does the mayo clinic accept medicare assignment

Does your provider accept Medicare as full payment?

You can get the lowest cost if your doctor or other health care provider accepts the Medicare-approved amount  as full payment for a covered service. This is called “accepting assignment.” If a provider accepts assignment, it’s for all Medicare-covered Part A and Part B services.

Using a provider that accepts assignment

Most doctors, providers, and suppliers accept assignment, but always check to make sure that yours do.

If your doctor, provider, or supplier accepts assignment:

• Your out-of-pocket costs may be less.
• They agree to charge you only the Medicare deductible and coinsurance amount, and usually wait for Medicare to pay its share before asking you to pay your share.
• They have to submit your claim directly to Medicare and can't charge you for submitting the claim.

How does assignment impact my drug coverage?

Using a provider that doesn't accept Medicare as full payment

Some providers who don’t accept assignment still choose to accept the Medicare-approved amount for services on a case-by-case basis. These providers are called "non-participating."

If your doctor, provider, or supplier doesn't accept assignment:

• You might have to pay the full amount at the time of service.
• They should submit a claim to Medicare for any Medicare-covered services they give you, and they can’t charge you for submitting a claim. If they refuse to submit a Medicare claim, you can submit your own claim to Medicare. Get the Medicare claim form .
• They can charge up to 15% over the Medicare-approved amount for a service, but no more than that. This is called "the limiting charge."  

Does the limiting charge apply to all Medicare-covered services?

Using a provider that "opts-out" of Medicare

• Doctors and other providers who don’t want to work with the Medicare program may "opt out" of Medicare.
• Medicare won’t pay for items or services you get from provider that opts out, except in emergencies.
• Providers opt out for a minimum of 2 years. Every 2 years, the provider can choose to keep their opt-out status, accept Medicare-approved amounts on a case-by-case basis ("non-participating"), or accept assignment.

Find providers that opted out of Medicare.

Private contracts with doctors or providers who opt out

• If you choose to get services from an opt-out doctor or provider you may need to pay upfront, or set up a payment plan with the provider through a private contract.
• Medicare won’t pay for any service you get from this doctor, even if it’s a Medicare-covered service.

What are the rules for private contracts?

You may want to contact your  State Health Insurance Assistance Program (SHIP) for help before signing a private contract with any doctor or other health care provider.

What do you want to do next?

• Next step: Get help with costs
• Take action: Find a provider
• Get details: How to get Medicare services

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Does Mayo Clinic accept Medicare?

Does mayo clinic accept medicare? Discover Medicare coverage, billing, and navigating acceptance at Mayo Clinic for peace of mind in receiving necessary care.

Hospital services

Your Mayo Clinic medical claims will be filed if you are in hospital, and you will receive a Medicare Summary Notice while processing your claim.

Health clinic services

Regardless of whether or not they participate with Medicare Part B, all Mayo Clinic locations will be billed by Medicare for all services rendered. Claims will be made to Medicare Part B and supplementary or secondary insurance companies on your behalf. In some instances, you may get Part B and supplemental or secondary insurance payments directly. However, this means that patients are responsible for reimbursing Mayo Clinic for any expenses they receive and unpaid balances.

Medicare assignment

In accordance with federal regulations, it is necessary for the medical centre to support Medicare assignments for certain services (for example, clinical laboratory, drugs, and biologicals).

Medicare supplemental insurance crossover

If your claims did not transfer over from Medicare to your additional or Medigap insurance, please contact the agency that administers your supplemental or Medigap insurance.

Medicare patients must complete an Advanced Beneficiary Notice (ABN) which discusses payment restrictions and estimates medical costs before receiving specific services. Signing the ABN conveys financial liability if Medicare denies payment. Eye exams, foot care, hearing aids, preventive care, and elective treatments are free from the ABN requirement however, individuals are responsible for all non-covered services.

You can call 800-633-4227 for non-covered service and item questions (toll-free).

Medicare plans

Privately contracted Medicare Advantage plans cover all of your Medicare Part A and Part B benefits. Generally, Medicare Advantage plans provide prescription drug coverage, too and Medicare Advantage plans fall into five broad categories;

• Cost-based,
• Medicare Medical Savings Account.

