Does the Mayo Clinic accept Medicare? Maybe, maybe not... or only for some?

[KarenK]

The Mayo Clinic was my first choice since they have all my records from a prior brain surgery and resulting complications.
I tried to make an appointment. They said they take my insurance, a United Healthcare Medicare Advantage plan, but then said their file said there were restrictions. They would not say anything more, nor would they make the appointment.

I came across a Mayo Clinic internal newsletter entitled, "Mayo Clinic, United Healthcare agree to a multi-year.....Medicare Advantage relationship."
"Mayo Clinic and UnitedHealthcare have established a new relationship that will give members enrolled in UnitedHealthcare Medicare Advantage plans in-network access to Mayo Clinic Rochester and Mayo Clinic Health System sites in the Midwest for the first time, effective Jan. 1, 2023."

Link: Mayo Clinic Newsletter Called again today and cannot get a response from Mayo or UnitedHealthcare.

 

[MdaPA]

KarenK,
You asked "Does the Mayo Clinic accept Medicare?"

"Yes, Mayo Clinic is a participating Medicare facility in Arizona, in Florida, in Rochester, Minn. and at all Mayo Clinic Health System locations."

Insurance frequently asked questions - Mayo Clinic

However, generally, if you have a Medicare Advantage Plan, like you appear to have with United Healthcare, then you may not have in-network coverage depending on where you live and what facility you want to go to. The letter you posted seems to indicate there was a recent agreement with Mayo Clinic and United Healthcare that may allow in-network coverage. Perhaps the person(s) you spoke with are not familiar with this new agreement?

Did you try the contacting Mayo Clinic listed on their website below? Or better option may be to visit in person.

Contact us - Mayo Clinic

 

[carolinemc]

The Mayo Clinic was my first choice since they have all my records from a prior brain surgery and resulting complications.
I tried to make an appointment. They said they take my insurance, a United Healthcare Medicare Advantage plan, but then said their file said there were restrictions. They would not say anything more, nor would they make the appointment.

I came across a Mayo Clinic internal newsletter entitled, "Mayo Clinic, United Healthcare agree to a multi-year.....Medicare Advantage relationship."
"Mayo Clinic and UnitedHealthcare have established a new relationship that will give members enrolled in UnitedHealthcare Medicare Advantage plans in-network access to Mayo Clinic Rochester and Mayo Clinic Health System sites in the Midwest for the first time, effective Jan. 1, 2023."

Link: Mayo Clinic Newsletter Called again today and cannot get a response from Mayo or UnitedHealthcare.

There are problems with Medicare advantage plans, so that is what is going on. Sad that it is hurting you. Keep fighting. For they should let you know what the restrictions are.

 

[KarenK]

KarenK,
You asked "Does the Mayo Clinic accept Medicare?"

"Yes, Mayo Clinic is a participating Medicare facility in Arizona, in Florida, in Rochester, Minn. and at all Mayo Clinic Health System locations."

Insurance frequently asked questions - Mayo Clinic

However, generally, if you have a Medicare Advantage Plan, like you appear to have with United Healthcare, then you may not have in-network coverage depending on where you live and what facility you want to go to. The letter you posted seems to indicate there was a recent agreement with Mayo Clinic and United Healthcare that may allow in-network coverage. Perhaps the person(s) you spoke with are not familiar with this new agreement?

Did you try the contacting Mayo Clinic listed on their website below? Or better option may be to visit in person.

Contact us - Mayo Clinic

Thanks I appreciate you taking the time to respond with some ideas for me.

My account with United Healthcare DOES show the Mayo Clinic in Minnesota to be in-network. Also I have a PPO which states I can go to any provider nationwide that accepts medicare. I'd never even consider an HMO.

The link you provided is the billing department for current accounts with Mayo Clinic. I don't know if that was the number I called but I did try a number under the heading of Insurance and billing. All Mayo Clinic ever says is to contact your insurance company and nothing more.

I've also tried contacting United Healthcare once again as I saw where it said Mayo needed pre-certification. United's customer service is off shore, heavy accents, and very muffled. Any communication requires having to ask them to repeat things 2 or 3 times and/or having them spell it out, that is if they don't put me on hold, never to return. No doubt this is deliberate, United just wants you to give up and go away. I've even googled United looking for different departments to call to perhaps get them to transfer me to a department that could help. Didn't work.

Visit in person? That seems like a long way to travel to only be turned away.
These companies don't have to honor their contracts. They can get away with it as what can one do?

Arkansas is rated #49 out of the 50 states in medical care. So next I'll try Cleveland Clinic, then Cedar Sinai in L.A.

 

[Haoming Li]

Thanks I appreciate you taking the time to respond with some ideas for me.

