Insurance Plan Contracts

Mayo Clinic has contracts with nearly 100 national insurance carriers (Aetna, CIGNA), third-party administrators (Beech Street) and employers (Tyson Foods).

If you are a member of a preferred provider organization (PPO) or health maintenance organization (HMO), please contact your health plan before scheduling a Mayo appointment to determine your plan's participation with Mayo Clinic and the terms of your contract. Please note that Mayo participates with a limited number of HMOs; all require medical director referral before appointments can be scheduled.

Claims will be filed to your commercial PPO plan. If Mayo is not part of your PPO network, your out-of-pocket expenses will increase. (PPOs reimburse at a lower rate when services are received outside the PPO network.)

Copayments will be collected during registration. You are responsible for the initial deductible, coinsurance, copayments and any charges for noncovered services.

Your Mayo physician will decide which procedures, tests and other physician consultations you may need. It's your responsibility to be aware of the terms of your health plan. Pre-certification is required for some procedures before some health plans will pay for them. Examples of services that may require pre-certification are inpatient services, invasive procedures, CT scans, MRIs and colonoscopies. You are responsible for knowing the pre-certification needs of your health plan. Payment for all services that your health plan considers "non-covered under contract" is your responsibility.

If you have secondary insurance coverage, you will receive a supplemental claim form (red and white form) from Mayo Clinic after your primary insurance has paid. You should attach a copy (not the original) of the Explanation of Benefits form from your primary insurance to this supplemental claim form and send it to your supplemental insurance carrier.

You will receive a statement of account (blue and white form) about five to 35 days after your appointment. This statement itemizes the services provided at Mayo Clinic.

You will continue to receive statements until all insurance payments and adjustments are posted and the patient responsibility portions are paid in full.