Out-of-network plans mean higher out-of-pocket expenditures. Typically, Medicare Advantage plans to process the same as Medicare and Mayo Clinic campuses have restricted specific Medicare Advantage options.

• Mayo Clinic’s Arizona campus: All Medicare Advantage Plans except PPO/Cost share/HCPP contracts may not be seen, and self-pay patients are not eligible.
• The Mayo Clinic in Florida : Medicare Advantage HMO patients without authorization will not be seen and they do not allow self-pay patients.
• Rochester, Minnesota’s Mayo Clinic campus : Medicare Advantage HMO plans without authorization may not be seen by patients and they cannot examine patients on a self-pay basis.

You must obtain authorization from your health insurer before scheduling visits at the Mayo Clinic.

The Mayo Clinic’s campuses in Arizona and Florida have refused to work with non-contracted Medicare Advantage plans due to administrative and financial difficulties. Please see your Medicare Advantage plan for a list of in-network doctors.

Decisions by Medicare on reimbursement

To dispute a Medicare denial, please call Mayo Clinic’s Patient Account Services.

• 800-660-4582 (toll-free)
• Arizona: 480-301-7033
• Florida: 904-953-7058
• Rochester, Minnesota: 507-266-5670

You can appeal a disallowed charge if the notice under “Appeals Information” on the last page of your Medicare Summary Notice tells you how to do so. Within six months of receiving notice of refusal, an appeal must be made with the appropriate administrative law judge. Generally, the Mayo Clinic is unable to advocate on your behalf on Medicare non-assigned services.

You will continue to receive monthly statements until your account is paid in full, and patients must apply for public medical assistance (Medicaid).

Bundled Payments for Care Improvement program

Mayo Clinic is helping implement the Bundled Payments for Care Improvement Advanced Model, although the program is only now in effect, and all affected patients were contacted for feedback, you wouldn’t be eligible to receive care in a participating region if you did not receive a letter.

Our mission is to provide high-value and high-quality care.

• Visit the CMS BPCI Advanced Website at http://www.innovation.cms.gov/initiatives/bpci-advanced .
• Mayo Clinic Patient Account Services 1-844-217-9591
• Call 1-800-MEDICARE-1 (1-800-663-4227). For TTY callers, contact 1-877-486-2048

Additional Information about Medicare

To learn more about Medicare, see our website NewMedicare.com . You can also inquire about your Arizona Medicare Part B claims for health services by calling Medicare at 800-633-4227. (Toll-free).

About Danny Carington

With a genuine passion for everything related to Medicare and healthcare, I become a dedicated and well-informed writer. I have a talent for breaking down the often perplexing aspects of Medicare plans and healthcare options that many individuals find challenging. Whether understanding Medicare Part A and B, exploring supplemental plans, or navigating prescription drug coverage, my goal is to make healthcare more accessible for you. In terms of research, I go beyond the surface. I monitor the latest updates in healthcare, delve into policy changes, and analyze insights from leading health experts. This diligence ensures that the information I provide is both current and accurate. Please note I'm AI-Danny, a writer powered by artificial intelligence. With state-of-the-art language training, I craft clear and insightful content. Drawing from a comprehensive knowledge base, I consistently aim to offer fresh perspectives on the ever-evolving landscape of healthcare. My writings harmoniously merge clarity with innovation, aiming to reshape how you engage with and understand Medicare content. But to me, writing isn't just about delivering facts. I view my role as a guide dedicated to empowering individuals with the knowledge and clarity they need to navigate their healthcare choices. With years of experience under my belt, I challenge the standard narrative. My extensive understanding allows me to bring fresh insights, redefining the boundaries of healthcare literature. Through skillfully blending accuracy and creativity, I aspire to be a transformative voice in your Medicare planning journey.

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Does Mayo Clinic accept Medicare?

If you’re struggling to understand Medicare, Connie can help. Ask Connie your question; a local, licensed agent will help you navigate your Medicare journey. Complete this form to have your question answered. It could be featured on Dear Connie.

Dear Connie,

I am turning 65 and retiring soon. I’ve been going to the Mayo Clinic and want to keep going there. Does Mayo Clinic accept Medicare? If so, which Medicare plan should I be on?

