Medicare Coverage for ascending aortic replacement at Mayo

@frisco07
I am sure your anxious about your husbands upcoming surgery. Can not answer your question directly, but will make a few comments. I think Mayo only does estimates for procedures. It would be hard to do estimates for surgery because everyone's is different. Also, there are different types of Medicare supplementals.

I would call the billing dept at Mayo to get your question answered. You can also submit questions to billing through the portal, but my experience with billing it is easier to talk to someone on phone for billing / insurance questions. If you are still in Rochester, you can stop at insurance / billing desk (on main floor of Mayo building). Or you can also call Medicare and ask if this is a covered surgery. Then you will not have to worry about any surprise bills.

Wishing you and your husband the best on upcoming surgery.

Morning!

Sharing some basic steps to possibly receive your husband’s Medicare and secondary insurance estimate. A bit lengthy before morning coffee!!!

1). Contact the billing department at Mayo Clinic located in your area, as they should have received a surgical coding request from the surgeon’s staff.

Mayo’s financial online info listed below:
For Mayo Clinic Rochester patient financial services inquiries, you can call Patient Account Services at 1-844-217-9591 (toll-free) or 507-266-0909 for international callers. You can also send a message through your Mayo Clinic patient online services account.
Patient Account Services: This is the primary contact point for questions about your bill, financial responsibility, cost of services, insurance, and other financial matters related to your care at Mayo Clinic.
Toll-Free Number: 1-844-217-9591.
International Callers: 507-266-0909.
Online Services: You can also send a message through your Mayo Clinic patient online services account.
Financial Assistance: Mayo Clinic offers financial assistance to individuals who are unable to pay medical treatment costs. You may discuss financial arrangements at the Admissions and Business Services location that is most convenient for you.
Payment Plans: Payment plans are available if you do not have the ability to pay your bill in full.

2). Contact Medicare and your secondary insurance through phone numbers on the back of your insurance cards. Ask what’s covered for the procedure and if the surgical referral was accepted, including post op care. Although Medicare secondary insurances usually pay the 20% difference Medicare does not cover, each may have different plans and benefits. As a precaution, it might be a thought to verify the hospital accepts your secondary insurance.

3). Cost of the procedure should be paid by Medicare’s fee schedule, not Mayo’s actual fees submitted. It can sometimes be frightening when initially seeing these amounts on a billing invoice!

My suggestions are only from personal experiences as a Mayo patient in FL for 20 yrs and retired medical manager.

“Your choice - Your voice”

Blessings!

Thank you SO SO much. It is a bit overwhelming right now. Definitely a Blessing we found the aneurysm before rupture...but shock for sure! Thank you again.....

Thank you also. All good suggestions. Appreciate you taking the time to share!

As for Medicare: yes, Medicare absolutely covers ascending aortic replacement surgery when it’s medically necessary, which it clearly is in your husband’s case. The fact that he also has a supplemental (Medigap) policy is even better—it typically covers most or all of the remaining 20% that Medicare Part B doesn’t pay, including hospital deductibles, coinsurance, and some additional expenses depending on the plan letter (e.g., Plan G, Plan N, etc.).

Mayo may not always provide formal surgery cost estimates upfront like they do for imaging or outpatient procedures—especially if the procedure is inpatient and covered under Medicare Part A. But you can call their Patient Account Services to ask if they’ll give you a breakdown of what Medicare is expected to cover and what, if anything, the supplemental plan might not. Many patients with both Medicare and a Medigap plan end up with little to no out-of-pocket costs, aside from things like travel or post-discharge medications.

You’re doing the right thing by asking now. It helps to feel more grounded when heading into such a major procedure. Wishing your husband a smooth surgery and recovery. Your husband's upcoming surgery at Mayo is in one of the best possible places in the world for complex aortic work. That’s a good thing. Peace.

As I have shared earlier today, all of your experiences and comments are so helpful and comforting coming from people who know. Thank you for taking the time to share, it is very helpful to me. All the best......

I am sure that Medicare and your supplement plan will cover the whole thing