Attorney General Keith Ellison joined with Minnesota Board on Aging Chair Maureen Schneider and Senior LinkAge Line’s Medicare Product Manager Kelli Jo Greiner to raise awareness around a significant challenge facing more than 60,000 Minnesotans with Medicare Advantage health insurance plans.
Background
During Medicare’s Open Enrollment period, from October 15 – December 7, people on Medicare can shop around for the health insurance plan that best meets their needs. Original Medicare covers things like hospital stays and outpatient care, with the option to add supplemental coverage for things like vision care, prescription drugs, and dental care. Medicare Advantage plans are offered by private insurers but approved by Medicare, and these plans bundle together original Medicare coverage with additional supplemental coverage all in one plan. They typically offer a wider range of coverage with less flexibility in which providers you see.
The Problem
This year, a number of health care providers in Minnesota have decided to not accept specific Medicare Advantage plans. Seeing a provider that does not accept your Medicare Advantage plan could result in care with either a much higher out of-pocket cost or care that is not covered at all. The result is that Minnesotans with Medicare Advantage plans may have dramatically different options in health care providers under those plans. This includes the possibility that a provider that someone with Medicare Advantage has seen this year, or even for several years, may no longer accept that person’s Medicare Advantage plan next year.
“It’s my mission to help Minnesotans afford their lives, which is why I am raising the alarm around some significant issues with certain Medicare Advantage Plans,” said Attorney General Ellison. “If you receive health insurance through Medicare, please spend some time reviewing your options before December 7, and please urge any friends, family, and loved ones on Medicare to do the same. I am also calling on members of the media to use their platforms to share this critical information far and wide to help ensure Minnesota’s seniors are not forced to spend a year stuck in a health insurance plan they cannot actually make use of.”
“This year, more than ever, it’s so important for Medicare beneficiaries to review their Medicare plan before open enrollment ends,” said Kelli Jo Greiner, Senior LinkAge Line Medicare product manager. “Providers and networks have changed and costs have increased. People need to make sure they have the right plan for 2025.”
Non-Participating Providers and Plans
Below is a list of health care providers who have decided not to participate in particular Medicare Advantage Plans, along with the plan or plans they are not participating in and the areas of Minnesota they serve.
Name of provider | Area served by provider | Medicare Advantage Plan |
Allina | Statewide | Humana |
Avera | Southwest Minnesota | Humana |
Essentia Health System | Northern Minnesota and Northern Wisconsin | Humana |
M Health Fairview Health Care System | Statewide | Aetna, Humana |
Mayo Clinic | May be statewide | HealthPartners |
North Memorial Medical Center and providers | Primarily Metro area | Humana |
Sanford Health | Western Minnesota | Humana |
Who Is Affected?
Senior LinkAge Line has estimated that more than 60,000 Minnesota Medicare beneficiaries are impacted by this change. One particular area of concern for Attorney General Keith Ellison and the Minnesota Board of Aging is ensuring this information reaches people in Greater Minnesota who may have a more limited selection of health care providers.
Advice from Senior LinkAge Line on Actions Minnesotans on Medicare Should Take Immediately
- Decide if it’s important to you to continue to see your current health care provider. If it isn’t important to you, you still should review your current plan in the Medicare Plan Finder to ensure your coverage and costs have not changed. If they have changed and you are concerned about this, review other plan options in the Medicare Plan Finder to find the best coverage for you in 2025. Click here to see slides from Senior LinkAge Line on navigating Medicare Plan Finder.
- If you do want to continue to see your current health care provider, you also need to visit the Medicare Plan Finder at https://www.medicare.gov/ to review other plan options and consider enrolling in a new plan.
- Create an account with a username and password.
- Enter in your current prescriptions.
- Enter in the pharmacy you use.
- Decide which plan(s) you want to explore further.
- Go to those plans’ websites and search the provider list to make sure your provider(s) participate with the new plan(s) you are interested in.
- Enroll in the plan you choose by either calling the plan directly or enrolling online on the Medicare Plan Finder tool.
- If you have questions or need more help, you can call 1-800-MEDICARE 24/7, or you can call the Senior LinkAge Line at 800-333-2433.
- Please note the Senior LinkAge Line is experiencing very high call volume and wait times may be longer than normal.
Why Is This Happening?
Providers have given a variety of reasons for no longer accepting specific Medicare Advantage Plans, including:
- Reimbursement is too low and does not cover the costs of care.
- Plans frequently deny services and care that providers believe are medically necessary.
- Plans do not pay the providers in a timely manner.
About Senior LinkAge Line
The Senior LinkAge Line is a free, statewide service of the Minnesota Board on Aging in partnership with Minnesota’s area agencies on aging. The Senior LinkAge Line helps older Minnesotans and caregivers find answers and connect to the services and support they need. It is Minnesota’s federally designated State Health Insurance Assistance Program (SHIP), offering unbiased help with Medicare statewide.