#WeAreMayoClinic
Earlier this year, you shared feedback about what's important when thinking about your healthcare benefits. Using that feedback, Mayo Clinic announced changes to the 2025 Mayo Medical Plan Network, including an expanded network of provider options and the elimination of network tiers so that providers will be either in-network or out-of-network.
Also, in advance of the Nov. 1–15 open enrollment period, Mayo Clinic is launching a new Mayo Medical Plan Network provider search tool, which can be accessed through any internet connection.
This simplified and consolidated resource includes 2024 and 2025 in-network healthcare professionals, facilities and durable medical equipment locations. Using the tool, you can confirm if a healthcare professional is in-network and plan future healthcare services that meet your health and well-being needs.
Importantly, a separate search option for mental health providers enables you to explore the expanded mental health network for 2025, which includes 305,000 clinicians and more than 6,400 locations nationwide. You can search for healthcare professionals who offer specialized services for conditions such as eating disorders, autism and substance use disorders.
Expedited appointments and virtual visits are also available, making services even more accessible. Further, starting Jan. 1, 2025, all therapists with Mayo Clinic's new external Employee Assistance Program (EAP) partner, Headspace, will be in-network.
If you have questions about the Mayo Medical Plan, contact Medica at 866-839-4015 or online.
Questions and answers
What is changing with the Mayo Medical Plan Network providers?
Effective Jan. 1, 2025, the Mayo Medical Plan will transition to a single, national network that includes providers in Medica, UnitedHealthcare, Optum Physical Health for chiropractic care, and Optum Behavioral Health networks. This change will significantly expand access to in-network care for remote staff, covered dependents and those whose providers are currently out-of-network.
What's not changing with the network providers?
All Mayo Clinic and Mayo Clinic Health System providers will remain in-network, helping support members with care from healthcare professionals they know and trust.
As Mayo Clinic's third-party administrator for the medical plan, Medica will continue to manage the plan's provider network, process medical claims and provide member support.
Why is Mayo introducing a national network?
When it comes to healthcare, Mayo Clinic is committed to providing medical plan members with exceptional healthcare access and coverage, regardless of where they live, work or travel.
Through surveys such as the All-Staff Survey and the Compensation and Benefits Survey, staff have shared the challenges of navigating and accessing in-network healthcare benefits through the Mayo Medical Plan Network. Mayo wants to address this need by significantly expanding the number of in-network providers nationwide. In addition, network provider directories and search tools have been simplified and consolidated, making it easier and more convenient to find in-network care options.
Further, to address claim processing concerns, adding providers from the UnitedHealthcare and Optum networks should make it easier for your care providers to recognize the network and file claims for you.
What if I'm currently receiving treatment, but my provider will no longer be in-network starting Jan. 1?
If this change results in a provider becoming out-of-network, Medica Member Services will work with you to help you find an in-network provider who meets your unique personal needs.
Additionally, you may qualify for continuity of care. Continuity of care for medical claims is the process by which Medica authorizes a covered person to continue accessing covered services for a limited period with a treating provider who is not in the Mayo Medical Plan Network while still receiving in-network benefits.
A covered person may be eligible if they are receiving an ongoing course of treatment for a serious acute or chronic condition, is pregnant and under ongoing care for that pregnancy, is undergoing a course of institutional or inpatient care from the provider or facility, or is scheduled for non-elective surgery, including postoperative care.
Do these network changes affect services covered by the Mayo Medical Plan?
No, the network changes will not affect what services are covered by the Mayo Medical Plan.
What does it mean that the plan is eliminating network tiers?
Today, the Mayo Medical Plan has three network tiers:
- Tier 1 providers are in-network.
- Tier 2 providers are expanded in-network.
- Tier 3 providers are out-of-network.
Beginning Jan. 1, 2025, the Mayo Medical Plan will eliminate network tiers, and providers will be either in-network or out-of-network. Most providers currently in Tier 1 and Tier 2 will remain in-network.
This change removes the complexity of a multi-tiered approach and the need for members to satisfy a higher deductible and out-of-pocket maximum since all in-network care will be covered at the same level.
Since the network will still include Mayo providers and other providers with Medica, what is changing for medical plan members who work in Rochester or Mayo Clinic Health System sites?
The single, national network will make it simpler and more convenient for all members, including covered dependents, to find and access in-network care options, no matter where they live, work or travel. Examples of when this will benefit Midwest plan members are when they travel to a place without Mayo Clinic providers or if they have a covered dependent attending college out of state.
Midwest plan members may be affected by the change to Optum Physical Health, which is replacing the current chiropractic services network. Medica is working with Optum Physical Health to encourage chiropractic providers to join the Mayo Medical Plan Network and help minimize disruption for members.
Will these changes affect pharmacy benefits?
No. The network changes do not affect pharmacy benefits or the pharmacy network.
Do any network changes affect the availability of the various Mayo Medical Plan options (i.e., Premier, Select and Custom)?
No. The Premier, Select and Custom plan options will continue to be available in 2025.
How can I learn more about how these improvements will affect me?
In October, open enrollment resources will communicate additional information about the new Mayo Medical Plan Network. Some opportunities to learn more will include Benefits University sessions, the open enrollment guide, News Center articles and the Benefits intranet site. You will also have the chance to ask questions of benefits experts during open enrollment expos, formerly known as benefits fairs, in October.
Why is there a separate search tool for behavioral health?
The behavioral health search tool includes advanced filtering options that allow members to easily find the types of behavioral health specialty services they need, such as therapy, counseling or psychiatric services. Members can search for providers by age, gender, language, cultural competence criteria, patient reviews, treatment/therapy methods and areas of expertise. The directory includes both virtual and in-person services to provide flexibility and accessibility.
How can I ensure the most accurate search results?
When you access the search tool, confirm your location to ensure you are looking in your intended search area. You can also adjust the search radius and refine your filters
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