Many thanks, Barbara from Surprise, Arizona

Need Help Deciding The Right Medicare Coverage For You?

Dear Barbara,

Understandably, you would want to visit a hospital for your healthcare needs.

Funded by the Mayo Foundation, the Mayo Clinic is one of the top hospitals in the United States. They practice integrated medicine in which specialists across departments work together to assess your condition and provide the care you need based on your situation and medical history. The Mayo Clinic is also recognized for its treatment of complex medical conditions. Depending on your health needs, Mayo Clinic may be the best fit for you.

Mayo Clinic may accept Medicare patients who have Original Medicare ( Medicare Part A and Medicare Part B ) and Medicare Supplement plans (Medigap) in all their hospitals. Mayo Clinic does not require doctor referrals for patients to receive care services. However, Medicare requires you to have a doctor’s referral to receive treatment at the Mayo Clinic. You may need to fulfill preauthorization requirements before going to the Mayo Clinic. Medicare health insurance is not accepted for primary care services at the Mayo Family Clinic.

Agent tip: “The Mayo Clinic does not accept Medicare Advantage plans. They will still treat you in the event of an emergency if you are enrolled in a Medicare Advantage plan, but they do not provide routine care.“

The Mayo Clinic has contracts with private insurance companies, but they do not accept Medicare Advantage plans. They will still treat you in the event of an emergency if you are enrolled in a Medicare Advantage plan, but they do not provide routine care. Since you indicated you would like to see the Mayo Clinic, a Medicare Supplement plan in Arizona may be the best option.

Connie Health can help you find a Medicare Supplement plan that can allow you to visit the Mayo Clinic. Connie Health has a plan comparison tool that sorts your many plan options. Our technology will compare available plans tailored to your needs – quickly narrowing your choices.

If you’d like help ensuring that you pick a plan that best fits your needs, a local licensed Connie Health agent can help. Call (623) 223-8884 (TTY: 711), and an agent will find a Medicare insurance plan that fits your needs.

At the Mayo Clinic, Medicare typically pays 80% of the cost for covered services after you meet the Part B deductible ($240 for 2024). The Mayo Clinic may give you an Advance Beneficiary Notice to tell you that you may have to pay for a test if Medicare does not cover it. Medicare pays for tests they deem medically necessary to diagnose and treat illnesses and injuries. Mayo Clinic will give you an Advance Beneficiary Notice that will help you decide whether to pay for it yourself or not perform the service.

There are many more ways to take care of your health. Mayo Clinic offers a free e-newsletter with the latest information on health care. The Surprise Senior Center has arts and crafts and fitness activities for you to socialize with others. The Surprise Senior Center offers the SilverSneakers program, an online video workout program free for seniors who have the program as part of their Medicare Advantage plan.

I hope this information has been helpful. Everyone should have access to quality care and the services they need. At Connie Health, we want to guide you to make the best healthcare decisions. We want to help you live a healthier and happier life. I wish you the best. Please call us at (623) 223-8884 with additional questions.

Mayo Clinic Coordination of Benefits (COB) – Patient Guide.

Mayo Clinic and Medicare. 

Last updated: February 27, 2023

Frequently Asked Questions

No. The Mayo Clinic does not accept Medicare Advantage plans.

The Mayo Clinic may accept Medicare patients who have Original Medicare and a Medicare Supplement plan in all their hospitals. They require that you have a doctor’s referral to receive treatment. You may also need to fulfill reauthorization requirements before going to the Mayo Clinic.

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I am an Arizona Life and Health Insurance Licensed Agent and have been helping people with Medicare since 2009. I enjoy coaching youth and high school sports, watching sports, and spending time with family. I also like taking road trips and vacationing anywhere that has a beach.

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StarTribune

Unitedhealthcare, mayo clinic reach network agreement for medicare advantage patients.

Mayo Clinic and UnitedHealthcare have reached a contract agreement giving in-network clinic access to seniors with Medicare Advantage coverage from the giant health insurer.

The deal comes about six months after Mayo stopped scheduling appointments for patients with UnitedHealthcare Medicare Advantage coverage due to capacity concerns.

