← Return to Ability to self-refer to Mayo with Traditional Medicare

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My mother was diagnosed with Cholagiocarcinoma back in November 2021. She went through several procedures to drain her bilirubin and started chemo in December 2021; however, she had to stop chemo treatment in March 2022 because her bilirubin levels started to increase. It has yet to subside. She has gone through several procedures to clean stents/drain the bilirubin but the oncologist has told us they've exhausted all resources and can't fix my mom's issue anymore.

I want a second opinion and I want to go to the Mayo Clinic.

My mother lives in Boise, Idaho and the closest Mayo is in Phoenix.

She has Idaho Medicaid which won't cover if she's down in Arizona.

Can someone provide me information on how to navigate through the insurance to ensure she's covered under the Medicaid umbrella.

Also, I've been reading that patients could 'self-refer'. Because my mother as a state specific insurance (Medicaid), she needs to be referred by her oncologist?

I am wondering if she could just get admitted to the ER at the Mayo so she could be seen.

We are racing against time right now.

Any guidance would be appreciated.

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Replies to "My mother was diagnosed with Cholagiocarcinoma back in November 2021. She went through several procedures to..."

Hi @danielywon, you’ll get the most specific answer according to your mom’s coverage directly from Patient Account Services at Mayo Clinic. They can answer all your Billing and Insurance questions specific to the Mayo Clinic in Arizona, Arizona regulations and her coverage and whether a physician referral is preferred or required.

Please contact them here: https://www.mayoclinic.org/patient-visitor-guide/billing-insurance/contact-us

Medicaid criteria may differ according to the campus you choose and the state Medicaid rules that govern.

Daniel, you may also wish to connect with other people with experience with cholangiocarcinoma is these related discussions:
– Cholangiocarcinoma – Bile Duct Cancer – anyone else dealing with this? https://connect.mayoclinic.org/discussion/cholangiocarcinoma-bile-duct-cancer-anyone-else-dealing-with-this/