From October, Patients Will Bear Full Cost for MRI Scans for Simple Headaches and Dizziness

Starting from October, even if there is a medical opinion that the condition is merely a simple headache and not a brain disease, if a patient wants to undergo a Magnetic Resonance Imaging (MRI) scan, the patient must bear the full cost. Since the health insurance coverage for brain and cerebrovascular MRI scans was implemented in 2018, health insurance will no longer support symptoms unrelated to brain diseases, such as simple headaches and dizziness.

On the 17th, the Ministry of Health and Welfare announced that it will revise the “Detailed Standards and Methods for Application of Medical Benefits” to strengthen the coverage criteria for brain and cerebrovascular MRI scans. The revised notice will be implemented from October 1 after a grace period to reduce confusion in medical settings. This revision is a follow-up measure to the “Health Insurance Sustainability Enhancement Plan” announced last February.

The Ministry views that since the previous government’s policy to strengthen health insurance coverage allowed MRI and ultrasound scans to be covered by health insurance, even mild symptoms have led to overuse of these tests. The medical expenses for MRI and ultrasound scans increased from 189.1 billion KRW in 2018, the first year of coverage, to 1.8476 trillion KRW in 2021, and the total number of MRI scans rose from 2.26 million in 2018 to 5.53 million in 2020.

Accordingly, to enhance the sustainability of health insurance, health insurance coverage for MRI scans will be applied only to headaches and dizziness suspected to be caused by brain diseases such as cerebral hemorrhage and cerebral infarction. For patients with a low necessity for MRI scans, such as those with simple migraines or chronic headaches, the scans will be non-covered, meaning patients must pay 100% of the medical fees.

However, the government plans to continue providing health insurance coverage for MRI scans as before for patients who have had brain diseases in the past, or those who show abnormal findings in neurological examinations.

Jung Yoon-soon, Director of the Health Insurance Policy Bureau at the Ministry of Health and Welfare, said, “There has been some overuse of unnecessary tests due to the rapid expansion of coverage for expensive imaging tests such as MRI. Through this revision of the notice, expensive imaging tests will be covered by health insurance only when absolutely necessary.” He added, “The savings from this will be reinvested into valuable areas such as severe and essential medical care to strengthen the foundation of health insurance.”