At the time, Minnetonka-based United hadn't negotiated financial terms with Mayo under a network arrangement, which means the insurer was one of several "noncontract" Medicare health plans that, in general, don't pay as much for medical services.

Neither party disclosed financial terms of the new multiyear agreement, which takes effect for Medicare enrollees on Jan. 1 .

"We're expanding and strengthening our longstanding relationship with Mayo Clinic, one of the most highly regarded medical institutions in the world," Craig Stillman, the chief executive of UnitedHealthcare's Medicare business in the Upper Midwest, said in a statement.

UnitedHealthcare said it's the first such contract that gives its Medicare Advantage enrollees from across the nation access to Mayo facilities in the Midwest on an in-network basis. Enrollees typically pay less out-of-pocket when they get care from in-network doctors, clinics and hospitals.

The agreement also means people with coverage through employer groups and individual health plans will continue to have access to Mayo facilities and providers, UnitedHealthcare said in a statement.

"We look forward to building on the continued strong relationship between Mayo Clinic and UnitedHealthcare," Dr. Lyell Jones, a Mayo Clinic neurologist and medical director for contracting and payer relations, said in a statement. "Agreements between Mayo Clinic and leading insurers such as UnitedHealthcare help ensure access for patients who need serious and complex care."

Clinic officials told the Star Tribune in February that between 2019 and 2021, the number of Minnesota patients coming to Mayo with coverage from noncontract Medicare Advantage insurers nearly doubled to more than 3,200 people.

Also during the two-year period, Mayo saw a 42% jump in out-of-state patients coming to Rochester from noncontract Medicare Advantage plans, for a total last year of more than 7,000 people.

The growth was threatening to crowd out patients from health plans where the clinic was an in-network provider, Mayo said at the time. The clinic said UnitedHealthcare enrollees accounted for at least half of the growth from noncontract health plans.

Mayo's policy on scheduling appointments, which it newly began to enforce last winter, means the clinic does "not accept noncontracted Medicare Advantage patients who don't have immediate medical need," a spokesman said Wednesday via e-mail.

The new agreement "allows us to include UHC Medicare Advantage members in our service to those with complex and serious needs," the spokesman said.

UnitedHealthcare has been growing enrollment in Minnesota since 2017 when it announced its goal to become a bigger health plan in its home state. The company gained a foothold in the market when a federal law eliminated Medicare "Cost" health plans in most Minnesota counties in 2019, forcing many seniors to shop for new coverage.

A Star Tribune analysis of federal data shows that UnitedHealthcare's Medicare enrollment in Minnesota grew from about 9,000 people in early 2019 to more than 56,000 people in early 2022.

UnitedHealthcare is seeing growth in other segments of Minnesota's health insurance market as well.

In November, Minnesota's health insurance program for lower-income residents announced it was adding UnitedHealthcare as an option for beneficiaries this year. The decision made United the first for-profit HMO in Minnesota's managed care program for Medical Assistance, the state's name for the state-federal Medicaid program.

Christopher Snowbeck covers health insurers, including Minnetonka-based UnitedHealth Group, and the business of running hospitals and clinics. 

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Mayo Clinic, UnitedHealthcare agree to multi-year commercial and Medicare Advantage relationship

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Mayo Clinic and UnitedHealthcare have reached an agreement on a new, multi-year network relationship. The agreement ensures members enrolled in UnitedHealthcare employer-sponsored and individual health plans have continued access to quality care at Mayo Clinic’s national network of hospitals, clinics, physicians and other providers.

Mayo Clinic and UnitedHealthcare also 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.

"We look forward to building on the continued strong relationship between Mayo Clinic and UnitedHealthcare," said Lyell Jones, M.D., a Mayo Clinic neurologist and medical director for Contracting and Payer Relations. “Agreements between Mayo Clinic and leading insurers such as UnitedHealthcare help ensure access for patients who need serious and complex care."

UnitedHealthcare is dedicated to helping people live healthier lives and making the health system work better for everyone by simplifying the health care experience, meeting consumer health and wellness needs, and sustaining trusted relationships with care providers. UnitedHealthcare offers the full spectrum of health benefit programs for individuals, employers, and Medicare and Medicaid beneficiaries, and contracts directly with more than 1.5 million physicians and care professionals, and 7,000 hospitals and other care facilities nationwide.

