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What will the Medica transition mean to me? Mar 1, 2021 | By Robert McGriff (@m039153)
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@m039153

Bruce: I want to offer a few counterpoints to your arguments.
1. There is nothing unusual about the fact that Medica did not allow you to talk to a "claims processor". That is standard practice. Those folks are busy doing their job and not equipped to respond to requests from plan members. That is the work of the Customer Service group that answers the calls.
2. HR Connect staff are correctly referring you to call Medica with your issue. The staff in HR Connect are not trained and do not have access to the right data to be able to respond to your specific questions about the Mayo Medical Plan.
3. The formal appeals/complaint process is by necessity in writing. This is not new to the plan.
I can certainly understand your frustration. If you would like to e-mail me at my Mayo e-mail address, I would be happy to ask a Manager to look into it further for you.
Robert McGriff
Mayo Clinic Benefits

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Replies to "Bruce: I want to offer a few counterpoints to your arguments. 1. There is nothing unusual..."
brucew | @brucew | Nov 1, 2019

Thank you for your response. The issue is I cannot find out benefit information from Medica related to hearing aids.
I visited Clear Wave Hearing Center where I purchased the previous pair. They cannot tell me what my out of pocket will be for new ones because when they submit claims to Medica, they are being paid less than the full $5,000 benefit. And no two claims are alike. They had no such problems when MMSI was handling claims.
They have a very difficult time getting answers from Medica about how claims are paid and it takes them roughly 4 MONTHS to get paid. MMSI paid within 2 weeks.
I'm not advocating for Clear Wave or anyone else, but I should able to get straight answers on benefits. Medica "customer service" personnel aren't trained to address these questions either.
I'm not sure putting the issue in writing will be understood or even addressed. Then what do I do?
Medica hasn't exactly bolstered my confidence they are interpreting Mayo benefits correctly. Is anyone at Mayo monitoring that?
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