• filter:
  • Text Only
  • Search this Topic »
Voting History
rated:
A friend who lives in Southern California wants to go to the Mayo Clinic in Rochester MN for a complete physical.  Has an appointment for a few weeks from now.

But, just got a big packet from Mayo with a lot of legalise to sign and return.  Friend doesn't really understand it and, neither do I.

Will Mayo accept Medicare and Supplement F as payment in full?  Can friend anticipate a blizzard of bills from Mayo for stuff it says Medicare doesn't cover?

I talked to Mayo billing  dept. and, as far as I can tell, they do not accept Medicare assignment which means they bill Medicare and the Supp F company but he checks go to friend and friend has to pay to Mayo as bills come to friend.

Will there be non-Medicare covered bills?   A few?  A lot?

Anybody here had any experience with this sort of thing?

Member Summary
Most Recent Posts
Wow, that's not even comparing apples and oranges. More like apples and elephants.

BocephusSTL (Nov. 02, 2016 @ 2:13p) |

Giving someone without cancer a "weak" form of chemo as a preventative measure is like letting your bathtub overflow and... (more)

cestmoi123 (Nov. 04, 2016 @ 1:45p) |

I'm gonna throw your idea here into a recursive loop - a possible side effect of cancer treatment is cancer.  Go at it.

Rubl (Nov. 14, 2016 @ 3:14p) |

Staff Summary
Thanks for visiting FatWallet.com. Join for free to remove this ad.

rated:
I didn't realize CA went so socialist that your friend couldn't get a physical in socal

rated:
If he can afford to fly to NY, rent a car there for the exam, then he can afford the extra costs that Medicare doesn't cover.
These so-called 'executive physicals' vary alot in price, from $1000-$8000, depending on how neurotic the patient is and how many unnecessary tests they do.
He won't know his actual out-of-pocket cost until he gets his bill.

Not accepting Assignment doesn't mean that the patient 'gets the checks'.  Rather, it means that the doctors bill is not limited to the Medicare allowable amount.

rated:
Why fly to another state for a physical? I'm sure theres some good doctors in California.

What does 'complete physical' entail? Are all the tests covered by Medicare?

What he's doing sounds like a giant mess with lots of surprise bills.

If he can't afford the entire cost out of pocket then I wouldn't risk it.

rated:
medicare assignment...
https://www.medicare.gov/your-medicare-costs/part-a-costs/assign...

But that doesn't really answer your questions. It just explains assignemnt.

I read it to mean that they're 'out of network' more or less, though I am no expert.

rated:
Check out page 1:
http://www.mayoclinic.org/documents/mayo-clinic-medicare-and-you... 

"Here’s how Mayo Clinic’s Medicare billing practice affects you:
Example
Mayo Clinic charge to Medicare patients .......................................$109.25
Medicare-approved amount .............................................................$100
Medicare allowed when not accepting assignment ...................... $95
Medicare pays you 80% of allowed amount .....................................$76
Supplemental insurance (if you have coverage) pays you
20% of allowed amount ................................................................ $19
Total paid by Medicare & supplemental ............................................$95
Patient responsibility ...........................................................................$14.25
(Patient responsibility if no supplemental ........................................$33.25)"

...also, keep in mind that is only for office visits and the like. Lab fees, imaging, etc, Mayo is bound to accept assignment for those, they will be billed and paid regularly.

rated:
Yep, I went through the Mayo site before posting--but found it uninformative as whether friend (with Supp F which pays in full the 15% no-assignment surcharge) is actually going to get a bill (or maybe hundreds of bills-one for each separate service) which is supposed to be paid for by the F Supp carrier sending friend checks for sums to be paid to Mayo.  In other words, will there be the kind of paperwork nightmare that Medicare usually avoids.

rated:
I'm confused. Is your friend going to Mayo for a routine physical or he is getting an "executive" physical? I doubt Medicare will cover all the extraneous tests that are involved in an executive physical and your friend will need to put a deposit down if any of the services are not covered. Mayo's explanation of benefits specifically states they are not a Medicare participating provider and your friend will be responsible for any difference in Mayo's billing and Medicare's reimbursement.

