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Does Mayo Clinic take Medicare?
For those of us who live in the U.S., this is a complicated issue. Whether or not Mayo Clinic takes Medicare comes up frequently. The short answer is yes, Mayo Clinic, on all campuses, does take Medicare. But here is where it gets sticky. It depends on the Medicare Plan you have.
If you have what is sometimes called "Traditional Medicare" then you have Medicare Part A (for hospitalization) and Part B (for outpatient). You also selected another Plan that covers the gap of what Part B does not cover. I have Transamerica Insurance for my Part G supplemental plan. It's very cumbersome however I chose traditional Medicare because it allows me to go anywhere in the U.S. that accepts Medicare. I don't need any prior authorization.
If you chose a Medicare Advantage Plan then you are in a network of hospitals and medical providers and have a managed care plan. You have Medicare Parts A and B but also C (Medicare Advantage Plan) that includes all of your medical services including prescriptions. However, Medicare Advantage Plans have networks so like the type of health care plan you probably had before you retired you have to get prior authorization for some services from your insurance company and you cannot go outside of your network or it will cost you a lot of additional money. Many people go with these Medicare Advantage Plans because the monthly cost is reasonable, it's easy to sign up, and if you live in a large urban area you'll have lots of choices of where you can go. But, if you want to go outside of your network, like Mayo Clinic then you'll have to check to see if your Medicare Advantage plan lets you go to Mayo Clinic.
Confused? It's mind-boggling. I figured all of this out when I signed up for Medicare shortly before I retired.
If you want to know if Mayo Clinic takes your Medicare Plan, you can call the business office at any campus and explain what kind of insurance coverage you have. They will help. I have experienced THE best service when I've contacted Mayo Clinic for insurance and billing questions.
https://www.mayoclinic.org/patient-visitor-guide/billing-insurance/contact-us
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Hi and I thought i would add if your a retired military and are eligible for tricare then that along with Medicare A and B work well so far. I found it much better coverage than when I was on BCBS Federal. The Tricare is paid via Medicare part B
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4 Reactions@naturegirl5 This is a great conversation. Helen, I did just as you suggested and called the Mayo billing office to find out which Supplemental insurance plans (Medigap) were accepted at Mayo Clinic with Traditional Medicare. They are designated by the letters either "F" or "G", and are named after the issuing company such as Mutual of Omaha, etc. At lot of Medigap plans have local limits and don't allow a patient to travel out of their own state for medical care, but there are a few that may have nationwide coverage, such as Mutual of Omaha or a United Health Care that is purchased through membership in AARP. (that information subject to change by insurance companies)
You are correct in staying with traditional Medicare in order to have care available nationwide. If you take a Medicare Advantage Plan (not the same as Medicare), you are stuck with their local networks and it is very difficult to be able to get off them and on to Traditional Medicare after that. Unfortunately, the commercials for these advantage plans bombard us with aging celebrities and sports figures promoting them promising all kinds of things like cash back, gym memberships and dental plans that you can get if you call the number to check your zip code. If you accept these promotions, you will be giving up your right to chose care out of your state of residence and will be limited to doctors in their network only.
I want to be able to come back to Mayo if I need further care in the future, and I don't live in any of the 3 states where there are Mayo campuses. I just signed up for Medicare, and will be choosing the supplement insurance soon which is denoted as a "G" plan. Traditional Medicare is part "A & B." Part "C" is an advantage plan that I am avoiding. Part "D" is for prescription drugs. There is a part "F", and if you have "F" or "G" depends on some criteria. You can have one or the other. If you choose the Advantage plan, you only have "C". If you choose Traditional Medicare you will have "A" + "B" + "D" (if you select a prescription drug plan) + either "F or G".
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12 Reactions@danab Good point. Yes, anyone who is retired military has other options including Tricare for their supplemental insurance.
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1 Reaction@jenniferhunter. Thank you, Jennifer, for the clarifications.
The "Plans' are set by the Medicare so Plan E, F, G, etc. so any insurance company will cover the same medical services. The only difference is what each insurance company charges so perhaps Mutual of Omaha may charge a different monthly rate than United Health Care.
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3 Reactions@naturegirl5 Helen, this is a great discussion.