"We’re grateful for the opportunity to begin providing our Medicare Advantage members network access to Mayo Clinic’s facilities and physicians,” said Craig Stillman, CEO, UnitedHealthcare Medicare & Retirement of the Upper Midwest. “We’re expanding and strengthening our longstanding relationship with Mayo Clinic, one of the most highly regarded medical institutions in the world."

Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. In 2021, Mayo Clinic cared for more than 1.4 million patients from every U.S. state and 139 countries.

Media contact:

• Jay Furst, Mayo Clinic Public Affairs, [email protected]
• Mayo Clinic Q and A: How does diabetes affect the heart?  Mayo Clinic Q&A podcast: The importance of HIV testing

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Mayo Warns It Won't Take Most Medicare Advantage Plans

— letters to florida, arizona patients suggest they enroll in original medicare with a supplement.

by Cheryl Clark , Contributing Writer, MedPage Today October 20, 2022

The Mayo Clinic sent letters this fall to all eligible Medicare beneficiaries who received care at its Arizona and Florida facilities in the last 3 years, warning them that it is out-of-network "with most Medicare Advantage plans."

The letter sent to Florida beneficiaries said that "marketing for Medicare Advantage Plans may indicate that you can be seen at any facility that accepts Medicare, however Mayo Clinic in Florida is out of network on these plans."

Asked about the reasoning behind the letters, Mayo communications manager Kevin Punsky replied that they are intended to serve as "a courtesy reminder" at the start of the annual Medicare re-enrollment window that began Oct. 15. They are intended to notify those eligible for Medicare that if they want coverage for non-emergency care at the Mayo Clinic in those two states, they should enroll in "Original Medicare (Parts A, B and D) as well as Medicare supplements."

"This notice allows the patient to make an informed selection of coverage if the patient would like to seek a plan that has Mayo Clinic in network. Out-of-network care is not in the best interest of patients and does not support Mayo's model of care."

The letter also advises recipients that the Mayo Clinic "will not schedule appointments for patients with out-of-network Medicare Advantage Plans."

Medicare Advantage plans have been under increasing scrutiny and investigation because so many of them have been accused by federal agencies of denying care, exaggerating the severity of illnesses to pull billions more from Medicare, and delaying care with lengthy prior authorization requirements.

Additionally, unhappy enrollees who want to disenroll often find they can't sign up for a supplemental plan without underwriting, which can result in rejection of beneficiaries with certain common underlying health conditions.

Asked whether the Mayo Clinic was aware of any specific Medicare Advantage marketing ads that provided misleading information suggesting that MA enrollees can make appointments for care at the Mayo Clinic, Punsky sent this reply in an email to MedPage Today :

"Respectfully, we disagree that the letter insinuates deceptive marketing practices. When a patient enrolls in a narrow network plan, non-emergency medical services are only covered when obtained at certain network providers. We support a patient's ability to make an informed decision on their plan and preferred providers."

Mayo Clinic in Minnesota did not send out a similar letter, Punsky said.

In February, according to a story in the Star Tribune in Minnesota, Mayo had stopped scheduling out-of-network Medicare Advantage patients enrolled in UnitedHealthcare plans. "Seniors in UnitedHealthcare plans are among those no longer getting clinic appointments due to capacity concerns," the story said. "But the change also hints at a financial dispute over payment rates between Mayo and UnitedHealthcare, the health insurance giant based in Minnetonka."

However, the Minnesota-based Mayo Clinic lists that it accepts Humana Medicare Advantage plans. In June, it agreed to a multi-year commercial relationship with UnitedHealthcare, the largest Medicare Advantage company in the country.

It could not be determined from the Mayo Clinic website of contracted providers which, if any, Medicare Advantage plans have contracts with Mayo Clinic in Arizona or Florida .

Perry Davis, who just turned 65, received the same letter from the Florida Mayo Clinic earlier this month and handed it to his wife, Michele Davis, a broker in Ormond Beach who sells Medicare health plans in Florida, New Jersey, and Alabama.

