Financing, billing and payment options at Mayo Clinic

@88lance, you posted in exactly the right place. I expanded the title of the discussion a little more. It sounds like you have already discussed some possible options with the Insurance & Billing Office at Mayo Clinic (https://www.mayoclinic.org/patient-visitor-guide/billing-insurance), but that you still have questions. You would like to hear what worked for others who have been to Mayo Clinic or to know what further questions you should ask Billing to avoid unexpected surprises and to prepare your financing.

I'll tag a few members like @roch @loribmt @jenniferhunter @ess77 @johnbishop who may be able to offer tips of what questions to ask and what they wished they had known. I'm confident that others will chime in too.

Additionally, you might find some of the information members shared in these discussions to be helpful:
- What Insurance plans does Mayo Clinic cover? https://connect.mayoclinic.org/discussion/insurance/
- Tips needed: How do you manage finances during a big medical event? https://connect.mayoclinic.org/discussion/tips-needed-how-do-you-manage-finances-during-a-big-medical-event

It is so hard to balance what you need vs the cost.

For my bills, Mayo has always asked 10% of balance per month. In past they did not charge interest, not sure if that is still their policy.

In certain situations, they may ask for payment in advance. I know for optional surgery (like cosmetic) they want money up front.

If having surgery Mayo may require a pre-approval process prior to scheduling. If they know insurance will not pay, not sure what they do. Just want to mention so you are aware of ahead of time.

I had situation where Mayo would not schedule a MRI till insurance approved. Insurance would not approve till had diagnosis. It was huge mess. After a biopsy confirmed cancer, then they would pay for MRI. It is a terrible situation to be in, stuck between insurance company and what provider tells you what is needed.

You are doing the right thing to ask these questions before hand.

Laurie

Hi @88lance, I think I would try to get a list of the tests along with their medical billing codes that Mayo Clinic is scheduling for you and then call and talk with your insurance company or rep to see specifically what is covered and what is not covered.

Thanks for the responses. The 10% of cost is what worries me, because on a 30,000 dollar medical bill, that's not even affordable for me. So other options would be good to know about.
The insurance that I currently have pays for 75% of a doctor's visit or evaluation or exam six times per year, which I have already used up trying to chase this issue down. So the only thing left on my insurance that I can use it for this year is something major like a surgery. If I remember correctly, it pays for everything after your first $3,000 in a surgery or bad scenario of getting admitted into the hospital.
I cover the 3,000, they do the rest. Hopefully my issue doesn't come down to that though. Or maybe i hope it does, it might actually be cheaper. lol
I'm also curious what the "discount" is for paying in full, I should have asked.

Besides the 10% payment option, and pay in full option, are there some other ones you have seen/heard of that I should consider?
Thanks again for the replies

@88lance Do you have any sense of what procedures or tests are needed for your vision or what medical departments you might be seeing? If you have local doctors referring you to Mayo, you could ask them what tests Mayo may do. I know that may be hard to answer, and vision can involve neurology because vision happens in the brain when the signals from the retinas are processed. That may involve an MRI of the brain, and that might be around $3500. Sometimes you can do an MRI on a cash basis for a lot less if you call the place that does them and ask what price they can do it for. Ask a local doctor you know which places do better quality MRI's. The prices of everything are based on being "in-network" with insurance companies to get a negotiated rate or "discount" according to their contract and prices are set by medical facilities knowing the insurance will not pay retail prices. You can ask for the same "discounted" cash price that they would be receiving from an insurance payment. You could ask Mayo if there are any tests you can do locally before you come and send them in ahead of your appointment and see if you can get them for less. Mayo accepted my MRIs done at other places. Make sure your provider clears this so you won't have to spend more money to repeat the same test at Mayo, but an MRI is pretty standard. You could also call the department where you are starting and ask if they have a ballpark guess of what tests they might do; again that may be impossible to answer because they haven't seen you yet.

