← Return to What insurance is accepted at Mayo Clinic?

Discussion
teresamason avatar

What insurance is accepted at Mayo Clinic?

Visiting Mayo Clinic | Last Active: Mar 25 10:12pm | Replies (12)

Comment receiving replies
Profile picture for vic83 @vic83

@bajjerfan Yes, if you check on the Medicare site, you can see the "full" claim charge and then what Medicare pays which is a much smaller amount. Private insurers do pay more for the same service but still much lower than the "retail" billed amount. It is up to Congress to increase what Medicare can pay. One thing to note, is that the charge by healthcare provider is extremely high. I have read that nobody knows why providers charge the exaggerated amount, just our system. Medicare however offers the provider access to a high number of patients which increases their revenue. In marketing, a product is given a price to promote highest volume in sales, because that produces a higher total profit for the company - higher unit price does not mean higher total profit for the company.
Before Medicare, many Seniors could not afford/find health insurance and just died. Private insurers may pay more but they are well known for requiring approval for a procedure and delaying things. And a research institution like Mayo needs patients with interesting issues. There is a reason to be "not for profit"

Jump to this post


Replies to "@bajjerfan Yes, if you check on the Medicare site, you can see the "full" claim charge..."

@vic83

For most services there is what's called UCR usual customary and reasonable charges for billing out those services. I don't know how strictly Mayo or any other provider adheres to that. IIRC they vary somewhat by area. Charges in excess of UCR are probably excluded by the insurer. Mine was supposed to be MRI with 3D rendering which is why it comes out higher, but I can't vouch for that. In my experience MC pays a lot higher percentage for an office call than other services from what I've seen from my EOBs.

Mayo or any other medical service would not survive very long if all they saw were MC patients. That's one reason so many rural hopitals are struggling or going under: MC doesn't reimburse at a high enough rate. Also a main reason why IMO a MC for all type national coverage could never fly. YMMV.