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.

所有跟帖: 

是不是好的医疗机构都是Medicare 的 out-of-network? -6degrees- 给 6degrees 发送悄悄话 (176 bytes) () 10/24/2022 postreply 13:51:18

不是。 这里说的是Medicare Advantage 的 out-of-network, 与Medicare 无关 -休闲时- 给 休闲时 发送悄悄话 (0 bytes) () 10/25/2022 postreply 07:50:55

所以,还是买Medigap plan G好。 -虎嗅蔷薇- 给 虎嗅蔷薇 发送悄悄话 (0 bytes) () 10/24/2022 postreply 15:55:45

Medigap 没有类似限制吗?Medigap 没有dental吧? -6degrees- 给 6degrees 发送悄悄话 (0 bytes) () 10/24/2022 postreply 21:14:41

没有这种限制。全美的医生都可以看。也没有copay。Plan G只需付200来块的年deductible -虎嗅蔷薇- 给 虎嗅蔷薇 发送悄悄话 (140 bytes) () 10/25/2022 postreply 04:27:24

没想到你们也推崇阴谋论的医疗机构了. LOL -独行仙人- 给 独行仙人 发送悄悄话 独行仙人 的博客首页 (0 bytes) () 10/24/2022 postreply 16:25:53

不同医疗保险公司或机构,在不同州都有特定涵盖面。 -pickshell- 给 pickshell 发送悄悄话 (296 bytes) () 10/24/2022 postreply 17:15:16

有人说可能会有更多的医院系统排斥Medicare Advantage Plans -dudaan- 给 dudaan 发送悄悄话 dudaan 的博客首页 (0 bytes) () 10/24/2022 postreply 18:29:26

Advantage Plan 就是HMO类的,不但有provider network的限制, -虎嗅蔷薇- 给 虎嗅蔷薇 发送悄悄话 (96 bytes) () 10/24/2022 postreply 18:47:02

我现在用的是Medicare Advantage PPO -dudaan- 给 dudaan 发送悄悄话 dudaan 的博客首页 (30 bytes) () 10/24/2022 postreply 18:58:58

哦哦,更准确的说法Advantage 是managed care医保 -虎嗅蔷薇- 给 虎嗅蔷薇 发送悄悄话 (0 bytes) () 10/25/2022 postreply 05:55:53

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