As the end of the open enrollment period for Medicare approaches, Minnesota officials are warning that major health care providers across the state soon won’t accept certain Medicare Advantage plans, affecting coverage for more than 60,000 people.
Open enrollment is Oct. 15 to Dec. 7, and with a little under two weeks until the deadline to sign up for 2025 coverage, Attorney General Keith Ellison and officials from state agencies handling aging and Medicare are trying to spread the word about providers dropping or changing Medicare Advantage plans.
“We are seeing not only the provider changes, but plan cost changes, formulary changes, meaning the drugs that they’re taking may or may not be covered in 2025 and may have higher cost sharing,” said Kelli Jo Greiner, who handles Medicare issues for Minnesota’s Senior LinkAge Line. “We want to make sure that they’re selecting the right plan and that they have the coverage that they need.”
The warning comes after numerous Minnesota health care providers said they’ll no longer accept Medicare Advantage plans from Humana in 2025.
Providers like Allina Health and North Memorial Health have argued reimbursement from the plans is too low, isn’t timely, and often care that providers see as medically necessary is declined, according to the attorney general’s office.
Other networks have been able to negotiate continued coverage. Earlier this month Health Partners and insurer United Health Care managed to reach a multi-year agreement allowing some 30,000 Medicare Advantage subscribers to continue getting in-network care at locations like Regions Hospital in downtown St. Paul and Lakeview Hospital in Stillwater.
Six providers not participating in Humana Medicare Advantage
However, six Minnesota health care providers aren’t participating in Humana Medicare Advantage in 2025, according to state officials. They serve regions across the state and include:
• Allina Health, Minneapolis-based provider operating statewide.
• Avera Health, Sioux Falls, S.D.-based provider operating in southwestern Minnesota.
• Essentia Health, Duluth-based system serving Northern Minnesota and Wisconsin.
• M Health Fairview, Twin Cities-based providing statewide service (also not participating in Aetna).
• North Memorial, provider primarily operating in the Twin Cities metro area.
• Sanford Health, Sioux Falls-based provider primarily serving western Minnesota.
Mayo Health is not accepting Medicare Advantage plans through Health Partners, but state officials noted this has been the case for a number of years
Around 1 million Minnesotans 65 or older or with disabilities use federal Medicare plans, and about 600,000 have Medicare Advantage plans. Those are Medicare-approved plans from private insurers that bundle government coverage with other benefits. The advantage is they offer wider coverage, but they’re also less flexible with which providers a patient can see.
“We are here to encourage conversations across dinner tables this week,” Ellison said. “We’ve only got less than two weeks, so we need people to have those dialogs about Medicare Advantage to make sure that they don’t miss out.”
Need help?
Minnesota’s Senior LinkAge Line advises anyone on a Medicare Advantage plan to consider whether it’s important that they continue seeing their current health care provider and review costs in the Medicare Plan Finder to see if coverage and costs have changed. That tool can be found at medicare.gov.
The plan finder also can be used to review options. When enrolling in a plan, do so directly by calling or through the plan’s website or online on the Medicare Plan Finder tool.
Anyone with questions about Medicare can call the 24/7 hotline at 1-800-MEDICARE or the Senior LinkAge Line at 800-333-2433.
State officials warn there has been a significant increase in the number of calls, and that wait times may be longer than usual.
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