Mayo Clinic Treat Medicare Advantage Plans as out-of-network

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.