Insurance covering treatment at Mayo

Posted by butterflykizzs @butterflykizzs, Jun 28, 2025

I just got a GI appointment but I am worried about ending up with a huge bill. I can barely cover the travel expenses. I have wonderful insurance BUT you never know what is and is not covered as far as test and procedures until after it is done. I heard of patients with huge bills even though they were insured.
Any advice or info on how this works before I set my plans to go into motion? TY

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Profile picture for sandy8043 @sandy8043

I have had MS for 30 years. So I always came in with a written list of "what's happened since I was here last" and questions. Now I do it through the portal a few days in advance. That gives the doc and nurse time to read it and think about it ahead of time. Its a huge improvement over them thinking on their feet or saying they need to research and get back to me.
My point is, you can ask your questions, present your current symptoms and also make sure they understand your insurance
concerns. That way if they are thinking about a test or scan they can check with insurance ahead of time. The portal is a Godsend.
Good luck!
Sandy.

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I like your suggestion about using the portal to send message to Doctor on new issues prior to visit. I have developed a lengthy medical record in the last 3 1/2 years and unrealistic to think Doctor can refresh his memory enough so I go in with a medical summary. I am going to send it a few days before a visit.

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Profile picture for Helen, Volunteer Mentor @naturegirl5

@butterflykizzs I’m not sure how this works in Minnesota either. If there is a test ordered that is on your portal it’s very possible that the test has then been coded for payment. The portal should give you an estimate however it’s possible you could call or go to billing and ask at Mayo. You could also check with your own insurance as I mentioned earlier.

As I look at what we are communicating about I think to myself what a huge hassle this is. No one wants to surprised by what is paid for by insurance and what is not. I’ve had that surprise in the past when I had health care insurance through my employer. It was irksome and had to do with different billing practices at different locations (not Mayo - I’m referring to local billing when a for profit business took over our local hospital and medical system).

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This happens a lot to me. I am fighting things from last year that I confirmed were covered and then someone makes an error or codes wrong. I called my insurance but they are dumber than a box or rocks! They can never get me any answers until the time comes. I will not know what procedures I get until I get there and speak to my doc at first appointment. From what I understand, they have a way of getting things approved very very quickly, like when you are in a hospital setting. I just do not want to waste a trip.

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Profile picture for butterflykizzs @butterflykizzs

This happens a lot to me. I am fighting things from last year that I confirmed were covered and then someone makes an error or codes wrong. I called my insurance but they are dumber than a box or rocks! They can never get me any answers until the time comes. I will not know what procedures I get until I get there and speak to my doc at first appointment. From what I understand, they have a way of getting things approved very very quickly, like when you are in a hospital setting. I just do not want to waste a trip.

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My insurance is the same. They now use a disclaimer telling me they are not responsible for giving me misinformation over the phone. We got zero documents from hubs employer and online info says "call for specific information.". Its maddening. When I had cataract surgery I called three times and got three different answers on what,would,be covered. When hubs,had his he called twice and same thing. I wrote it all up and,sent it to Customer Support. Crickets.

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@sandy8043 That’s maddening! I’ve been told by attorneys that these disclaimers are often meant to discourage you from filing a claim and that such disclaimers rarely hold up in court.

You are wise to document each conversation with your insurance company for your records and to send to customer service. When I had problems with BC/BS (under my employer) paying their cost I asked the Benefits Manager at my university for help. She was wonderful. Maybe there is someone at your husband’s employment who can be assistance if needed?

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Profile picture for butterflykizzs @butterflykizzs

This happens a lot to me. I am fighting things from last year that I confirmed were covered and then someone makes an error or codes wrong. I called my insurance but they are dumber than a box or rocks! They can never get me any answers until the time comes. I will not know what procedures I get until I get there and speak to my doc at first appointment. From what I understand, they have a way of getting things approved very very quickly, like when you are in a hospital setting. I just do not want to waste a trip.

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@butterflykizzs I really do expect that you will find the staff and medical providers at Mayo Clinic to be compassionate and helpful. I’d like to think also that their billing department is used to dealing with these insurance companies that are resistant to paying the claims.

I am usually polite whenever I talk with a customer service employee at a business or insurance company. But there are times I’ve become so frustrated that I have told the person that I need help they can’t provide and I’m going to hang up. Then I find another way around the problem because I’m nothing if not tenacious.

I understand your anxiety and concern about making this trip to Mayo Clinic given your past experiences with your insurance. I do hope you have similar experiences to my own.

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I was just on my patient portal. When you sign on scroll down to the box that says "Pay my Bill". Then scroll down to the hyperlink that says "Contact Customer Service". There you will find 13 boxes. One is titled "Before care Certifications and Prior Authorizations." I think that's a good place to start and let them know you have concerns. Good luck.
Sandy

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Profile picture for sandy8043 @sandy8043

I was just on my patient portal. When you sign on scroll down to the box that says "Pay my Bill". Then scroll down to the hyperlink that says "Contact Customer Service". There you will find 13 boxes. One is titled "Before care Certifications and Prior Authorizations." I think that's a good place to start and let them know you have concerns. Good luck.
Sandy

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TY so much! I will look now. I know they do not give much time between suddenly scheduling your test and you getting it.

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Profile picture for sandy8043 @sandy8043

My insurance is the same. They now use a disclaimer telling me they are not responsible for giving me misinformation over the phone. We got zero documents from hubs employer and online info says "call for specific information.". Its maddening. When I had cataract surgery I called three times and got three different answers on what,would,be covered. When hubs,had his he called twice and same thing. I wrote it all up and,sent it to Customer Support. Crickets.

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It is very difficult for us. My husband and I live in Florida but his company is based out of Cali. So we have BCBS Cali. Yet the benefits are different for out of state. Nobody ever understands or knows what will and will not be covered. They are always baffled when I contact them.
So it is always a guessing game or incorrect info. So I am really worried about BCBS Cali but us in another state then treatment in even another state...lol

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Profile picture for butterflykizzs @butterflykizzs

It is very difficult for us. My husband and I live in Florida but his company is based out of Cali. So we have BCBS Cali. Yet the benefits are different for out of state. Nobody ever understands or knows what will and will not be covered. They are always baffled when I contact them.
So it is always a guessing game or incorrect info. So I am really worried about BCBS Cali but us in another state then treatment in even another state...lol

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I'm thinking Mayo has experience dealing with out of state insurance.
Patients come from all over the world. So they may be able to give you advice if you give them a heads up on your complicated situation.

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