I’m glad you’ve found a place that’s a good fit.

I find that for large academic (and therefore expensive) medical centers, and even some smaller clinics, they can be very hesitant to accept patients out of network, even if the plan allows for it. Whenever this has happened to me, I suspect they’re leery of whether or not the patient will pay. Or maybe it has something to do with the additional administrative hoops to jump in the case of the smaller clinic where my dad has been turned away.

@rola, I'll give you an example. A patient I know who needed spine surgery wanted to go to Mayo. She was able to get an appointment as out of network at the Mayo Clinic Health System which is a local rural hospital in Minnesota (or Wisconsin). The wait to get into the main Mayo Clinic was long, so she called the Health System instead. She was scheduled for surgery, and the insurance played games and wouldn't authorize surgery, so with only 2 days left, the patient had to cancel all the reservations for airfare and accommodations she had made. The insurance then picked out a different surgeon (who she did not want) and told her they would only cover that surgeon, so she was forced to have surgery with a surgeon she didn't trust because she was in so much pain.

That should not happen. They were covering the appointments, but then refused to pay for the surgery which of course is a huge expense. They are probably price shopping for a facility that will do it for a lesser fee. Care at Mayo is good and thorough, and there is a cost involved.

It sounds to me like the insurance is making this more difficult that necessary and it just wastes time for all the people at a medical center behind the scenes who are working to try to get authorization. The insurance company of course holds all the control for what they will or won't pay for and they are in this game to make a profit.

I made my insurance choices (real Medicare and a Medigap plan) according to what Mayo accepts because I wanted to be able to have care there if needed in the future since I have already had spine surgery there.

I am glad you have another option now for your care, and I certainly wish you the best. If you wanted to change at the next enrollment period, you would have that opportunity.

Jennifer