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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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I'm sorry I was responding to mpeters, I was basically saying that the social workers are a great asset to help figure out problems with anything really not just Insurance, so I apologize I was not responding directly to your situation.
I'm in Arizona and the Mayo here dosnt have primary care doctors so I'm not familiar with how Insurance works with Mayo primary care. I personally use a non Mayo doctor for my primary. So maybe you may have to seek a non Mayo doctor for primary care.
I have a no Mayo doctor as my primary. The problem is that when he refers me to Mayo, the answer is that they have too many patients. Demand is too great.
Tried that about 4 times. Don’t get anywhere.
Have you tried to talk with the social worker dept?
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1 ReactionThat is a good idea, Dana. @hennykatz, have you considered getting a social worker to help navigate insurance issues?
Thanks for explaining this so well! Excellent!
Great explanation! I would only add that people with Advantage plans do pay less BUT LOSE CHOICE. One must go to the doctors in their network. I have traditional Medicare with Medigap plan that lets me go where I want. I self-referred to Mayo for lung cancer and got an immediate appointment and surgery set up promptly. I did not have the anguish of waiting to get approval for anything, nor did I need a referral from my primary care doctor. The commercials on TV are outrageous and should not be allowed.
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1 ReactionThanks for bringing that up. I have some friends who wanted to save money so they went with Advantage plans. One of them needed dermatological surgery, so instead of being seen locally, she had to drive 200 miles to get the procedure done.
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1 ReactionI had traditional Medicare combined with a Plan F. This gave me close to absolute freedom in selecting doctors and have zero to very minimal copay. For this year, I fell victim to the advertising and took out a Medicare Advantage Plan, and I am nickel-ing and dime-ing my self to death with co-pays for almost everything.
I will go back to a Plan F for next year. Mayo Clinic Jacksonville informed me recently that they will not accept advantage plans anymore.
The advantage plans are OK if you see a doc for the common cold only, as soon as you need specialists they are way to expensive.
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1 ReactionExactly. And Mayo Clinic stopped taking Advantage Plans ....only recently did they renegotiate with one provider here in MN. Advantage Plans cost the government more and provide less choice and freedom. It is heart breaking to read about someone with something serious and they are WAITING for approval to see a specialist or to get a PET scan. Then they advertise you get dental and vision, but I am very fussy about dentists! Whatever I overpaid for my Medigap policy these last ten years, I have now made up because I had serious stuff and I went to Mayo for lung surgery and a cardiac stent.