Patient Estimates
Disclaimer
Good Faith Estimates (GFE) show the costs of items and services that are reasonably expected for your health care needs to help you understand and plan for your health care costs. The GFE is based on the best information known at the time the estimate was created. Actual items, services, or charges may differ from the GFE due to unknown or unexpected costs that may arise during treatment. There may be additional items or services recommended as part of your course of care that must be scheduled or requested separately and are not reflected in the GFE. Factors that may alter your estimated out of pocket costs include, but are not limited to the following: • The personalized nature of medicine, patient differences, unforeseen complications, additional medically necessary services, and unexpected or same day services. • Variations to the medical procedure codes, length of time for the procedure or surgery (including recovery), equipment, supplies, medications, and number of days in the hospital (if applicable). • Receiving care at a different Mayo Clinic location. Charges and insurance coverage will vary between Mayo Clinic locations. • Receiving healthcare services between the estimate date and date of service, as your remaining deductible or maximum out-of-pocket with your insurance coverage may change. • Inaccurate coverage or benefits provided electronically from your insurance. Secondary or tertiary insurance coverages are not able to be estimated. The Good Faith Estimate (GFE) is not a contract and does not require the individual to obtain the items or services from any of the providers or facilities identified in the GFE. This estimate is not a guarantee of your health care charges or out-of-pocket costs. This GFE is not a contract for the charges, insured amount, or out-of-pocket expenses. You will be responsible for the actual amount due based on the services provided to you. If you have insurance, your benefits will ultimately determine your out-of-pocket costs (including denied services, deductibles, co-pays, co-insurance, and out-of-pocket maximums). It is your responsibility to contact your health plan to best determine your in or out of network status, out-of-pocket expenses, and if any prior authorizations are required. Obtaining healthcare at providers who are not within your health plan’s network will likely result in higher out-of-pocket costs. The estimate assumes insurance will cover services using in-network benefits. Discounts applied to this estimate are tentative pending regulatory criteria and any required administrative approvals. Uninsured discount eligibility applies to uninsured domestic patients for medically necessary services only. To obtain an additional Good Faith Estimate, go to https://estimator.mayoclinic.org/ or call us at 1-833-479-5483 (domestic patients) or 1-507-284-5063 (international patients). Mayo Clinic offers Financial Assistance for those who qualify. For more information visit https://www.mayoclinic.org/patient-visitor-guide/billing-insurance/financial-assistance or call 1-844-217-9591.