But if your friend demands the Mayo name and has money to burn, go for it. I would at least go to Rochester and not Florida as the link you posted suggests he is not going to the mothership. It seems like a silly thing to do considering there are equally as good if not better physicians that can be found at Stanford, UCLA, UCSF, etc...

rated:
sloppy1 said:   These so-called 'executive physicals' vary alot in price, from $1000-$8000, depending on how neurotic the patient is and how many unnecessary tests they do.
If an unnecessary test finds early stages of heart disease or cancer before there are any symptoms and there is a better chance of a cure, seems like a worthwhile expense. If you don't have two nickels to rub together, maybe not.

rated:
atikovi said:   
sloppy1 said:   These so-called 'executive physicals' vary alot in price, from $1000-$8000, depending on how neurotic the patient is and how many unnecessary tests they do.
If an unnecessary test finds early stages of heart disease or cancer before there are any symptoms and there is a better chance of a cure, seems like a worthwhile expense. If you don't have two nickels to rub together, maybe not.

Does anyone know how much "executive physicals"  typically are for Mayo AZ. Can one  preauth these with UHC prior to agreeing to tests ? 

rated:
atikovi said:   
sloppy1 said:   These so-called 'executive physicals' vary alot in price, from $1000-$8000, depending on how neurotic the patient is and how many unnecessary tests they do.
If an unnecessary test finds early stages of heart disease or cancer before there are any symptoms and there is a better chance of a cure, seems like a worthwhile expense. 

  And if you pick the right numbers, a lottery ticket is a good bet.  

rated:
I'm an MD, but this isnt' my area of expertise.
A LOT of this stuff will not be covered via insurance. Remember- this isn't your run of the mill physical- with a few basic labs- which insurance companies cover. Mayo likely would (and should, for this type of physical) run many tests which will most certainly NOT be deemed medically necessary, and almost certainly will NOT reimbursed by any insurance. You're 'friend' will likely have to sign paperwork accepting this and agreeing to pay for everything not covered (which will likely be most of it). Your friend needs to call the mayonnaise clinic and see what they are signing up for, and how much they will have to pay. This isn't the 'show up in the ER and wait for the bills'. This is 'plan ahead and anticipate the 10k in bills you are causing'.

rated:
Is there a specific need for this exam that requires him to go to Mayo? (I can't guess what that would be).

I think if your friend is worried about how much medicare is going to cover for extensive (likely optional) medical exam tests then they shouldn't be flying half way across the country to voluntarily get such tests and instead get a regular physical at home from a local doctor.

ETA: This may be in the "if you have to ask, you can't afford it" category.
 

rated:
wp746911 said:   I'm an MD, but this isnt' my area of expertise.
  Are those "virtual physicals" that are frequently advertised in my area using body scans of much benefit? One ad mentions a patient who had a scan and they found a kidney tumor before there were any symptoms. With early treatment the prognosis was excellent, 

rated:
atikovi said:   
sloppy1 said:   These so-called 'executive physicals' vary alot in price, from $1000-$8000, depending on how neurotic the patient is and how many unnecessary tests they do.
If an unnecessary test finds early stages of heart disease or cancer before there are any symptoms and there is a better chance of a cure, seems like a worthwhile expense. If you don't have two nickels to rub together, maybe not.

There are risks with too much testing, too. Most notably - possible adverse effects to testing procedures; radiation exposure; and potential of finding "something", and then treating it more aggressively than warranted. 

rated:
BrianGa said:   
atikovi said:   
sloppy1 said:   These so-called 'executive physicals' vary alot in price, from $1000-$8000, depending on how neurotic the patient is and how many unnecessary tests they do.
If an unnecessary test finds early stages of heart disease or cancer before there are any symptoms and there is a better chance of a cure, seems like a worthwhile expense. If you don't have two nickels to rub together, maybe not.

There are risks with too much testing, too. Most notably - possible adverse effects to testing procedures; radiation exposure; and potential of finding "something", and then treating it more aggressively than warranted. 

  Sounds like the insurance co response. All I know is I rather find something early and treat it aggressively, than find it too late and not be able to treat it at all.

rated:
WHY?!

Sounds like a complete waste of time and resource.

rated:
atikovi said:   
BrianGa said:   
atikovi said:   
sloppy1 said:   These so-called 'executive physicals' vary alot in price, from $1000-$8000, depending on how neurotic the patient is and how many unnecessary tests they do.
If an unnecessary test finds early stages of heart disease or cancer before there are any symptoms and there is a better chance of a cure, seems like a worthwhile expense. If you don't have two nickels to rub together, maybe not.

