as well.
Plan N is a very comprehensive plan but the best way to know for sure is to call the customer service number on the back of your card but your doctor should be able to check and see as well with no problem.
You have to pay Medicare’s deductible of $257. Once you pay that deductible, you’ll have a $20 copay for a doctor visit and a $50 copay to the ER. Your supplement will pay 100% of the remainder for the rest of the year.
If you’re on Medicare Supplement Plan N, your MRI is likely covered because Original Medicare (Part B) usually pays 80% of the cost for medically necessary MRIs, and Plan N helps with the rest. You may still have to pay a small copay (up to $20 for doctor visits or $50 for the ER if you weren’t admitted). You’ll also need to pay the Part B deductible if you haven’t met it yet for the year. As long as the MRI was medically necessary and Medicare-approved, your cost should be low.
We must review the N benefits and confirm the facility accepts Medicare patients. From there one part b deductible is met, we will confirm any additional out of pocket that may exist.
Once your Part B deductible is met, there should be no charge for the MRI. On a Plan N you should only see a bill for your PCP and at the emergency room.
This is a great question, we can review the plan N benefits so that way you understand what to expect when you go to the doctor or have any procedures done.
It appears that whomever the agent was, who signed you for the N plan, did not properly explain it to you. The N plan covers everything after you pay the Part B deductible ($257 this year), plus you sometimes will pay up to a $20 co-pay for some provider visits. So yes, the N plan will cover the MRI.
As long as there isn’t any excess charges Medicare doesn’t pay. That’s a drawback of Plan N. May be cheaper but doesn’t cover that. That’s determined by Medicare
Your PLAN N should cover the 20% of the cost of the MRI if your Doctor says it is necessary. Remember 80% of the cost of the MRI is covered by your ORIGINAL MEDICARE and your supplemental Plan helps with the other 20%. As always consult an Independent Broker for your best answers.
More than likely, your MRI was Medicare approved and covered. That said, your supplement plan N does have a couple of items you could be responsible to pay for. If you have not paid your annual Part B deductible ($257 in 2025) yet in 2025, you will likely owe that deductible and be billed for it. It's also possible you could be charged up to a $20 copay imaging services. That may have been collected at the time of your visit but if not, it's possible they could add that copay to your bill as well. Beyond that, unless the MRI provider does not accept Medicare assignment (meaning takes Original Medicare Parts A and B and agrees to their pay schedule), that should be all you would owe. If the provider does NOT accept Medicare assignment, you could be charged up to 15% more than the Medicare approved rate and be responsible for that 15% upcharge.
The short answer is yes, you will be covered—however, there are a few important conditions you'll want to be aware of.
Original Medicare (Part B) pays 80% of the approved cost. Plan N typically covers the remaining 20% coinsurance, except:
You may have to pay a copay of up to $20 for a doctor visit or $50 for an emergency room visit (if not admitted).
You are responsible for the Part B deductible (which is $257 in 2025).
Plan N does not cover Part B excess charges, which occur if a provider doesn’t accept Medicare assignment and bills up to 15% more. (Most providers do accept assignment, so this is often avoidable.)
Medicare members on a Plan N supplement only have copays for doctors visits ($20) and ER visits ($50 (if not admitted). All plan N clients also have the Part B deductible if $257 (2025) they are responsible for.
MRIs are typically covered under Part B if medically necessary and when ordered by a doctor.
So what do you owe? First, you pay the annual deductible. ($257 in 2025) A medically necessary MRI, with Plan N, has a $20 copay. The total would be $20 or $277. Legally I need to explain the possibility of paying Part B excess charges. Some providers charge up to 15% more than Medicare’s rate if they don’t accept Medicare. Always ask your provider if they “accept Medicare”, first. Personal note: since 2015 I haven't had a client pay part B excess charges. These are very rare.
If you have met your deductible for the year then you will not get a bill, however if you have not then you will get the remaining balance of the deductible.