My account with United Healthcare DOES show the Mayo Clinic in Minnesota to be in-network. Also I have a PPO which states I can go to any provider nationwide that accepts medicare. I'd never even consider an HMO.

The link you provided is the billing department for current accounts with Mayo Clinic. I don't know if that was the number I called but I did try a number under the heading of Insurance and billing. All Mayo Clinic ever says is to contact your insurance company and nothing more.

I've also tried contacting United Healthcare once again as I saw where it said Mayo needed pre-certification. United's customer service is off shore, heavy accents, and very muffled. Any communication requires having to ask them to repeat things 2 or 3 times and/or having them spell it out, that is if they don't put me on hold, never to return. No doubt this is deliberate, United just wants you to give up and go away. I've even googled United looking for different departments to call to perhaps get them to transfer me to a department that could help. Didn't work.

Visit in person? That seems like a long way to travel to only be turned away.
These companies don't have to honor their contracts. They can get away with it as what can one do?

Arkansas is rated #49 out of the 50 states in medical care. So next I'll try Cleveland Clinic, then Cedar Sinai in L.A.

I would suggest you to have your surgeon/team to contact your insurance to get pre-approval of all procedures you are going to do, they know how to deal with your insurance.
Wish you the best of luck
HaoMing Li

 

[KarenK]

I do not have a surgeon/team at the Mayo. That's not how it works. The doctors are all employees of the Mayo Clinic. I can't see any of the doctors unless the Mayo Clinic accepts me. It's not like a standard hospitals where any doctor can become associated with the hospital. The Mayo Clinic has quality controls on everything. That's why people from around the world seek treatment there. One nice thing is after a stay at The Mayo Clinic is you get only one neat bill for absolutely everything which simplifies it greatly. Then you are only left with fighting with the insurance company to pay it. I've never had an insurance company not try to do me dirty.

 

[pellicle]

Morning

I've never had an insurance company not try to do me dirty.

sad isn't it...

 

[KarenK]

Morning


sad isn't it...

It certainly is. I like to tell people how I instantly nipped the problem in the bud the last time it happened. I don't want to see insurance companies do people dirty like they tried to do with me.

I had major surgery, the bill was $100,000+. I had already paid the max. out of pocket for the year so Blue Cross Blue Shield was supposed to pay 100% of this bill. They sent a letter saying they were paying 50% and the remaining was my responsibility. I reviewed the policy, set up a tape recorder, then called a person in upper management. She came up a few excuses why they weren't paying which I was able to counter by quoting from the policy. She ran out of excuses and getting frustrated started making just ridiculous statements.

I had great pleasure in telling her I was recording the call. That stopped her in her tracks and she abruptly hung up. The very next day I received an email that say they were paying 100%! I think it would have worked even if she didn't go off the wall.

This was legal and could be used in court. Many people think this would be illegal in the States. It's legal in all states except a couple on the west coast.
That call saved me $50,000+. I don't know what I would have done if this didn't work.

I would love to hear how others have dealt with their insurance companies in such situations.

 

[pellicle]

It certainly is. I like to tell people how I instantly nipped the problem in the bud the last time it happened. I don't want to see insurance companies do people dirty like they tried to do with me.

I had major surgery, the bill was $100,000+. I had already paid the max. out of pocket for the year so Blue Cross Blue Shield was supposed to pay 100% of this bill. They sent a letter saying they were paying 50% and the remaining was my responsibility. I reviewed the policy, set up a tape recorder, then called a person in upper management. She came up a few excuses why they weren't paying which I was able to counter by quoting from the policy. She ran out of excuses and getting frustrated started making just ridiculous statements.

I had great pleasure in telling her I was recording the call. That stopped her in her tracks and she abruptly hung up. The very next day I received an email that say they were paying 100%! I think it would have worked even if she didn't go off the wall.

This was legal and could be used in court. Many people think this would be illegal in the States. It's legal in all states except a couple on the west coast.
That call saved me $50,000+. I don't know what I would have done if this didn't work.

I would love to hear how others have dealt with their insurance companies in such situations.

I'm vexed about the lack of proper reactions available, what I want to say is closer to

and it sounds like
(funny I can't type "that sounds like shlt", but I can use the emoji i

 

[MdaPA]

My account with United Healthcare DOES show the Mayo Clinic in Minnesota to be in-network. Also I have a PPO which states I can go to any provider nationwide that accepts medicare. I'd never even consider an HMO.

Good! So you should be covered then.

All Mayo Clinic ever says is to contact your insurance company and nothing more.

I've also tried contacting United Healthcare once again as I saw where it said Mayo needed pre-certification.

