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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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The problem is in AZ one cannot obtain Traditional Medicare if under age 65. No insurance company offers. I am 62 and can only ge Advantage PPO programs which are not accepted!!
Actually you can in Arizona get Medicare I'm 63 and have it. But as for supplements I'm also retired military and have Tricare for life as my secondary
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2 ReactionsIn Mayo Clinic Jacksonville: If you are looking for an Internal Medicine or Family Physician doctor as a new patient with Medicare they don’t accept you. The other specialists do as well but it depends which Medicare you have. I have Medicare (A&B) & never had problems. We have been patients of Mayo since 2009 and there was no chance for me to get an Internal or Family physician there. Medicare doesn’t pay too much to these doctors. So I had to get a physician outside Mayo Clinic. The schedulers in Mayo told me that they could add my name to a 2-yr waiting list to get one Physician. Ridiculous! Also even Mayo is good every time you ask for an appointment with a specialist they schedule you with a Nurse practitioner. Seldom you can see the specialist. I am a RN so I am not going to tell another nurse what is my health issue, I know what it is. She takes notes and asks the same question I want to ask the specialist and then the NP say: “I will pass this on to the specialist so he/she checks what is going on and I will call you.” Well…the NP is just a messenger. Waste of money. I wish Mayo Clinic would stop hiring so many NP. It is not goid for the patients.
Great information all! Is there an appreciable difference in premium for the G supplemental plans across insurance companies? For instance Florida Blue (BCBS) over United Healthcare through AARP?
@snoshu I suggest that you call Medicare directly to ask that question. My understanding is that the Medicare rules are federal and so apply in all states. I just heard a discussion about this very topic on Health Connections on SiriusXM where they talk about all sorts of insurance issues. Call Medicare and ask the question about eligibility for Medicare under the age of 65.
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2 Reactions@gaildw67 This is a good question. Yes, there will be differences in premiums for G supplemental plans across insurance companies even though the benefits/services are exactly the same. The services offered are regulated by Medicare so cannot vary between insurance companies. These premiums can differ quite a bit as I found out when I first began the research into supplemental plans.
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3 Reactions@naiviv. Are you referring to Traditional Medicare or Medicare Advantage programs. My understanding is that Mayo Clinic as a whole in all locations will take Traditional Medicare regardless of the type of practice. Whether or not you see a physician vs. a nurse practitioner will vary according to the practice. Personally I see a nurse practitioner for my cancer surveillance and I'm very satisfied working with her. I don't see my NP as a messenger at all. She collaborates with all the providers in her department and has advanced training in nursing (a graduate degree) and advanced training in gynecological oncology.
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4 Reactions@naturegirl5 thanks! I found a huge difference in the RX Part D in terms of premium as well as the out of pocket. Do you know if you buy the part D with one insurance company if you must buy the Part G supplement from the same company? I can call Medicare but thought someone might have had the experience. This is a great resource. Thanks!
My Primary Care Provider for over 20 years is Nurse Practitioner is definitely not "another nurse." She is a doctor of nursing practice with 2 PhD's, and specialties in both lung health & geriatrics. She has 25 years of experience treating patients directly, and knows more on many topics than the physicians in our clinic.
In Minnesota, Nurse Practitioners must have 2 years current patient care experience, a BS in Nursing, over 50 credit hours of Advanced Nursing Practice training (equivalent to an MS), a practicum of about 1000 hours, and board certification. Many jobs require additional training in a specific areas as well.
I would rather start with an experienced NP (who in our clinical/hospital system is granted twice as many minutes per patient contact as the MD) than a harried, overworked MD anytime. My lung disorders, joint degeneration and chronic pain were all diagnosed by my NP, then referred to an appropriate specialist.
Sue
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5 ReactionsEvery year I get a letter from Mayo Clinic stating that they don’t accept Medicare Advantage.
A point of confusion is this: Mayo will accept your Medicare (however see above) but you have to pay the part of your bill not covered by your Medicare plan. The phrase Mayo uses is “we do not accept Medicare assignment”. Some people interpret this to mean that Mayo does not accept Medicare. That is not correct. It means you pay the difference between what Medicare pays and the bill.
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