Connect
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
Like
Helpful
HugInterested in more discussions like this? Go to the Visiting Mayo Clinic Support Group.
Connect
@gaildw67
I have different insurance companies for my Medicare Supplemental G plan (Blue Cross) and drug part D (Wellcare). I also use GoodRx coupons for my prescriptions that are not Tier 1 because it is cheaper.
Laurie
-
Like -
Helpful -
Hug
5 Reactions@gaildw67. I have Part G with Transamerica and my RX Part D plan is with Wellcare. It takes some time but checking around for your prescription plan will help you save money. I also check prices on Good RX (no membership fee, you can just sign up online) because I've learned that some prescriptions cost less on Good RX than with my prescription plan.
-
Like -
Helpful -
Hug
4 ReactionsPerfect! Huge difference in FL Blue and the others for Part D RX. We picked FL Blue our first year (2022) but we will NOT use them next year since you've validated we can shop that coverage. Thank you!
@mpeters. I have never received this letter probably because I have Traditional Medicare and not Medicare Advantage. I'm assuming this means in your case, @mpeters that Mayo does not accept your Medicare Advantage plan? With Traditional Medicare Mayo accepts what Medicare pays and I do not have to pay the difference.
I am glad your health has improved. Stay safe and healthy. Well wishes.
-
Like -
Helpful -
Hug
1 ReactionI have traditional Medicare and a good supplement plan. We have been going to Mayo for over thirty years. I do have to pay what my two plans don’t cover.
-
Like -
Helpful -
Hug
1 ReactionHere is the information from Medicare about what it means to "accept Medicare Assignment" vs. "do not accept Medicare Assignment".
Does your provider accept Medicare as full payment?
- https://www.medicare.gov/basics/costs/medicare-costs/provider-accept-Medicare
If your medical provider does NOT accept Medicare assignment you may be asked to pay the full amount of the bill and then you submit your claim yourself to Medicare. Medicare will then reimburse you but only for the amount that Medicare would have paid the provider.
Confused? Of course so are well all!! In order to get the accurate information I will ask someone in the Billing Office these questions.
-
Like -
Helpful -
Hug
4 ReactionsI See your delima, back before Medicare I was in that situation with BCBS and I ended up working with the social workers to discover a better plan to move to during open season. they were very helpful choosing a plan I was eligible for and now I have very little out of pocket something maybe to try?
-
Like -
Helpful -
Hug
2 ReactionsI 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?
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