For my 2nd surgical visit, I set up a payment plan in my patient portal that stretched my payments out 10 months. If you are expecting a $20,000 bill, talk to a real person at Mayo about a payment plan and be honest about what you can afford each month. Discuss this with all the providers at Mayo; they will not want to do unnecessary tests that would increase the bill unnecessarily. I had insurance for my treatment at Mayo, so my portion of the payment was reasonable. My out of pocket maximum from my insurance company was $6000 annually, and I didn't have to pay after that, and I did hit that max the first time I came to Mayo because I had been through seeing a lot of providers and testing before I came to Mayo, so when I had a spine surgery that was $65,000, I didn't have to pay anything. The 2nd visit was surgery for a broken ankle that cost a lot less, I don't remember how much, but my portion was around $4000.

Call your insurance company to verify what your benefits are, and if Mayo is in network with them. There is also an online cost estimator for certain procedures that lets you get an estimate based on what insurance you have, and you can select no insurance to see a cash price. You can find it at this link. https://estimator.mayoclinic.org/mychartguestpay/GuestEstimates/

They have some typical tests and procedures listed. Some people say Mayo is more expensive than other places, but I don't know what I would have paid if I had gone elsewhere. Mayo is thorough in their testing and they have to be to be confident in a diagnosis. They do neurology testing differently, and I had to repeat that at Mayo for the spine surgeon, but my MRI was 9 months old and that was new enough for surgery.

Thanks for the reply, I'm really not sure what test they will do because I've already done about every test I can think of.
I really don't even know what the next step would be, which is why I am heading to Mayo.
Being vision, my first thought was that had something to do with the eyes or the optic nerve or something. So I had about every eye test and OCT done that they had, and then I had an mri, and then a few ultrasounds on a few other areas, and everything came back clear. Out of all the places I've been and specialists I've talked to and MRI and oct's, and blood work, nobody can find a problem.
Luckily, I submitted all these tests to Mayo clinic, so I'm hoping they will use most of those and cut down on a lot of costs and wasted time. I'm sure it will help. 👍
But now that almost every test we can think of is done, I'm really not sure what mayos next step will be. When they call to start my appointment scheduling I will definitely ask, because me and all my specialists are stumped here.

Hi and I'm not sure if this will help but I'll just tell you my story and some things I found along the way. Now realize I was recommended to Mayo for a Heart Transplant evaluation and at the time it was just a precaution to have it done in case my Heart got worse.
I at the time had BCBS which normally is not contracted with Mayo except for Transplants. But it turned out my heart did get worse and I got the transplant. But here is where it gets expensive for me. My insurance only covers the transplant and the first year of follow-up treatments for the transplant related things. Now after my first year I did devope some blood and virus issues(this was pre covid) and had some hospital stays where the insurance became out of network. So my out of pocket went thru the roof. I'm actually still working that part . The insurance did finally cover the hospital stays but I also needed Iv treatments for a virus causing blood problem. These treatments I had monthly and cost 8000 dollars each. Luckily during that time I was able to get a secondary insurance from my military service called tri care which has helped.
So long story is I set up a payment plan. I owed along with some out if pocket from the transplant well over 30,000. But that's getting reduced thru some mistakes in billing. I ended up calling and setting up a payment plan for 500 a month. Now the web site says 10% but when I did it with a live person they said they could set it up for far less. So for the better part of 3 years I was working on it at 500 a month. So my suggestion is there pet answer will be 10% but after talking to a counselor in the financial dept it became a lot less.
Also I would also suggest getting in contact if your eligible with the social worker dept. They have many ways of suggesting options on programs and departments that have helped me a lot.

Great, thank you for the information, I will reach out to them also. Did they need to go through your income and assets to determine how much they would set your monthly price at, or did they just decide on that number themselves?
I'm really hopeful that all the previous tests that I've done and things I have tried eliminates a lot of the costs and testing when I get there. Of course you never know, they might redo it all too, but hopefully not

Do they determine what your monthly payment will be based off of income and tax return or something, or just decide based off of what you tell them?

Just what I requested. No finicial information was requested by them and I didn't offer any. I basically said that their was no way I could do the 10% I think it originally was like 2000 a month but I'm not sure on that amount. It was actually them that just said we can go as low as 500. Now the only thing I will add is my original deal was in late 2019 I think or early 2020.