MN health care providers dropping Medicare Advantage plans: What you need to know


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Published  November 27, 2024 9:47pm CST

Medicare changes coming to Minnesota

Some health care provider networks in Minnesota have announced they will no longer accept specific Medicare Advantage plans in 2025. Health officials encourage Medicare users to review their plans for cost and provider changes before open enrollment closes on Dec. 7. FOX 9's Leon Purvis has the full story.

(FOX 9) - Lots of changes are coming to the Medicare Advantage Plans in Minnesota. It may be confusing to some. It could be a good idea to talk with your loved one about it over the holiday weekend.

What to know

The big difference is that some healthcare providers decided not to accept Medicare Advantage Plans. So the doctor you’re used to seeing for years could result in a higher out-of-pocket cost.

"They need to look at if it's important to them, whether or not to continue to see their current health care provider," said Kelli Jo Greiner, Senior Linkage Line Project Manager.

Six healthcare providers decided not to participate with Humana, including Allina, Avera, Essentia Health System, M Health Fairview Health Care System, North Memorial Medical Center and Providers, and Sanford Health. Mayo Clinic didn’t participate in the past.

Why are providers opting out?

"They insist that the plans do not reimburse them timely," said Jo Greiner.

To figure out what is and isn’t covered you can go to Medicare.gov and review your current plan. You want to make sure your coverage and costs have not changed for 2025.

"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 Jo Greiner.

You need to take another step online.

RELATED: Humana should correct Medicare Advantage ‘misinformation’: AG Ellison

"They also need to go to the plan finder to review other plan options, and we strongly encourage them to create an account with a username and password in the medicare.gov plan finder," said Jo Greiner.

The reason you need to go to Plan Finder before you enroll in a plan is to see if your current medical provider accepts a plan available to you.

"Medicare.gov. does not list the doctors, hospitals, clinics, therapy providers, or any kind of medical provider that people may need to see are only going to be listed on the plan's website," said Jo Griener.

Help available

Enrollment ends next Saturday, and you may still have questions. FOX 9 has you covered. You can call 1-800 Medicare. There is also the Senior Linkage Line at 800-333-2433 or visit their website.

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