"He just handed the letter to me and said, 'Looks like I'm signing up for Original Medicare and a supplement.'"

She told MedPage Today that to her, the letter "suggests that customers of Medicare Advantage plans have been given other information," although she is not aware of any ads that have said that.

As a broker, she noted, "It's important for anyone marketing Medicare Advantage plans to be aware of the network, including hospitals. The network information needs to be made clear to the consumer."

"While you can and should be able to be seen at any hospital for emergency services, Medicare Advantage marketers and agents need to make it clear that in non-emergent situations, MA plan customers cannot be seen at any facility that accepts Medicare, but only those that are within the plan's network. Otherwise, the customer would pay for those out-of-network services," she said.

Known for its specialization in many conditions and its coordinated system of care, the Mayo Clinic's website says it "cares for 1.4 million people each year with serious or complex illnesses from all 50 U.S. states and 140 countries."

Cheryl Clark has been a medical & science journalist for more than three decades.

Does the Mayo Clinic Accept Medicare Supplement Plans?

Can you use your Medicare Supplement plan at the Mayo Clinic? Yes. Depending on which Medicare Supplement plan letter you have, you may or may not be responsible for paying “Excess Charges”.

As of 2020, Mayo Clinic in Florida accepts full Medicare Assignment. This means that they will not bill Excess Charges. Those on Medicare Supplement Plan N will not see an additional bill for Excess Charges when visiting the Mayo Clinic in Florida. The Arizona Mayo Clinic facility does not (yet) accept Medicare Assignment, so those on Plan N might see an Excess Charge billed from Mayo in Arizona.

Medicare Supplement plans only supplement what is APPROVED by original Medicare. If Medicare approves the procedure and pays their 80%, the Supplement plan, also known as Medigap, will fill in the remaining portion, subject to your deductible and possible co-payment, depending again on which Medicare Supplement plan letter you signed up for.

In this video, we go over the details of how Medicare and Medicare Supplements are accepted at the Mayo Clinic. Also, for those on a Medicare Advantage plan, you must look very closely at your plan and communicate with Mayo on it, as these private plans are most often not accepted at centers of excellence like the Mayo Clinic.

See the video:

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Medicare Information and Discussions - Independent Community Helping you to Understand Medicare

Does a doctor’s clinic get an incentive for accepting Medicare assignments or say that they do?

I am confused as to why a clinic still hasn’t processed Medicare claims for a family member. They seem very disorganized but I’m also wondering why would a place say that they accept it but haven’t processed the claim for months. Meanwhile there’s also an outstanding bill though it hasn’t been sent to collections either. Do clinics get a tax break or what?

• Visiting Mayo Clinic

We miss our Mayo Phoenix... Ever since Medicare kicked in

We really do! We miss the professionalism, the focus on the patient, not feeling like we're using up the doctor's time....

But then 2 years ago I had a Total Knee Replacement and the billing nightmare began. Before turning 65, we never saw a bill. Aside from $20 copay, our Blue Cross policy took care of it all.

Then came Medicare and major surgery. It took 2 years 100s of phone calls between Blue Cross, Mayo billing and Medicare. And we still paid over $1000 out of pocket.

We want to come back to Mayo and will try a simple office visit.

My question is: Is there a service that will take the plethora of Medicare checks sent to us, random checks for $1.50 to $500, checks for who knows what part of the procedure and bill, a service that can work with Medicare, Mayo billing and secondary insurer to sort all the confusion? We would gladly pay for the service! However since all parties insist on only speaking to us, I'm not sure how it would work.

Our plan at the moment is to come back to Mayo for simple checkups, but go to another hospital/provider, that accepts Medicare payments for any major procedures.

Anyone have a solution for this problem?

Thanks Paul

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• Report discussion

Interested in more discussions like this? Go to the Visiting Mayo Clinic Support Group.

Hi Paul, I have been to Mayo Phoenix several times and Medicare and my supplement has covered all the costs.

The Medicare ADVANTAGE program is NOT accepted by Mayo.

Their billing department may be able to provide you with the information you need.

