Mayo Insurance Question

Posted by danab @danab, Thu, Feb 14 12:45pm

Good Morning, I have a general question on insurance plans and Mayo Clinic. I have currently Federal BCBS and they did pay for my transplant and follow up care for a year. I am also a retired National Guard member with 26 years and I turn 60 soon. I will then be eligible for Tricare prime or select. My question is does anyone out there have Tricare and how well does it pay for Mayo Doctors. With BCBS after a year Mayo becomes out of network so im looking for options. Thanks Dana

We used Tricare Prime a couple of years ago at Mayo. My husband had surgery for prostate cancer. Tricare requires a referral from your PCP. It is always good to go to your Tricare account and double check that your pre-authorization has been approved before visiting. Here is a link to Mayo's Tricare info: https://www.mayoclinic.org/patient-visitor-guide/billing-insurance/insurance/accepted-insurance/champus-tricare. Here is the link to all Mayo's insurance information so you can check to see if your present insurance is accepted. You would need to check the Mayo Campus that you plan to visit to see if they contract with your insurance. https://www.mayoclinic.org/patient-visitor-guide/billing-insurance/insurance/accepted-insurance

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@that_girl

We used Tricare Prime a couple of years ago at Mayo. My husband had surgery for prostate cancer. Tricare requires a referral from your PCP. It is always good to go to your Tricare account and double check that your pre-authorization has been approved before visiting. Here is a link to Mayo's Tricare info: https://www.mayoclinic.org/patient-visitor-guide/billing-insurance/insurance/accepted-insurance/champus-tricare. Here is the link to all Mayo's insurance information so you can check to see if your present insurance is accepted. You would need to check the Mayo Campus that you plan to visit to see if they contract with your insurance. https://www.mayoclinic.org/patient-visitor-guide/billing-insurance/insurance/accepted-insurance

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@that_girl Thank you i will Check out the links, i do know my current insurance only covered the transplant plus 1 year. So going forward now that im post 1 year is my concern how did the tricare workout after 1 year. Thanks

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@danab

@that_girl Thank you i will Check out the links, i do know my current insurance only covered the transplant plus 1 year. So going forward now that im post 1 year is my concern how did the tricare workout after 1 year. Thanks

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Tricare approves a set number of visits per referral. If you need more visits and aren't switching to a new physician/group, then the physician's office will usually contact Tricare to cover more visits . If you are switching doctors/groups even if it is for the same medical issue, then you get your PCP to make a new referral. Just remember that every referral must go through your Primary Physician even if a specialist is the one sending you to a different specialist (For example, my husband's urologist was sending him and the medical results to Mayo, but the actual referral still had to be requested by our PCP.).The trick is to be sure that each time you switch doctors/location, you get your PCP to make the referral first. Always follow-up to be sure it is authorized before your first visit. (They do this quickly and you can check the authorization online.) I have also found when I have called Tricare's insurance number with questions or problems they are ALWAYS nice and work to quickly resolve any issues. For example we were referred to a particular physician for radiation. Even though the entire group accepted Tricare Prime, this physician was new and had not yet made it onto Tricare's approved physician list. It was initially denied because he wasn't recognized, but after talking to them on the phone and explaining the situation. it was subsequently approved. I hope this helps. I do know that our insurance is much better than most. Also, thank you for your service!

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@that_girl Thanks you have been a great help. Luckily my PCP is a PCM with Tricare and i already ask if he had a problem referring me and he did not see a problem. My only concern is there are 2 options in Arizona for transplant related services but i want to use Mayo. Well we will see im eligible in April so i figure I'll keep my current BCBS and give tricare a few months before stopping BCBS.

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