MRI Preapproval Falls Short: Patient Pays Most of the Cost

A Washington woman was told her breast MRI would be covered after insurer preapproval, but she still wound up paying about $1,191 out of $1,205 plus $65 for meds because the MRI wasn’t classified as preventive care and counted toward her deductible. The case underscores how employer plans that are self-insured are regulated federally, not by state mandates, leaving some protections out of reach and allowing high out-of-pocket costs even with coverage. It also reflects broader health‑care cost trends in the U.S., where rising deductibles and medical debt persist despite insurance, fueling policy discussions on price transparency and reforms.