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@lilianna

Regarding Mayo. Last year I tried making an appointment to Mayo for my bronchiectasis and MAC and they did not accept my insurance Aetna Medicare advantage pop. I was very disappointed; I could drive there instead of flying to Denver which becomes an expensive trip. I am at NJH and I am glad to be with their doctors so far.

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Replies to "Regarding Mayo. Last year I tried making an appointment to Mayo for my bronchiectasis and MAC..."

@lilianna I'm sorry Mayo doesn't take your insurance. There are issues with the so called "advantage" plans. They limit the list of physicians they will cover to those within their own network which is a contract between them and the providers. They may also limit coverage to their list only within the state where you live. My physical therapist will not take advantage plans because they are always reviewing care after the fact if they had covered it, and they will reverse a decision and come back to the provider for reimbursement of money they had already paid out. That is too big a risk for a provider to accept particularly in a very small PT clinic. Places like Mayo with huge operating costs also need to make sure they will be able to pay their employees. before I chose my Medicare and insurance plans, I called the Mayo Billing office to make sure what I selected would be good at Mayo if I need care there in the future. I have been a surgical patient there, and would come back if I need care for a complex issue. When the next enrollment period comes around, you could select insurance that Mayo would also accept.

You might be interested in this discussion about these insurance issues.
Vising Mayo Clinic - "Choosing best insurance and insurance at Mayo"
https://connect.mayoclinic.org/discussion/insurance-2/

Sorry that you had problems, especially since you're close enough to drive. I initially had insurance problems as I was in a United Health Care Advantage Plan -- which was a plan that Mayo Rochester didn't accept. I was able to change to a a different UHC Advantage plan which wasn't as quite as generous in benefits (primarily dental and OTC drugs and a $10 higher co-pay for specialists), that Mayo accepted as in-network. UHC has a relationship with Rochester Mayo only. I worked with the Mayo Billing office who were very helpful as were the UHC staff. I am going to be seen at Mayo in July, so I haven't experienced the claims processing end of it so I can't talk to that. Fingers crossed that works smoothly.

UHC has created some Advantage plans with a national network which includes Rochester Mayo and NJH. This is very new -- I think may have started just last year so there have been kinks, but UHC staff have helped me through it. I used to work in health care administration, both in HMO management and provider/hospital management, so I just kept working through the details. If you're not happy at NJH because of the travel, etc. you can change Advantage plans at open enrollment for January 1st coverage. I'd be sure to check with Mayo before I switched though.

Hopefully this will change over time. Over 50% of new Medicare enrollees join Advantage Plans, so that's a pretty big trend. Doesn't help us now, but the direction is positive. It's confusing for sure.