Mayo Clinic accepts a wide range of insurance plans to provide accessible healthcare to patients across its various locations. Understanding which insurance plans are accepted is crucial for patients seeking care at this renowned medical institution. Mayo Clinic works with numerous insurance providers, including major national carriers and regional plans, to ensure comprehensive coverage options for its patients.
The insurance plans accepted by Mayo Clinic can vary depending on the specific location and type of care needed. It’s important to note that acceptance of insurance plans may differ between Mayo Clinic’s primary locations in Rochester, Minnesota; Phoenix and Scottsdale, Arizona; and Jacksonville, Florida, as well as its associated health systems and clinics across multiple states.
| Insurance Type | Acceptance at Mayo Clinic |
|---|---|
| Medicare | Accepted (including some Medicare Advantage plans) |
| Medicaid | Accepted in some states |
| Private Insurance | Many major carriers accepted |
Medicare and Medicare Advantage Plans
Mayo Clinic accepts Original Medicare (Part A and Part B) at all of its locations. This means that patients with traditional Medicare coverage can receive care at Mayo Clinic facilities. However, the situation is more complex when it comes to Medicare Advantage plans.
As of 2025, Mayo Clinic has announced changes to its acceptance of certain Medicare Advantage plans. These changes are significant and may affect patients’ ability to receive care at Mayo Clinic facilities under their current insurance coverage. Specifically:
- Mayo Clinic will not accept HealthPartners Medicare Advantage plans starting in 2025.
- The clinic continues to accept many other Medicare Advantage plans, but patients are strongly advised to verify their coverage.
It’s crucial for Medicare Advantage plan holders to check with both Mayo Clinic and their insurance provider to ensure their plan is accepted before scheduling appointments or procedures. The changes in Medicare Advantage plan acceptance are due to ongoing issues with reimbursements and coverage denials for medical services that Mayo Clinic deems necessary.
Impact on Patients
These changes could potentially affect thousands of Minnesotans who rely on Medicare Advantage plans. Patients with plans that are no longer accepted may face:
- Higher out-of-pocket costs for services at Mayo Clinic
- Possible lack of coverage for certain treatments or procedures
- The need to switch insurance plans to continue receiving care at Mayo Clinic
Private Insurance Plans
Mayo Clinic works with numerous private insurance companies to provide in-network care for patients. Some of the major private insurers that Mayo Clinic has agreements with include:
- UnitedHealthcare: Mayo Clinic Laboratories is part of UnitedHealthcare’s Preferred Lab Network (PLN).
- Blue Cross Blue Shield: Various Blue Cross Blue Shield plans are accepted, including Blue Plus plans in Minnesota.
- Medica: Mayo Clinic has a special relationship with Medica for employee health plans.
It’s important to note that even within these insurance companies, not all plans may be accepted. For example, Mayo Clinic may be in-network for some Blue Cross Blue Shield plans but out-of-network for others.
Verifying Insurance Coverage
To ensure coverage, patients should take the following steps:
- Contact their insurance provider directly to verify Mayo Clinic is in-network
- Check with Mayo Clinic’s billing department for specific plan acceptance
- Review any pre-authorization requirements for specialized treatments
- Understand potential out-of-pocket costs for both in-network and out-of-network care
Medicaid and State-Specific Plans
Mayo Clinic’s acceptance of Medicaid varies by state and specific Medicaid program. The clinic is registered as an approved Medicaid provider in several states, but coverage can be limited and may require referrals or prior authorizations.
For state-specific plans, such as Minnesota’s Medical Assistance program, Mayo Clinic participates in some capacity. However, the extent of coverage and acceptance can vary widely. Patients with state-sponsored health plans should:
- Verify eligibility with their state’s Medicaid office
- Check with Mayo Clinic about specific Medicaid plan acceptance
- Understand any limitations on coverage or services
International Insurance and Self-Pay Options
For international patients or those without accepted insurance, Mayo Clinic offers several options:
- International insurance: Some international health insurance plans may be accepted, but this varies greatly.
- Self-pay: Patients can choose to pay for their care out-of-pocket.
- Financial assistance: Mayo Clinic provides financial counseling and may offer assistance programs for eligible patients.
Self-Pay Discounts
Mayo Clinic offers an automatic 6 percent discount for patients without insurance who are paying out-of-pocket. This can help alleviate some of the financial burden for those who do not have coverage or whose insurance is not accepted.
Specialty Services and Clinical Trials
Insurance coverage for specialty services or participation in clinical trials at Mayo Clinic may have different requirements:
- Some specialized treatments may require additional authorization from insurance providers.
- Clinical trial participation often involves a mix of standard care (which may be covered by insurance) and investigational treatments (which are typically covered by the trial sponsor).
- Patients should discuss coverage details with both Mayo Clinic and their insurance provider before beginning any specialized treatment or trial.
Changes in Insurance Acceptance for 2025
As healthcare landscapes evolve, so do insurance partnerships. For 2025, several significant changes have been announced regarding insurance acceptance at various healthcare providers, including Mayo Clinic:
- M Health Fairview will not accept Humana or Aetna
- Mayo Clinic will not accept HealthPartners
- North Memorial Medical Center will not accept Humana
- Other health systems like Allina, Avera, and Sanford Health have also announced changes in their acceptance of certain Medicare Advantage plans
These changes underscore the importance of regularly reviewing and potentially updating insurance coverage to maintain access to preferred healthcare providers.
Tips for Navigating Insurance at Mayo Clinic
To ensure the best possible coverage and avoid unexpected costs, patients should:
- Review their insurance plans annually, especially during open enrollment periods
- Contact Mayo Clinic’s billing department directly for the most up-to-date information on accepted plans
- Understand their plan’s network tiers, as Mayo Clinic may be in different tiers for different services
- Keep track of any changes announced by Mayo Clinic or their insurance provider regarding coverage
- Consider working with a healthcare advocate or financial counselor to navigate complex insurance situations
FAQs About Insurance Accepted by Mayo Clinic
- Does Mayo Clinic accept all Medicare Advantage plans?
No, Mayo Clinic does not accept all Medicare Advantage plans. Acceptance varies by location and plan. - Can I receive care at Mayo Clinic if they don’t accept my insurance?
Yes, but you may face higher out-of-pocket costs or need to pay for services yourself. - How often does Mayo Clinic update its list of accepted insurance plans?
Mayo Clinic regularly reviews and updates its insurance agreements, often annually. - What should I do if my insurance plan is no longer accepted by Mayo Clinic?
Contact Mayo Clinic’s billing department and your insurance provider to explore your options. - Does Mayo Clinic offer payment plans for those without accepted insurance?
Yes, Mayo Clinic offers financial counseling and may provide payment plans or financial assistance to eligible patients.
In conclusion, while Mayo Clinic accepts a broad range of insurance plans, including Medicare, Medicaid, and many private insurers, the specifics can vary significantly by location and type of care. Patients should always verify their coverage directly with both Mayo Clinic and their insurance provider before seeking care. With the announced changes for 2025, it’s more important than ever for patients to stay informed about their insurance coverage and how it relates to their ability to receive care at Mayo Clinic facilities. By understanding their insurance options and staying proactive about any changes, patients can better navigate the complexities of healthcare coverage and continue to access the high-quality care that Mayo Clinic is known for.