Medicare and Mayo Clinic: What does Medicare cover?

Hello @clutch Mayo Clinic does accept Medicare at all three of its campuses — Florida, Arizona, and Minnesota.

Are you considering an appointment there? From personal experience I can say they provide exceptional care!

Mayo policy for Medicare patients varied by location in past. Based on Mayo insurance web page, that appears to have changed.

Even though Mayo except Medicare, there are certain specialty sections that might be closed to new patients. And if you have supplemental Medicare insurance, you need to check with you insurance company to see if Mayo is in network.
And like all places that accept Medicare, there are some restrictions on certain tests and preventive care.

I am on Medicare and have a Blue Cross plan that has Rochester Mayo as an in network provider. I have ran into problems with some visits based on how coded, example if coded as routine visit, Medicare would not cover and if Medicare denied, by Blue Cross insurance also denied.

Also, not all tests a provider orders may be covered, but that is not unique to Mayo. If a dr orders a blood test not covered, they will ask you to sign a form before receiving test stating you are responsible for any tests not covered by insurance.

I suggest you check out Mayo Insurance web site, and if any doubt, call and verify info with Mayo and your insurance company before visiting so you have no surprises.
https://www.mayoclinic.org/patient-visitor-guide/billing-insurance/insurance
Laurie

I warn everyone on medicare..... DON'T TAKE THEIR DECISION AS FINAL, CALL AND ASK WHY IT WAS TURNED DOWN AND EXPLAIN YOUR SIDE. Personal Case in point..... I was scheduled for an early morning urine test, had to sign that Medicare MIGHT NOT COVER this test. However that same day I was scheduled for a cystoscopy, which I couldn't have if I had an infection... which is what the urine test was for. I objected to the denial, sent them a copy of that days agenda for me, and they paid it.

I agree with Bill on investigating anything rejected. When I have something denied by Medicare, I investigate reason.
It could be mistake on Medicare end or how the visit was coded. I have worked with Mayo's insurance / billing dept to have problems corrected and resubmitted to Medicare. It takes time to track all bills and EOB and have issues resolved, but if saves me money it is worth it. You can send messages via Mayo online portal to billing dept. It may take days to hear back, but I would rather do that then call and be on hold. Also if use portal, then have record of correspondence.

Laurie

@roch Yes, it definitely pays to know what is covered. I currently am going through a lot of different tests. Bless the phlebotomist's heart at the Quest Labs I go to. She saw a flag on a lab order in the computer, and right there, called the dr office to get the correct code. She is on top of her game!
Ginger

Scott,
Thanks for the reply. And yes I am going to attempt a physician referral to Mayo this time as I have been turned down twice when I self-referred. Do you happen to know if there is a standard referral form for physicians?
Thank you again.

Hi Clutch, here is the link to the physician referral information at Mayo Clinic https://www.mayoclinic.org/medical-professionals/provider-relations/refer-patient

Also, when signing up for plans, work with a social worker at the Mayo. Lining you want to to. They know all the ins and outs of the plans that will work with Medicare i that state for the Mayo Clinic

Hello everyone, I'm going to apply to go to Mayo for Complex Conditions. I recently found out I have another medical issue, that I'm certain is a inherited condition, But; my Dr's are not sending my on to genetic counseling. When I get to Mayo, has anyone had genetic testing done there, while being on a medi are advantgage plan, was it a issue for pmt? I appreciate any replys back. Thank you!

Laurie, I'm wondering about genetic testing, did you happen to have any done at your visits?