Insurance covering treatment at Mayo

Are you signed up through the Patient Portal? I regularly get "Estimates" posted to my portal for appointments, procedures, tests, and scans. That might help you.

@butterflykizzs,
Welcome to Mayo Connect.

@sandy8043 is correct that you can always request an estimate for procedures and tests. I belevie it can only be done after the provider orders because they need specifics of excatly what is ordered. Sometimes it is combination of diagonsis on file and type of test to determine if medically necessay. During the estimating proces, it takes into effect the insurance that is on file, so make sure you update your profile with insurance information.

It is important to know your insurance pre-certification and prior authorizations. If contact your insurance company, they can advice and it is often in the insurance plan docuements.
https://www.mayoclinic.org/billing-insurance/insurance/insurance-approvals

@butterflykizzs Which Mayo Clinic campus will you be going to? Florida, Arizona, or Minnesota?

1) Call the phone number on the back of your insurance card. Ask if Mayo Clinic is covered by your insurance plan. That’s a first step in the process.

2. Call Mayo Clinic and ask if your insurance is accepted. You won’t know any of the costs other than your initial appointment so you can start there.

Mayo Clinic Insurance Types Accepted:

— https://www.mayoclinic.org/billing-insurance/insurance/accepted-insurance

If labs, tests, or other appointments are ordered while you are at Mayo Clinic you can again call the phone number on the back of your insurance card and ask if the procedures are covered. You can also check with Billing at Mayo Clinic while you are there. Mayo Clinic in Rochester has a large billing desk on the first floor of the Gonda Building. When I have gone to the billing desk to ask questions I’ve received very good information and advice.

I have been going to mayo for several years. I use their portal and I get estimates ahead of time for appointments. I would call their billing department with your insurance information for estimates on your scheduled appointments and procedures.

Per others, definitely call your insurance company to check on coverage, if Mayo Clinic is in network for you, and if you need any preauthorization for any thing.
I am on original Medicare with a good Medigap plan, so I never see a bill at Mayo, but I did have one interesting experience in the beginning. I had a local angiogram which found cardiac blockage. I asked Mayo for a consult on whether I should put in stent or stay on medication since I could need surgery in the near future. Mayo Cardiologist wanted to run a non-invasive test for blood flow which local angiogram had not performed. If it was OK he would keep me on medication instead of stent and make me exercise like heck. The Mayo PA put into system which alerted that Medicare would not cover it. They were very surprised. The cost without insurance was $11,000. So I had to repeat the more invasive angiogram at Mayo and they decided to put in a stent and that was covered. I researched and I think the reason Medicare refused coverage was because the exam Mayo ordered was LESS diagnostic than the recent Angiogram, and could still require an angiogram after...

Thanks everyone. I will be going to Minn. campus. I did get the estimate for my initial gastro visit but I was unsure how it worked once they ordered test ect.
I know from having went to Mayo in Jacksonville once, that they suddenly just send you for tons of stuff.
My insurance now is a mess. I have great insurance but they never can tell me what will and will not be covered because it all depends on how the billing was coded. I have no control over the coding. So it is usually a guess.
Great to know billing desk there can go over things with me.
So can I get the estimate for a test that is ordered to be done next day or immediately?
At Jacksonville, I even had some issues with labs being considered "experimental". That I have zero way to know about or have any control over. Jacksonville always managed to recode or fix any uncovered things. Not sure how Mayo works in Minn.

Not yet as they only have me for initial appointment with gastro and then will assign what needs done while there. So it will all be very last moment.

@butterflykizzs I’m not sure how this works in Minnesota either. If there is a test ordered that is on your portal it’s very possible that the test has then been coded for payment. The portal should give you an estimate however it’s possible you could call or go to billing and ask at Mayo. You could also check with your own insurance as I mentioned earlier.

As I look at what we are communicating about I think to myself what a huge hassle this is. No one wants to surprised by what is paid for by insurance and what is not. I’ve had that surprise in the past when I had health care insurance through my employer. It was irksome and had to do with different billing practices at different locations (not Mayo - I’m referring to local billing when a for profit business took over our local hospital and medical system).