There are risks with too much testing, too. Most notably - possible adverse effects to testing procedures; radiation exposure; and potential of finding "something", and then treating it more aggressively than warranted. 

  Sounds like the insurance co response. All I know is I rather find something early and treat it aggressively, than find it too late and not be able to treat it at all.

 In a world where tests had no false positives and no risks, that would make perfect sense.  We don't live in that world.  

rated:
ZenNUTS said:   WHY?!

Sounds like a complete waste of time and resource.

  Maybe ask somebody with recently diagnosed Stage IV cancer if it would have been a complete waste of time and resource if they had an advanced physical and were diagnosed 6 months previously with just Stage I.

rated:
atikovi said:   
ZenNUTS said:   WHY?!

Sounds like a complete waste of time and resource.

  Maybe ask somebody with recently diagnosed Stage IV cancer if it would have been a complete waste of time and resource if they had an advanced physical and were diagnosed 6 months previously with just Stage I.

  If you know how science, statistic, and logic works then you would know EXACTLY why that would be the wrong question to ask.  Note, I'm not saying any medical test is a bad idea, but there should be a logical reason to order a specific test.

https://www.sciencebasedmedicine.org/why-doctors-order-too-many-...
Dr. Hall said: The need for a test can be informed by scientific studies. Does routinely ordering x-rays on all patients with ankle injuries improve outcomes? No, it doesn’t. Simple sprains are much more common than fractures, and x-rays expose patients to radiation. Science-based guidelines like the Ottawa ankle rules have been developed to help clinicians decide when to order tests.

Another consideration is “what difference will the test make?” What are we going to do differently if the result is x rather than y? If we can’t answer that question, we probably shouldn’t be doing the test. That’s particularly pertinent in genomic testing, where patients may be told they are at high risk of developing a disease that they can’t do anything to prevent.

rated:
Also, specifically for cancer, I urge everyone to read up on the whole mammogram debate and understand why there is proven harm for doing it too much and too early.

rated:
Or men that had painful invasive treatment for prostate cancer at 40 that wouldn't likely have killed them until age 90.

rated:
ZenNUTS said:     If you know how science, statistic, and logic works then you would know EXACTLY why that would be the wrong question to ask.  Note, I'm not saying any medical test is a bad idea, but there should be a logical reason to order a specific test.  

Corny saying but an ounce of prevention is worth a pound of cure. Most of those against advanced physicals or more tests bring up statistics and say, on average, those that get more testing don't live any longer than those that don't. I'm no medical professional but can imagine someone just diagnosed with a Stage IV disease who may only live 6 months, while someone diagnosed at Stage I with the same disease may be cured and live another 20 or 30 years.

rated:
atikovi said:   
ZenNUTS said:     If you know how science, statistic, and logic works then you would know EXACTLY why that would be the wrong question to ask.  Note, I'm not saying any medical test is a bad idea, but there should be a logical reason to order a specific test.  

Corny saying but an ounce of prevention is worth a pound of cure. Most of those against advanced physicals or more tests bring up statistics and say, on average, those that get more testing don't live any longer than those that don't. I'm no medical professional but can imagine someone just diagnosed with a Stage IV disease who may only live 6 months, while someone diagnosed at Stage I with the same disease may be cured and live another 20 or 30 years.

  

Would you take a 8 in 100,000 chance of a test saving your life if it came along with a 30 in 100,000 chance of a overdiagnosis of cancer and then going through months of unnecessary chemo?


 

rated:
atikovi said:   
BrianGa said:   
atikovi said:   
sloppy1 said:   These so-called 'executive physicals' vary alot in price, from $1000-$8000, depending on how neurotic the patient is and how many unnecessary tests they do.
If an unnecessary test finds early stages of heart disease or cancer before there are any symptoms and there is a better chance of a cure, seems like a worthwhile expense. If you don't have two nickels to rub together, maybe not.

There are risks with too much testing, too. Most notably - possible adverse effects to testing procedures; radiation exposure; and potential of finding "something", and then treating it more aggressively than warranted. 

