@nlback22 Before you make your decisions about Medicare and Medigap insurance, it's worth checking with each Mayo campus to see what insurance they accept because it is different at each one. A lot of the "Medicare Advantage" plans that replace traditional Medicare have networks of local doctors that they will cover, and they may not cover out of state care.

A friend of mine just ran into this with an "advantage" plan and had spine surgery planned at Mayo, but it was canceled because insurance would not cover Mayo even though the Mayo billing department tried to work it out with the insurance, and the wording of the insurance plan implied that out of state care should be covered.

My PT told me the traditional real Medicare along with a "Medigap" supplement plan would have nationwide acceptance, and that is what I chose. I called the Mayo billing department and asked them, and they told me what was accepted there. The insurance you chose now will determine where you can be seen for spine care which is very expensive, so it is best to choose one where Mayo is in network if that is where you want to go. You can have out of network surgery, but there would likely be a lot more expense assigned to you.

Mayo Rochester is the original Mayo Clinic and largest campus and has more specialists, and this is where they are teaching the 7 year neurosurgery program, so you are right. There are a lot of experienced spine deformity care specialists there, and it is a high volume medical center.