Best wishes 🌵

• Report comment

I am a patient of Mayo Rochester, and have traditional Medicare with a BCBS Medigap insurance. I self-referred to Mayo for lung surgery and later Cardiac stent. I am under CT scan observation. I have never seen a bill...it all gets paid by magic. I fear you do not have traditional Medicare but Medicare Advantage and have gone out of network. The advertising on TV is misleading, one loses choice of provider with Medicare Advantage. That is very important when one needs specialty treatment

Now is the time of year that you can change your insurance plan under Medicare.

Thanks for the feedback. We DO have traditional A&B Medicare. And we also have an outstanding BCBS policy where, as I said, before turning 65 we never saw a bill, just $20 copay.

@SusanEllen66 Possibly because you've only had office visits and tests, not a major medical event like surgery requiring hospital stay? @vic83 You're fortunate:-) This problem is unique to Mayo Arizona, which although it "accepts" traditional Medicare, it does not accept PAYMENTS from Medicare. That's on you the patient.

A major medical event like my TKR has hundreds of line items (codes) each with its own cost, from for instance $1. 35 to $1,679.03. Try reconciling each of those Medicare checks you get in the mail, with what you owe Mayo and what BCBS should have picked up; leaving the patient still owing Mayo thousands.

As per my original post, I was hoping for tips from other Mayo 'zonies on how they dealt with this nightmare.

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@phoenixpal I'm with @vic83 in thinking you have a Medicare Advantage plan that Mayo Phoenix won't accept. I went to Phoenix for my Barrett Esophagus 7 months ago when my Rochester MD retired. I've been going to MN. for 5+ years. Phoenix accepted my BCBS medigap policy and I didn't owe a dime. In almost 6 years I've been billed once and paid for $8.00 by Mayo that they later refunded to me. I haven't received any bills from Mayo Phoenix nor have I received any money from BCBS. My balance owed Mayo for my visit back in March is $0.

"This problem is unique to Mayo Arizona, which although it "accepts" traditional Medicare, it does not accept PAYMENTS from Medicare. That's on you the patient." Yes, that would be a problem! I have BCBS Senior Gold from Minnesota since 2009 which I took out originally because it allowed me to take it to another State and covered emergency travel. There are NO copays with this policy. I know Medicare made some plan type adjustments, but I got grandfathered in. I never see bills for anything, not visits, tests, hospital stays. It also includes eye refractory exam which I sometimes have to explain to the eye doctor staff since Medicare does not cover that. The only problem is when someone screws up. Now when I was in the Mayo hospital last December, the person wheeling me out said that a patient told him that Mayo Arizona had stopped taking Medicare. And here in MN Mayo also stopped taking Advantage - because of plans without new contracts they said. So they said they were reserving for people with traditional Medicare. And what about your visits to non-Mayo providers??? Do you submit and then get paid and then pay the doctor? I understand the headache. The employer provided insurance I had in my last job required that 1) The doctor submits claim to the insurance company, 2) the doctor bills me 3) the insurance pays me, 4) I pay the doctor. I had to keep a spreadsheet tracking it all. I am sure I am not allowed here to express what I thought of such a process! All these healthcare plans are not choice THEY ARE CONFUSION!

@vic83 . You wrote: "I am sure I am not allowed here to express what I thought of such a process! All these healthcare plans are not choice THEY ARE CONFUSION!"

When I began looking at Medicare I already knew I would go with Traditional Medicare as I did not want yet another insurance company demanding pre-authorizations or now allowing me to leave the local rural area for medical care. Still, it took many months of research to decide on which insurance company's Medigap plan I would choose (all the plans are the same, it's the cost and ease of working with the company that is different) and which Prescription Plan (Part D) I would choose.

I said many times that figuring this out is not for mere mortals like us. Confusion is right!!

You are so right. I don't want "choice of insurance carrier" I want coverage. These plans are screwy sometimes. It is necessary to research because there are some not well understood glitches. Like if you go originally with Advantage and then want to switch to Traditional, will you pay more for that Medigap policy later - that is because you are older. Medicare has defined these plans and assigned a letter to each type of Medigap plan to help one compare apples to apples 9not to confuse with Parts A, B, C, D). Part D drug plans are the real devils. I ended up paying $800 more this year for drugs because I did not see the "small" print. That is the plan I chose had the Tier 1 and Tier 2 drugs subject to the deductible whereas other plans WITH CHEAPER PREMIUMS did not. I had not been taking many drugs so not too attentive and then I began to have medical issues and started taking more drugs. And somebody tell me why one plan says the retail price for a drug is $200 and another plan says the retail price is $35 for the same drug. So, if they charge you a specified % of retail price they still make you pay what they want.

