Does Mayo Clinic take Medicare?

Posted by Helen, Volunteer Mentor @naturegirl5, Jun 3, 2022

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

Interested in more discussions like this? Go to the Visiting Mayo Clinic Support Group.

@hennykatz

I don’t understand your answer. I have been a patient of Mayo in Jacksonville, FL since they opened. At a certain point Mayo and my Insurance Company coils not come to an agreement about fees for 2 years. When they accepted my insurance company again, I had turned 65.
They don’t take new Medicare patients.
I still see a neuro surgeon and pain doctor, but can’t get any other physician.
I am even willing to take a resident as my family physician. What can I do?

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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.

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@danab

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.

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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.

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@colleenyoung

Henny, I might suggest calling an Insurance coordinator at the Mayo Clinic FL campus. Here is the contact information
- Insurance & Billing: Contact https://www.mayoclinic.org/patient-visitor-guide/billing-insurance/contact-us

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Tried that about 4 times. Don’t get anywhere.

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@hennykatz

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.

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Have you tried to talk with the social worker dept?

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@danab

Have you tried to talk with the social worker dept?

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That is a good idea, Dana. @hennykatz, have you considered getting a social worker to help navigate insurance issues?

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@jenniferhunter

@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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Thanks for explaining this so well! Excellent!

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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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@vic83

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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Thanks 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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@mpeters

Thanks 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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I 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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@lindes

I 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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Exactly. 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.

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