Letter to the editor: Medicare Advantage can create healthcare challenges

By NALANI BEVER | Elroy

We have always had wonderful service and coverage through our Quartz Medicare Advantage, an HMO Plan with Medicare Contract.  

My husband was recently referred to Mayo Clinic by our Gundersen neurologist to investigate a treatment possibility for his essential tremors.  A treatment not offered at Gundersen.  We were denied by Quartz and advised to make an appointment at UW Health in Madison. UW Health had nothing to offer other than what Gundersen had already made available, so we appealed their decision. To make a long story short, after about three months of going back and forth with appeals and still attempting to get an appointment, the lady from Mayo Clinic said, “Mrs. Bever, Mayo Clinic does not have a contract with Quartz Medicare Advantage HMO.” I was stunned. We changed our insurance, making sure we would be accepted at Mayo. In fact, due to time constraints in getting an appointment at Mayo, we ended up going to the Cleveland Clinic! We aren’t leaving Gundersen; we just want to be able to go elsewhere, covered by our insurance, if need be. 

I have no idea of the issue or issues which stand in the way of Mayo and Quartz Insurance executives coming to an agreement. Their health systems are competitors, after all.  My only suggestion to folks who are looking around for a Medicare Advantage or Medicare Supplement policy is to ask if your policy is accepted at Mayo, Gundersen, Aurora, Cleveland Clinic, or any health system other than your usual. Both Mayo and Cleveland have a link on their websites listing insurers they accept.  Yet another tool to use as an informed consumer.

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