Does Rochester Mayo work in a multi-disciplinary way?

@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.

lindam272
about 7 years ago I asked at Mayo rochester if they took my Medicare traditional insurance. They did but with a surcharge added. I found out that our WPS medicare supplement had a rider we had that covered the additional charges. Opted to go to NJH ...which Medicare covers totally. Very pleased with NJH.

Thank you. I am currently with NJH and it works so far.

Thanks for again explaining the situation with Medicare Advantage plans. When one first goes on Medicare it is a bit confusing to understand the differences.
Most important to understand is that with original/traditional Medicare (Parts A, B) one can self-refer to any doctor in the US that takes Medicare. One loses choice and is restricted by Medicare Advantage to their network. And that is a problem when one gets sick.
The second biggest issue that if one thinks to change back to original Medicare because unhappy with Advantage, then it is quite difficult to find the insurance for the 20% that Medicare does not pay. In the beginning all companies have to take you, but not after. People are then stuck with Advantage plan.
I fortunately went with Original Medicare + my Medigap supplemental plan because I now really use it and I have no problems and never see a bill except my monthly insurance premium. I have been a patient at Mayo Rochester for 2.5 years with and have seen multiple doctors in several departments.

Vic, You are so right! We spend our winters with young to old retirees, and we ALWAYS (along with a number of friends) encourage people to look beyond the monthly premium, and the first few years, to make sure the policy they choose will meet their needs in the long term.

My friend and neighbor, now nearing 80, always described her premium as a "down payment on future medical bills." Like you, she (and we) never see a bill beyond the premium and our medication co-pays. My friend with her Advantage Plan paid $3200 out of pocket for an ER visit because it was not at her "preferred" hospital - and wiped out a whole year of premium savings in 6 hours.

Another thing to consider is that if you travel regularly, or spend part of the year in another place, an Advantage Plan can leave you without insurance. We have seen ER docs, specialists, and even have a family practice doc at our winter home - all accept our BlueCross Medicare plan seamlessly - just like at home. Very important as we get older. This winter, just one small wound with 2 ER visits and a doctor followup were worth more than my annual Medigap premium! Under my (pre-Medicare) plan I had a 50% copay for "out of network" emergency care, and no coverage for "routine" care - I was expected to travel home for care.

Sue