  Sounds like the insurance co response. All I know is I rather find something early and treat it aggressively, than find it too late and not be able to treat it at all.

Don't care what it sounds like, but it's the advice that most wise doctors would give you. It's, in part, why routine mammography has been curtailed. 

rated:
jerosen said:   Would you take a 8 in 100,000 chance of a test saving your life if it came along with a 30 in 100,000 chance of a overdiagnosis of cancer and then going through months of unnecessary chemo?  

That's what 2nd and third opinions are for. And where did you come up with 8 in 100,000? I think they say that 1 out of 3 people will get cancer in their lifetime.

rated:
cestmoi123 said:   
atikovi said:   
BrianGa said:   
atikovi said:   
sloppy1 said:   These so-called 'executive physicals' vary alot in price, from $1000-$8000, depending on how neurotic the patient is and how many unnecessary tests they do.
If an unnecessary test finds early stages of heart disease or cancer before there are any symptoms and there is a better chance of a cure, seems like a worthwhile expense. If you don't have two nickels to rub together, maybe not.

There are risks with too much testing, too. Most notably - possible adverse effects to testing procedures; radiation exposure; and potential of finding "something", and then treating it more aggressively than warranted. 

  Sounds like the insurance co response. All I know is I rather find something early and treat it aggressively, than find it too late and not be able to treat it at all.

 In a world where tests had no false positives and no risks, that would make perfect sense.  We don't live in that world.  

  To be fair, there are tests with no risks. (MRI's don't have any direct risks.  Sure, CT scans do cause measurable increases in cancer mortality.  Makes little sense to order xrays or CT with no reason, their benefit would have to overcome the increased mortality from the scan itself.)  False positives is a different issue and valid.

Insurance and medical risk equations value everyone's health equally and unnecessary testing displaces testing someone else might get.  But, everyone's health value is not equal.  A millionaire would have more value for finding something early than a fast food worker.  Equation might be 1:10000 chance of finding something life threatening early but costs $1000 extra expense.  Even if there were no false positives/unnecessary treatment risks that equation would make insurance co and even doctor groups would say it's a bad idea in general.  It would make no sense for someone paycheck to paycheck to put two months rent together for that testing.  But if there person has $1B assets, they might value their life over the $10M average cost to catch the cancer early (10000*$1000).  Arbitrary numbers in the example, there's probably cases where at no point it makes sense or where it makes sense for people with fair amount of means ( but much less than $1B).  Just speculation here, I see where atikovi's reasoning is coming from and it somewhat makes sense.

rated:
OP here--interesting discussions above but ... to get back to topic ...

Anyone have practical experience with physicals at Mayo (or similar places such as Cleveland Clinic, UCLA etc.) or with medicare and Supplements coverage with providers who don't accept assignment?

rated:
No experience with Mayo,  but I think with most health care plans you get a physical once a year.  Maybe your insurance covers it at Mayo, but if it is less than 365 days since the last physical, you will not qualify.  I don't know about extra tests.

rated:
No experience with Mayo,  but I think with most health care plans you get a physical once a year.  Maybe your insurance covers it at Mayo, but if it is less than 365 days since the last physical, you will not qualify.  I don't know about extra tests.

rated:
atikovi said:   
jerosen said:   Would you take a 8 in 100,000 chance of a test saving your life if it came along with a 30 in 100,000 chance of a overdiagnosis of cancer and then going through months of unnecessary chemo?  

That's what 2nd and third opinions are for. And where did you come up with 8 in 100,000? I think they say that 1 out of 3 people will get cancer in their lifetime.

  Clearly then , we should all get a round of chemo every year. just in case! 

rated:
That is brilliant insight. Chemo has always been used to treat, not to prevent. If it works well in treating cancers, wouldn't it work better at preventing them from starting? Surprised medical research hasn't considered this. Or is it more profitable to treat a disease than prevent it?

rated:
MrKlick said:   OP here--interesting discussions above but ... to get back to topic ...

Anyone have practical experience with physicals at Mayo (or similar places such as Cleveland Clinic, UCLA etc.) or with medicare and Supplements coverage with providers who don't accept assignment?

  
Since nobody is saying anything I'll chip in with what little I have on it.