Why are you contacting the Mayo Clinic? e.g. you were told you need surgery, some test/procedure, or seeking a 2nd opinion?

Based on that, usually, you would call the office at the hospital associated with the doctor/specialty you want to see or the procedure/testing you need. If you need a test, procedure or surgery, they then work with you insurance company to get the approvals and pre-certifications they need. You as the patient, should not be involved in this process unless it gets denied (in that case you would get a letter from your insurance company which you can then appeal).

So where are you at in this process?

 

[KarenK]

Good! So you should be covered then.


Why are you contacting the Mayo Clinic? e.g. you were told you need surgery, some test/procedure, or seeking a 2nd opinion?

Based on that, usually, you would call the office at the hospital associated with the doctor/specialty you want to see or the procedure/testing you need. If you need a test, procedure or surgery, they then work with you insurance company to get the approvals and pre-certifications they need. You as the patient, should not be involved in this process unless it gets denied (in that case you would get a letter from your insurance company which you can then appeal).

So where are you at in this process?

I contacted the Mayo as I wanted their opinion and I wanted them to do the surgery.

I did call the office at the hospital associated with the doctors/specialty that I want to see. Mayo Clinic's denial is based upon an unknown status with my insurance company. Of course, they want to know that they're going to receive payment for their services. The problem here seems to be my insurance company. When I log into my insurance account it shows that the Mayo Clinic is "supposed" to be in network. However, insurance companies play dirty all the time. So next I'll try the Cleveland Clinic.

It sounds like you are talking from the position of having a regular doctor that you go and are taking this process for granted. It works like that with my regular doctor too however I had to provide insurance info upfront and they take a copy of my insurance card at the start of every year.

I feel like I'm nowhere in the process. If you saw my post about my current local cardiologist... bad news. I need to find a new local cardiologist and I don't what another bad one and don't know how to insure I don't get another bad one.

I have a heart cath. scheduled in a week scheduled with the old cardiologist and debating if I should keep it. I don't trust him, so how can I trust the results.

 

[MdaPA]

Mayo Clinic's denial is based upon an unknown status with my insurance company. Of course, they want to know that they're going to receive payment for their services. The problem here seems to be my insurance company. When I log into my insurance account it shows that the Mayo Clinic is "supposed" to be in network.

What does "unknown status" mean? Is your insurance active/paid-to-date?

If you have a PPO, then Mayo Clinic should still see you have active insurance, just with out-of-network coverage rather than in-network. I can see where they might have a concern with doing your surgery with out-of-network coverage (i.e. that you might have trouble paying the higher costs) but you haven't seen anyone there to even determine that yet, correct?

I have a heart cath. scheduled in a week scheduled with the old cardiologist and debating if I should keep it. I don't trust him, so how can I trust the results.

I would also be reluctant to have a cath with a cardio I didn't trust. I would perhaps leave the cath to the surgeon.

So next I'll try the Cleveland Clinic.

CC is a good option but might you have the same insurance issue though?

 

[catwoman]

Karenk,
Is your United HealthCare MA plan through AARP or a broker? Not all United HealthCare plans are identical.
My United HealthCare MA plan covers all providers, in-network or out-of-network. My PCP is out-of-network and that group gets paid. My plan is through the Employees Retirement System of Texas; customer service reps are in the U.S. and probably only deal with TRS retirees and their dependents. My late husband retired from Texas' higher education system.

Because you are having issues talking to a UHC rep, is there an email addy where you reach someone for a definitive answer?

 

[KarenK]

What does "unknown status" mean? Is your insurance active/paid-to-date?

If you have a PPO, then Mayo Clinic should still see you have active insurance, just with out-of-network coverage rather than in-network. I can see where they might have a concern with doing your surgery with out-of-network coverage (i.e. that you might have trouble paying the higher costs) but you haven't seen anyone there to even determine that yet, correct?



I would also be reluctant to have a cath with a cardio I didn't trust. I would perhaps leave the cath to the surgeon.


CC is a good option but might you have the same insurance issue though?

I am afraid I will have the same insurance issue. Since I cannot not get any info from the insurance company I may have to just keep going down a list of hospitals until I find one. Another option, Medicare said I could change plans but it may just be more of the same.

 

[KarenK]

Karenk,
Is your United HealthCare MA plan through AARP or a broker? Not all United HealthCare plans are identical.
My United HealthCare MA plan covers all providers, in-network or out-of-network. My PCP is out-of-network and that group gets paid. My plan is through the Employees Retirement System of Texas; customer service reps are in the U.S. and probably only deal with TRS retirees and their dependents. My late husband retired from Texas' higher education system.

Because you are having issues talking to a UHC rep, is there an email addy where you reach someone for a definitive answer?

There's no email address either.