In my own experience, as I researched out what direction to take years ago, when turning 65, I found meeting with the ombudsman [advocate] at my then-county's Area Agency on Aging to be invaluable for me. They had access to all types of things, and personalised it for me and my situation at the time. As the gal wisely stated, "You don't know what will happen in the future, and here is what I would recommend based on my experience." I have medicare A+B+D+F. It has been a great set-up for me. For me, my "F" plan supplemental is through AARP United HealthCare.
Ginger
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3 Reactions@naturegirl5 Right Helen, each category of plans are the same coverage. They have charts for billing that say what the premiums will be as your age increases for comparison between companies. Most get more expensive each year as a person becomes older. For clarification in my prior post, an F or G plan isn't mandatory. It is a supplement (Medigap) insurance plan that must be purchased that will pay what is left over that Traditional Medicare does not pay. Medicare Part A is at no charge to me because I have paid taxes toward that with employment. Medicare Part B will have a monthly premium cost to me, and when I start receiving Social Security payments, the premium will be an automatic deduction from the social security payment. Until that time, I will need to make the payments for Medicare Part B.
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1 ReactionHelen, Volunteer Mentor @naturegirl5
Thanks for topic, it is very confusing trying to navigate Medicare. I actually just attended a seminar on this and there happen to be a Mayo employee in room (not as representative of Mayo, just attending) and he mentioned that each campus has own policies regarding Medicare Advantage policies. That is where people get confused. If someone says I am on Medicare and go to Mayo, is NOT the same as everyone over 65 on a type of Medicare policy can go to any Mayo facility. You must check your individual policy and specific Mayo location.
There were many Mayo employees in room approaching Medicare age trying to figure out what next. So not only is it confusing to general population, Mayo employees have to make same type of decisions. By the way, I am not an Mayo employee or retiree.
The other part that makes it more confusing, some of the Medicare plans available in past are no longer available. Example, Plan F is no longer available unless you were eligible before a certain date. So if your 75 year old aunt tells you what great coverage she has, it might not be an options that is currently available to you. I was born in 1955 and could not sign up for plan F.
Another suggestions, beside calling Mayo and asking about coverage, call your specific insurance company and asks if your policy covers a specific Mayo campus. They know the details of your plans. And seeing all "Mayo" campus are not the same when comes to insurance coverage, you need to identify the Mayo campus you are going.
Insurance companies use the Tax ID to identify covered providers, that can be found at:
https://www.mayoclinic.org/patient-visitor-guide/billing-insurance/insurance/faq
If you are just starting to look at Medicare in future, there is good reference material on Medicare site:
https://www.medicare.gov/basics/get-started-with-medicare/medicare-basics
As someone suggested, many communities have programs to help people with that decision. Make sure it is an unbias program / advice your are receiving and they are not just trying to sell you their policy.
Each type of Medicare plans has it's pros and cons. And your needs are different then what your friends or family needs are.
Do your research.
Laurie
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8 ReactionsI live in Wisconsin and have a Medicare advantage plan. It covers two different providers in the area plus Mayo Clinic, which is a reason I went with it.
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2 ReactionsThank you, @gingerw I live in a rural Michigan and we have a County Area Agency on Aging. There is no cost to use this service and it is funded by federal and state funds. The people that staff your County Area Agency on Aging are experts on the Medicare policies available to you where you live.
As @roch wrote, if you go to an insurance broker who advertises that they will help you with Medicare then you are paying for their service. They are selling you a policy and may not be looking out for your best interests.
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2 ReactionsI am glad you are addressing the topic of Traditional/Original Medicare vs. Medicare Advantage. There is a tremendous amount of advertising on TV for Medicare Advantage, but NO MENTION that for all the so-called "extras" one is restricted to their network. And one needs referrals to see specialists. But not all doctors are created equal as one learns with experience. I have original Medicare with a costly Medigap insurance, and it has proved well worth it over the years. I could search out an experienced specialist for my needs and simply go. Specialists have areas they focus in and that can be very important to know. And large networks of providers do not necessarily have a high level of expertise in specific areas nor offer all treatment options. For example, open chest surgery vs. Video Assisted Thoracic surgery. Big difference in recovery time!!!! Then there is Part D drug insurance. Use the Medicare on-line tool to compare plans. Look carefully. Insurance plans are not always transparent about costs. I got snookered last year and am paying at least $400 more this year than I should be, because I thought I was getting a plan similar to the one for the year before.
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