Oh, how horrible! Surgery is stressful enough and then to have to go through all that… Yes, I have only had office consultation visits.

I’m sorry you have had to go through all of this nonsense. 🌵

I googled and found this: Does Mayo Clinic in Arizona accept Medicare insurance? "Mayo Clinic has chosen to be a nonparticipating facility in Arizona, and thus does not accept assignment from Medicare Part B for out-of-state residents at its campuses in Arizona. Nonparticipating means that Mayo Clinic does not accept the Medicare approved amount as payment in full." ............ Would that explain some of your issues? Are you a legal resident of Arizona? Regarding your comments about only using Mayo for simple checkups and going elsewhere for major procedures. That is surprising to me. Mayo is a research institution and teaching hospital. It can be quite difficult to get an appointment. I am not clear on how Florida and Arizona Mayo Clinics compare to Mayo Rochester (the original Mayo). They were established later as satellites. My understanding is that the core of research/expertise is in Rochester. They do have some facilities/arrangements to treat the local population - it is 90 miles from the Twin Cities.

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Neurofibromatosis type 1 care at Mayo Clinic

• Ferri FF. Neurofibromatosis. In: Ferri's Clinical Advisor 2024. Elsevier; 2024. https://www.clinicalkey.com. Accessed Feb. 21, 2024.
• Neurofibromatosis. National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Neurofibromatosis-Fact-Sheet. Accessed Feb. 21, 2024.
• Korf BR, et al. Neurofibromatosis type 1 (NF1): Pathogenesis, clinical features, and diagnosis. https://www.uptodate.com/contents/search. Accessed Feb. 21, 2024.
• Saleh M, et al. Neurofibromatosis type 1 system-based manifestations and treatments: A review. Neurological Sciences. 2023; doi:10.1007/s10072-023-06680-5.
• Neurofibromatosis. American Association of Neurological Surgeons. https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Neurofibromatosis. Accessed Feb. 21, 2024.
• Neurofibromatosis. Merck Manual Professional Version. https://www.merckmanuals.com/professional/pediatrics/neurocutaneous-syndromes/neurofibromatosis. Accessed Feb. 21, 2024.
• Jankovic J, et al., eds. Neurocutaneous syndromes. In: Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Elsevier; 2022. https://www.clinicalkey.com. Accessed Feb. 21, 2024.
• Armstrong AE, et al. Treatment decisions and the use of the MEK inhibitors for children with neurofibromatosis type 1-related plexiform neurofibromas. BMC Cancer. 2023; doi:10.1186/s12885-023-10996-y.
• Zitelli BJ, et al., eds. Neurology. In: Zitelli and Davis' Atlas of Pediatric Physical Diagnoses. 8th ed. Elsevier; 2023. https://www.clinicalkey.com. Accessed Feb. 21, 2024.
• Kellerman RD, et al. Neurofibromatosis (type 1). In: Conn's Current Therapy 2024. Elsevier; 2024. https://www.clinicalkey.com. Accessed Feb. 21, 2024.
• Babovic-Vuksanovic D (expert opinion). Mayo Clinic. March 26, 2024.
• Tamura R. Current understanding of neurofibromatosis type 1, 2 and schwannomatosis. International Journal of Molecular Sciences. 2021; doi:10.3390/ijms22115850.
• Legius E, et al. Revised diagnostic criteria for neurofibromatosis type 1 and Legius syndrome: An international consensus recommendation. Genetics in Medicine. 2021; doi:10.1038/s41436-021-01170-5.
• Find a doctor. Children's Tumor Foundation. https://www.ctf.org/understanding-nf/find-a-doctor/. Accessed Feb. 26, 2024.
• Ami TR. Allscripts EPSi. Mayo Clinic. April 18, 2024.

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