I have been to Mayo (Rochester), I got one bill from them covering everything that was done.  They billed my insurance, I paid what was left.  However, this was not Medicare and it wasn't an executive physical.

rated:
atikovi said:   That is brilliant insight. Chemo has always been used to treat, not to prevent. If it works well in treating cancers, wouldn't it work better at preventing them from starting? Surprised medical research hasn't considered this. Or is it more profitable to treat a disease than prevent it?
  Can't tell if you're being serious or not?

Chemotherapy is poison. It kills most cells. The hope is that you can kill the cancer cells before the rest die off too.

rated:
stanolshefski said:   
atikovi said:   That is brilliant insight. Chemo has always been used to treat, not to prevent. If it works well in treating cancers, wouldn't it work better at preventing them from starting? Surprised medical research hasn't considered this. Or is it more profitable to treat a disease than prevent it?
  Can't tell if you're being serious or not?

Chemotherapy is poison. It kills most cells. The hope is that you can kill the cancer cells before the rest die off too.

  A flu shot contains a weakened version of the flu virus to help prevent the flu, so why couldn't a weakened form of chemo be a preventative therapy to help prevent cancer? And there are many versions of chemo including those that help your own body fight the disease like Jimmy Carter got. Immuno something. 

rated:
stanolshefski said:   
atikovi said:   That is brilliant insight. Chemo has always been used to treat, not to prevent. If it works well in treating cancers, wouldn't it work better at preventing them from starting? Surprised medical research hasn't considered this. Or is it more profitable to treat a disease than prevent it?
  Can't tell if you're being serious or not?

Chemotherapy is poison. It kills most cells. The hope is that you can kill the cancer cells before the rest die off too.

  I made the mistake of reading sarcasm.  But probably he was somehow serious....

rated:
As a heart attack. What part of my theory do you think is sarcastic?

rated:
atikovi said:   As a heart attack. What part of my theory do you think is sarcastic?
  Chemo's probably the "treatment" with the most widely known extremely harsh side effects.  Saying it might be a good idea as a preventative measure for someone who doesn't have any cancer is really odd.  It's hard to imagine someone not being slightly aware, therefore I was assuming it was sarcasm because to me it seemed like "obviously such an absurd idea".

It reminded me of this reddit thread. 

I guess at least you didn't suggest people get radiation treatment as a preventative measure against possibly getting cancer.

rated:
Bend3r said:   Saying it might be a good idea as a preventative measure for someone who doesn't have any cancer is really odd.
 

  All I suggested was that research in this area could be useful. And I did say, a "weak" form of chemo. They recently come out with a vaccine for HPV that can also help prevent some types of cancer. https://gifts.mdanderson.org/mdanderson/main.php/micro_sites/showpage/id/89/page_number/1?gclid=Cj0KEQjwkdHABRCHiZ2gs6yGh50BEiQAA91Wlv92e8DVyljokjZCrmyY7S-YPuOBEUFiw3L8SRammvAaAltb8P8HAQ

Skipping 3 Messages...
rated:
atikovi said:   
stanolshefski said:   
atikovi said:   That is brilliant insight. Chemo has always been used to treat, not to prevent. If it works well in treating cancers, wouldn't it work better at preventing them from starting? Surprised medical research hasn't considered this. Or is it more profitable to treat a disease than prevent it?
  Can't tell if you're being serious or not?

Chemotherapy is poison. It kills most cells. The hope is that you can kill the cancer cells before the rest die off too.

  A flu shot contains a weakened version of the flu virus to help prevent the flu, so why couldn't a weakened form of chemo be a preventative therapy to help prevent cancer? And there are many versions of chemo including those that help your own body fight the disease like Jimmy Carter got. Immuno something. 

  I'm gonna throw your idea here into a recursive loop - a possible side effect of cancer treatment is cancer.  Go at it.

  • Quick Reply:  Have something quick to contribute? Just reply below and you're done! hide Quick Reply
     
    Click here for full-featured reply.


Disclaimer: By providing links to other sites, FatWallet.com does not guarantee, approve or endorse the information or products available at these sites, nor does a link indicate any association with or endorsement by the linked site to FatWallet.com.

Thanks for visiting FatWallet.com. Join for free to remove this ad.

While FatWallet makes every effort to post correct information, offers are subject to change without notice.
Some exclusions may apply based upon merchant policies.
© 1999-2016