Choosing best insurance and insurance at Mayo

Mayo Clinic Jacksonville puts out an official letter to it's patients regarding open season for Medicare enrollment. I think it helps explain the differences and why so important to know exactly that Medicare Original/Traditional is Federal Medicare and when you go to Medicare Advantage you are moving to a private company coverage not federal Medicare.
Below is official letter put out by Mayo Clinic Jacksonville yearly on this insurance subject.
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At Mayo Clinic, our patients are at the center of everything we do, and your trust is very important to us. Sharing information is one way to help ensure we continue to be trusted partners for your health care needs.

As you may be aware, beginning in mid-October, it will be time to select health care coverage for 2024. Mayo Clinic in Florida is not in-network with most Medicare Advantage Plans. We want to be sure that you are aware that Mayo Clinic in Florida will not schedule appointments for patients with out-of-network Medicare Advantage Plans.

Many patients are making elections for their coverage in 2024, including Medicare. Marketing for Medicare Advantage Plans may indicate that you can be seen at any facility that accepts Medicare, however Mayo Clinic in Florida is out of network on these plans.

Medicare Advantage Plans are managed by commercial insurance companies on behalf of Medicare and offer a specific network of contracted medical providers and hospitals, which may not include Mayo Clinic in Florida. These plans are required to have a substantial network of qualified providers to accommodate their members' medical needs.

As you consider your options for health coverage, you can confirm Mayo Clinic's participation by providing the insurance plan under consideration the Tax ID information below:
Mayo Clinic Florida Hospital 59-0714831
Mayo Clinic Florida Outpatient Clinic Services 59-3337028

We do accept Original Medicare (Parts A and B), and supplement plans, sometimes referred to as Traditional Medicare. If you choose to enroll in a Medicare Advantage Plan, we can provide your medical records to the next in-network facility you select for your care.

Learn more about your Medicare options online, or by calling Medicare (1-800-MEDICARE), or a State Health Insurance Assistance Program (locate a local resource by calling 877-839-2675). Mayo Clinic is not authorized to assist with Medicare enrollment decisions.

Please continue to update Mayo Clinic on any changes to your health care coverage.

Sincerely,

Mayo Clinic in Florida Leadership

I ask how can Medicare Advantage afford all those commercials flooding the TV during open enrollment. Commercials are extremely expensive, and those blaring ads are long and loud. Do not fall for that. Follow the excellent advice on this thread. Traditional Medicare + part G, N, or HD G which means you pay a deductible but are still covered. I went to Mayo, had an appointment with a specialist, and had some tests. No bill. My Traditional Medicare + G (Mutual of Omaha) covered all of it. There are many companies to choose from. I suggest talking to a broker such as Boomer Benefits or a qualified agent to walk you through the process.

Retuning to the original question of what supplement plan does Mayo Clinic accept, I don’t think they really care about your supplement plan. Billing goes to Medicare and Medicare goes to the supplement. Having a supplement plan only suggests that you are covered if Medicare doesn’t pick up everything. Even with all that, you might still be liable for anything that can be remotely connected to dental or vision.
Just a disclaimer here, Advantage Plans are NOT Medicare.

Medicare Advantage Plans incorporate private insurance companies such as Blue Cross/Blue Shield, Aetna, and others that contract with the Centers for Medicare (CMS) to provide health insurance. How does this work? You sign up for Medicare Part A (no cost to you) and also are required to sign up for Medicare Part B ($174.70/month). If you are getting Social Security, Part B is automatically deducted from your Social Security check. You find the Medicare Advantage Plan that works for you (this is called Part C). The Part B amount you pay via your social security is directed to the Medicare Advantage Plan you choose to provide your Medicare Advantage insurance.

And yes, these Medicare Advantage Plan companies blast us with ads, mailings, and the like this time of year because we are in the “Open Enrollment” period from Octover 15 to December 7. They want your money and they want to make a profit on your health care.

Compare Original Medicare & Medicare Advantage:

— https://www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/your-coverage-options/compare-original-medicare-medicare-advantage

So, bottom line is this. Traditional (Original) Medicare has been around for a long time. Medicare Advantage Plans came about later and both are available to you.

Hi @skipinjb, you’ve received great answers from fellow members regarding choosing the insurance plan that is right for you and how to find out which plans are accepted if you wish to seek care or are already a patient at Mayo Clinic.

Allow me to post links directly to the departments at Mayo Clinic should you wish to speak to a coordinator.

- Mayo Clinic Billing & Insurance https://www.mayoclinic.org/patient-visitor-guide/billing-insurance
- Insurance, including types of insurance https://www.mayoclinic.org/patient-visitor-guide/billing-insurance/insurance
- Contact info https://www.mayoclinic.org/patient-visitor-guide/billing-insurance/contact-us

You may also be interested in these related discussions:
- Medicare and Mayo Clinic: What does Medicare cover?
https://connect.mayoclinic.org/discussion/medicare-and-mayo-clinic/
- Does Mayo Clinic take Medicare?
https://connect.mayoclinic.org/discussion/does-mayo-clinic-take-medicare/
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It’s not easy to wade through insurance plans. After reading all the responses, do you have any further questions?

In 1997 the program then called “Medicare Choice,” became official with the passing of the Balanced Budget Act. In 2003, Medicare Part D was created, and Medicare Choice plans were renamed to Medicare Advantage plans.

1) "Obamacare" obligated insurance companies to pay out 80% in services or give a credit to beneficiaries – in fact my Medigap premium stopped increasing 10% each year with it! When I bought my Medigap plan, the insurance brochure proudly announced they paid out 67% in services. People under employer plans did not get a credit because employers kept the extra money.
2) Obamacare mandated that health institutions/doctors had to digitize their records and make them available to patients to facilitate changing of doctors. The added benefit that saved me much pain and provided me with a much better prognosis is that I could read my tests online and I knew my specialist was inadequate.

