BCBS Advantage no more Mayo

@roch OK, My not-for-profit PPO advantage plan is CDPHP (Capital District Physicians Health Plan) http://www.cdphp.com. It is what my employer offers for retirees, a non-Medicare option is offered to present employees. Choices given to employers are different than those offered to individuals, so in some ways, comparisons between what I have and others is not a truly valid comparison. The mission statement and company overview is on their website and is among the highest rated in NY.

Thank you for contacting Mayo Clinic Patient Account Services.

I understand you have questions about your insurance and which plans would cover your appointments at Mayo Clinic.

Mayo Clinic will not accept out-of-network Medicare Advantage Plans (MAP).

Mayo Clinic in Arizona and Florida are out of network for MAPs. MAPs are managed by commercial insurance companies on behalf of Medicare and offer a specific network of contracted medical providers and hospitals, which do not include Mayo Clinic in Arizona or Florida. These plans require a substantial network of qualified providers to accommodate their members' medical needs.

We will continue to accept Original Medicare (Parts A, B, & D), and supplement plans, sometimes referred to as Traditional Medicare. If you choose to enroll in a Medicare Advantage Plan, we can provide your medical records to the in-network facility that you select for your care.

Additionally, you, or an insurance agent, may call different insurance carries to see if they will be contracted with Mayo Clinic in 2026 with the tax ID number(s) for the site(s) where you have your services rendered. For a list of our Tax ID numbers, please see Out-of-network patient information - Mayo Clinic.

If you have any additional questions or if you need further assistance from our office, you may send a secure message through Patient Online Services or contact our Patient Accounts Service Center by calling 844-217-9591.

Thank you for choosing Mayo Clinic for your healthcare needs.

Sincerely,
Jamie R.
Patient Account Services

@tsch That is the idea of any advantage plan, PPO included - to stay within a network. However, if a treatment is not available, a good plan will pay for you to go elsewhere. That is what my not-for-profit advantage plan paid for when I had my septal myectomy at Mayo. Absolutely no problems, if there were any, I was not aware them. In fact, I was charged the in-network hospital copay amount ($350) rather than the $800 stated in my benefits list for a hospital out of network. It is so sad, stressful and unnecessary that we practically need to get a PhD in insurance coverage to navigate this maze. My former employer has a particular plan for retirees.

@walkinggirl
I think we are on the same page. It sounds like you have excellent insurance. Many plans offered to retirees are not so good- more expensive and fewer benefits than Medicare. Insurance is complicated for sure. Many people with advantage plans have excellent coverage, but it seems those that dont have an undue influence, and there can be many reasons people have problems.

@mk52dk51
Just saw your comment. With traditional Medicare you can self-refer to any doctor in the United States that takes Medicare including Mayo Clinic. You can buy a Supplemental/Medigap plan to cover the 20% that Medicare does not cover....only problem is that you are not newly enrolled in Medicare so insurance companies no longer obligated to accept you. I tell everyone to always sign up for Original Medicare so that when they are sick they can go where they want. You lose choice with Advantage, it is an insurance company with its network of doctors to whom you must go, and many places are dropping Advantage plans. John Oliver, the Comedian did a recent good show about Medicare showing the weakness in the Advantage plans

@vic83 Choice and satisfaction depend on the Advantage plan. I have a PPO from a not-for-profit Advantage Plan founded by physicians and overseen by a board that includes medical personnel, no referrals needed. I can go to any medical facility where Medicare is accepted, including Mayo in Rochester where I had a septal myectomy, no questions asked. Many (Most?) advantage plans are administered by insurance companies that have for their goal to make a profit in order to give shareholders dividends. You'd think that this country can do better so we do not need PhD's in insurance coverage to navigate our medical care.

@vic83
Thank you sooooo much. Having worked 47 years with employer insurance, then 8 yrs on Medicare and an Advantage Plan that worked just fine, the choices are daunting. But I met a great broker and your message with a few others on this platform helped maneuver the maze. We will both go back to traditional Medicare with a plan G. Its more per month but we can afford it. Plus, for probably one time in our lives there's no underwriter to go thru to get accepted. Now I just have to decide on the supplemental plan.
So again, thank you very much for helping me know I'm making the right choice...the smart choice.

Is it Select Health?

@mk52dk51 ....When you start needing a good specialist - and specialists have subspecialties - you will be happy because you can self-refer with no problem. One doesn't get healthier getting older! I am so grateful I went with traditional Medicare; it was just by luck because someone told me how much they liked their plan, so I went with their Medigap plan without really looking much because the rep said I could travel with it and I was moving to Florida. Now I really need it so I am ahead premium wise. They pay out more for me than my premium!
Mayo Clinic sent out a letter recently to all patients that they will no longer take Advantage plans (and they only took special ones before).
The Medicare site has a good tool to find plans with. You tell it where you live and what type of plan you want and it pulls up all the plans you are eligible for and tells you how much each one will cost you. It is excellent for Part D (drug) plans. You give it your medications (and it saves them for you too) and it will pull up all the plans and tell you how much each one will cost you for the year (premium plus copays). That is what brokers use!

@walkinggirl ...You are fortunate if you have choice and no problems...that is not the case usually.
Also are you aware that Mayo Clinic recently sent out a letter to all its patients that it NO LONGER will take Advantage plans in 2026? Before Rochester Mayo took some that had negotiated with them...but Florida and Arizona did not take any