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Does Mayo Clinic take Medicare?
For those of us who live in the U.S., this is a complicated issue. Whether or not Mayo Clinic takes Medicare comes up frequently. The short answer is yes, Mayo Clinic, on all campuses, does take Medicare. But here is where it gets sticky. It depends on the Medicare Plan you have.
If you have what is sometimes called "Traditional Medicare" then you have Medicare Part A (for hospitalization) and Part B (for outpatient). You also selected another Plan that covers the gap of what Part B does not cover. I have Transamerica Insurance for my Part G supplemental plan. It's very cumbersome however I chose traditional Medicare because it allows me to go anywhere in the U.S. that accepts Medicare. I don't need any prior authorization.
If you chose a Medicare Advantage Plan then you are in a network of hospitals and medical providers and have a managed care plan. You have Medicare Parts A and B but also C (Medicare Advantage Plan) that includes all of your medical services including prescriptions. However, Medicare Advantage Plans have networks so like the type of health care plan you probably had before you retired you have to get prior authorization for some services from your insurance company and you cannot go outside of your network or it will cost you a lot of additional money. Many people go with these Medicare Advantage Plans because the monthly cost is reasonable, it's easy to sign up, and if you live in a large urban area you'll have lots of choices of where you can go. But, if you want to go outside of your network, like Mayo Clinic then you'll have to check to see if your Medicare Advantage plan lets you go to Mayo Clinic.
Confused? It's mind-boggling. I figured all of this out when I signed up for Medicare shortly before I retired.
If you want to know if Mayo Clinic takes your Medicare Plan, you can call the business office at any campus and explain what kind of insurance coverage you have. They will help. I have experienced THE best service when I've contacted Mayo Clinic for insurance and billing questions.
https://www.mayoclinic.org/patient-visitor-guide/billing-insurance/contact-us
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Helen,
Thank you for this information, glad you are on here.
I have UHC AARP Medicare Advantage Plus and just verified that I can only go the Mayo Clinic in Rochester with my 2024 plan. I have Medicare due to disability from a crash that left me with severe TBI that left me unable to work. My wife is unemployed also or only works part-time.
I am curious about financial resources for travel and lodging. The impacts of the TBI include seizures and focusing or remembering can be really hard. I would like to be able to take my closest friend, they are familiar with many of the medical things and are great support. Any information would be wonderful, Thanks. -Mike
Sorry Mike, I am not Helen. Did you respond to the wrong message?
But for info on lodging in Rochester, see Visiting Mayo on Mayo Connect. Also Mayo Concierge Service is very helpful. Phone number is 507- 538-8438 M-F
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2 ReactionsSorry, I guess I did. Apologies and many thanks for the phone number.
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1 ReactionHi @mayoconn3ct, I'd like to add my welcome. @vic83 gave you a great tip about Mayo Clinic Concierge Services for lodging recommendations. They can offer tips on many things including transportation, accommodation and more
Phone: 507-538-8438
Email: concierge@mayo.edu
Website: https://www.mayoclinic.org/patient-visitor-guide/minnesota/concierge-services
You may also wish to connect with others living with TBI in the Traumatic Brain Injury (TBI) Support Group here https://connect.mayoclinic.org/group/traumatic-brain-injury-tbi/
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1 ReactionVic,
Hello and yes there are differences between traditional and advantage plans.
I have learned with my husband's procedures over the years that every provider is billed separately (surgeon vs. anasthesiologist) and now patients have to cross-check to verify in-network status of providers and often groups (the facility or location where providers practice). We see this in mental health also, I am a clinician and this issue can be a barrier for service and simply should not.
I manage my father's traditional Medicare since he began preparing for retirement this last year. In that time I have learned much, as such when our friend Mike asked for help I had to explore his plan as things were not consistent between one source's info and another.
I learned Mike's insurance is a combination plan UHC AARP Medicare Advantage plan.
There is a difference between HMO, PPO, POS, and so on. He does not understand how they work in general so it has been a learning curve for each of us and my father with his as well.
Thank you for the information and phone numbers, I will reach out to them and see what I can learn in working to help find ways to get Mike to Mayo in MN.
With Care,
Maria
Calling the financial office and requesting to connect with financial counselors proved to be invaluable. I was able to connect with a wonderful person who offered much insight and was incredibly helpful. When I called back with new information to verify the status of Mayo in MN as a participating provider Mike and I encountered another wonderful human who took the time, answered my questions, and listened to Mike's confusion.
If anyone needs to find out specifics about their insurance plan call the Billing Dept or Financial Office and request to speak with a financial counselor to cross-check the details of our insurance plan. For anyone doing this for a loved one, you will need them present to give verbal consent to speak about their insurance plan, medical needs, or in any manner about their protected medical information.
With Care,
Maria
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3 ReactionsHi,
I am moving to Wisconsin and wonder if you tell me the name of your Medicare Advantage plan?
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1 ReactionHumana Choice
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1 ReactionThank you so much for the quick response! I find Medicare is so difficult to navigate at times.
Seems like it needs to be more user friendly.
Take care,
Dusty
My Medicare Advantage Plan, a PPO, worked well with the Mayo Clinic and covered almost all of the open heart surgery and related costs. I was surprised that I was charged the "in network" copay for my hospital stay ($350) when I was 1000 miles from home. Genetic testing was fully covered and there was a minimum of copays. Policies are so different from each other, do ask questions.
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