Medicare Advantage

@wandering24, that is a good question. I recommend contacting Mayo Clinic Patient Account Services for answers specific to you. Here's the contact info for all Mayo locations:
https://www.mayoclinic.org/patient-visitor-guide/billing-insurance/contact-us
Here's more info regarding insurance at Mayo Clinic, including a section on self-pay https://www.mayoclinic.org/billing-insurance

Are you an existing Mayo Clinic patient?

May I ask which Mayo Clinic you're using? I have a United Health Care Medicare Advantage Plan and have an appointment on July 18th at Rochester Mayo. I believe Rochester is the only site that accepts certain plans. It took a little bit of doing to find the right plan that they would accept. I worked with their billing/finance counseling people. You might try calling them directly. That number is (833)479-5483. I believe it's a centralized number that handles all three Mayo locations.

Hope you're able to figure something out.

I have been using a Advantage plan at Rochester for the last 4 years. Can't believe that all 3 aren't the same in that regard.

That's exactly what I thought, Patrick. I live in FL in the winter and would have gone to Jacksonville, but they don't accept Advantage plans. The Mayo financial people told me that AZ doesn't either, only Rochester. I had to change from one United Health Care Advantage plan to another to get into Rochester. Don't know their thinking, but that was my experience this March (2024).

One of the issues with advantage plans that likely will start affecting their acceptance anywhere is the issuing insurance company requiring approval for all treatment. Supplemental plans pay for Medicare approved treatment that your doctor says you require. There is no “middle man”.
Advantage plans are not regular Medicare and insert their own requirements for approval of any treatment your doctor says you need. This adds time and paperwork and causes more steps in getting treatment.
I am not surprised that Mayo is rejecting many of those plans as they are known for their comprehensive and quick treatment of patients even if they have to see several people for treatment.

I think of Medicare Advantage like the health care plan I had through my employer. I had Blue Cross/Blue Shield before I retired. It was a group plan paid for by my employer and I had a monthly charge also. My union negotiated my/our payment responsibilities with the employer such as co-pays and deductibles.

With Medicare Advantage, substitute Medicare for your employer. Medicare "pays" for your plan through contracts with private health care insurance companies. This time, though, you pick the plan the you want with how much you want to spend for your co-pay and deductible.

Personally, I have Traditional Medicare. I pay more out-of-pocket however I can go anywhere that accepts Traditional Medicare. All non-profits are required to accept Traditional Medicare (Mayo Clinic is a nonprofit). Each state in the U.S. has their own laws regarding Medicare Advantage. Just like your employer-paid insurance plans you have to check to see if the doctor or clinic accepts your Medicare Advantage Plan since the private insurance companies have any number of restrictions of when and where you can use their plan.

I have a company plan and pay additional above the Medicare cost for added benefits. I felt we had a great plan, very few problems, and quickly resolved. This year they switched us from our standard plan to the Medicare Advantage. I don't want to switch out since I can't switch back. I am hoping the company recognizes the problem and switches away from the Advantage plan and back to the regular Medicare. Probably wishful thinking.

I don't understand why Mayo accepts the Advantage plan at 1 of their 3 campuses. That is wrong.

@wandering24 As I explained above, Mayo is "hamstringed" of sorts by state regulations in Arizona and Florida. If you want more information you might like to call Mayo Clinic:

Mayo Clinic Insurance and Billing: Contact Us:

-- https://www.mayoclinic.org/patient-visitor-guide/billing-insurance/contact-us

I have no other practice or hospital dropping Medicare Advantage. Is it isolated to Mayo. I don't think it is an AZ/FL regulation problem.

My PCP is confused as to why Mayo did this.

@wandering24 When you follow up at Mayo Clinic about Medicare Advantage in Florida and Arizona, would you please let me know?