Free MRI and CT through CAS: how to get the referral and how long you wait

Yes, an MRI and a CT can be free (0 lei) through the Casa de Asigurări de Sănătate (CAS, the health insurance house) — if you have a bilet de trimitere (referral) for investigations from a specialist doctor and you book at a provider under contract with CAS. The state covers the investigation in your place. The obstacle is usually not the referral but the waiting list, which appears because each provider has a limited monthly budget.

What “free through CAS” means

An MRI (magnetic resonance imaging) and a CT (computed tomography) are high-performance paraclinical investigations covered by the National Unique Social Health Insurance Fund, under the framework contract approved by Government decision and the CNAS rules.

For it to be free for you, three conditions must be ticked:

• you are insured (your insured status up to date);
• you have a valid referral for that investigation;
• you go to a provider under contract with CAS (not every private clinic has a contract, and some have a contract only for certain services).

If all three are met, you pay 0 lei.

How to get the referral

The key step is the referral. In practice:

1. Go to the family doctor. They assess the situation and, if warranted, send you to a specialist (neurologist, orthopaedist, oncologist, gastroenterologist, etc.).
2. The specialist establishes the indication and, if the imaging investigation is justified, issues the referral for the MRI/CT. Usually, MRI and CT are recommended by the specialist, not directly by the family doctor.
3. The specialist can attach a medical letter explaining why the investigation is needed — useful for the appointment.

See the list of family doctors in Cluj for the first step, and the radiology and medical imaging specialists for providers.

How to book at a contracted provider

With the referral in hand, you call providers who have a contract with CAS for MRI/CT and ask for an appointment. A few things to keep in mind:

• Ask explicitly whether they still have room on the CAS list that month.
• Confirm which documents they require: the referral, the medical letter, an ID document, proof of insurance.
• If contrast is needed, tell them from the start — there may be additional requirements (blood tests, for example).

Why waiting lists appear

This is the crux of the problem. CAS allocates each provider a monthly cap (budget) for covered investigations. When the cap runs out in a given month, the provider can no longer book for free until the following month — hence the queues.

Practical consequences:

• the waiting time varies a lot — from a few days to a few months, depending on the provider and the period;
• it’s worth calling several contracted providers; where the cap isn’t exhausted, you catch an appointment sooner;
• new caps are released at the start of the month, so slots may open up.

When you can skip the list

For urgent cases and for certain conditions (oncological ones, for example), the referral can be marked as urgent, which gives it priority over routine appointments. Ask the specialist how to note the urgency on the referral and whether your situation qualifies. Don’t force the “urgent” label if it doesn’t apply — the decision belongs to the doctor.

How much it costs privately

If you don’t want to wait or don’t have a referral, you can pay for the investigation in full. As a rough guide, an MRI or CT costs between roughly 400 and 2,700 lei, depending on:

• the region examined (a joint is cheaper than a complex examination);
• the use of contrast (which raises the price);
• the provider and the equipment (higher-tesla machines can cost more).

Prices differ significantly between clinics, so ask for quotes from several before you decide. Because rates change often, check the current price directly with the provider.

Check your insured status beforehand

Reimbursement only works if you are insured and up to date. Before you book:

• check your insured status on the CNAS online platform or ask CAS;
• if you work under a contract, the contribution is withheld automatically; if not, you may need to pay the contribution to ANAF (the tax authority) to regain your insured status;
• special categories (children, pupils/students, pregnant women, low-income pensioners, people without income under certain conditions) are insured without paying the contribution — check whether you qualify.

Without insured status, even with a referral, the investigation is not covered and you pay for it in full.

Quick summary

• MRI/CT = 0 lei through CAS with a referral from a specialist, at a contracted provider.
• The referral comes from the specialist, not the family doctor; you often also need a medical letter.
• The waiting list appears because of the monthly cap per provider — call several.
• Urgent/oncological cases can have priority.
• Private: roughly 400–2,700 lei; check the price with the provider.

Sources

• The framework contract on the conditions for providing medical care in the social health insurance system (a Government decision) and the CNAS methodological rules — the rules for covered paraclinical investigations (MRI/CT), the referral, and the caps per provider.
• Legea nr. 95/2006 on healthcare reform.
• CNAS — cnas.ro and the Casa de Asigurări de Sănătate Cluj (Cluj Health Insurance House) — casan.ro (the list of contracted providers and the reimbursement conditions are updated periodically; check before booking).