I had original Medicare and therefore I could self-refer to Mayo Clinic – and I thank my lucky stars I did not have an Advantage Plan!

Check the Mayo Oncology Dept – they give out brochures on what to do when your insurance company refuses to pay for your cancer treatment – they recommend checking your benefits with your insurance company and they note that original Medicare patients do not have this issue. I could not believe my eyes when I saw that and I tell everybody – you get sicker with age, do not buy an Advantage Plan

Again I urge those who need Medicare/Medicaid to stay away from dis-advantage plans. [Beware of] private insurance compan[ies] that send you to an advantage or Supplemental plan. “Both are basically the same plan”. Many cases have cost these plans millions of dollars in fines for using their favorite plans to write the expenses by fraudulently double and tripling billing.

AARP is an example. They get a piece of the action from AARP or vica/versa. If you look at AARP plans they are all United Healthcare advantage plans if using AARP for your healthcare.
I was on UHP for a month and hated it and went back to my Neighborhood Health plan integrity.

Everything you can think of health wise is covered with no co-pays or deductibles.
I pay by Social Security. $160 a month for the dual Medicare-Medicaid plans and other than that premium $160.00 a month I have not paid anything for health care the past 10 years.
You name it, it’s paid for 100%. I think United is too big. I once received a bill for $600.00 for dental care because they said the dentist was out of network. I checked my policy and found her listed as “in network “ I had to call and eventually spoke on the phone to a person in Kansas who said that “ you can always appeal it”

I’m in RI, 1,000 miles from Kansas.
I told him that I wasn’t going to appeal anything because it’s covered. I never heard from them again and I disenrolled from United and went back to NHP. A local insurance company.

RI does have a remarkable Medicaid expansion program and it pays whatever Medicare won’t including copays and deductibles. You have to qualify though. Many states [...] get crumbs or low no Medicaid plans at all.
So do your homework and don’t let a friendly advantage plan salesman offer you an advantage or supplemental plan as they are both the same thing with little difference between them.

There is big difference in supplements plans and advantage plans. The supplement plans pay after Medicare pays. I have BCBS Federal as secondary insurance that pays after Medicare pays. There is still an in Network and Out of Network requirement but my plan pays as long as the provider you are seeing accepts Medicare.

I set up an automatic crossover with Medicare. Thus when Medicare finishes paying their portion the automatically send that information to my secondary insurance BCBS federal. My EOB for BCBS then shows what Medicare paid and what BCBS paid. Important to remember the amount authorized to be charged is Medicare amount as primary payer thus BCBS is only responsible for the co-pays and deductibles for what Medicare authorizes to be charged.

Yes, "Medicare Advantage" plans are run by insurance companies, and the name is purely a marketing trick for there is no advantage in these plans!. But it is simple:
1) ORIGINAL MEDICARE (Part A, Part B, Part D) - Part A and Part B covers 80%. Part A is hospital, and there is no monthly premium. Part B covers doctors and tests and there is a monthly premium. It is taken out of your Social Security if you sign up. People with low income may have a reduction on cost.
2) With original Medicare, I bought a Medigap supplemental plan that covers the 20% that Medicare does not pay. I pay a monthly premium and I never see a bill. I self-refer and never need approval for tests, procedures or anything. I got the best one frankly and I can go anywhere in the US where they take Medicare, and I can take it to other States if I move. It also gives me Silver Sneakers, one vision exam, one hearing test year - Medicare covers one Health exam of eyes, just not the eye glass exam.
3) I also bought a cheap Part D plan for prescription drugs. Those plans depend on the State you live in. They are easy to change. Each year I go on the Medicare site where I have my drugs listed and it shows me the cost of each plan, I am eligible for. Good to check each year because plans change, so do your drugs so you may want to change plans. It is a great tool to use. Medicare really does a good job. And Medicare is far more cost effective than insurance companies for healthcare!
BUT
MEDICARE ADVANTAGE Part C - evil
1) The insurance companies take over. You will have copays, need to be referred to specialists, need approval for certain tests and treatments etc.
2) You must go to their network doctors who have agreed to take less that Medicare price
Many places are dropping Advantage plans. You risk not having right specialist.
Remember people:
You might look for a good deal on a used car, but you don't want to save money on the wheels. The same with Medicare. One gets sicker with age not healthier, and you will want the best doctors and not stress about waiting for approval for a cancer treatment. Get the best you can!

Yes I watch developments - I have degree in economics and work experience in corporate America so I understand their business models.
Medicare is cost effective andpays out 90cents/on dollar in services. Insurance companies do not. they have all their administrative, sales and marketing expenses and bonuses. Healthcare is poorly served with profit driven model. They increase profits by limiting services to you.
Everyone needs affordable quality healthcare. We must look at solutions. Seniors would never get healthcare without Medicare.
The whole debt ceiling discussion is irresponsible. No other country does it. the budget should be addressed in Congress not as a threat and now Moody's has again lowered the credit rating of the US because of it.
Wehave a growing national debt because they keep cutting taxes. That is not good business planning. First you decide what the country needs, then you tax to pay for it. Look at history tax rates, they were once much higher. Paying taxes is an investment in your future. Education produces the jobs of tomorrow not tax breaks. You enable the government to hire experienced people to solve problems - like more IRS people to go after big entities who do not pay taxes - google number of US multinational companies who paid zero tax - because they have fancy accountants who know how to use the finance laws to avoid paying taxes. And remember, it is the little people who go to fight for this country and put their lives and limbs in danger. The elite wealthy do not have to go to war but have more to lose. It makes sense to me that we have a progressive tax rate and rich pay more.