The Medicare open enrollment period for 2025 ends on December 7, and Minnesota seniors enrolled in Medicare Advantage plans are facing significant disruptions to their healthcare options. Minnesota Attorney General Keith Ellison has issued a warning that several major healthcare providers across the state will no longer accept certain Medicare Advantage plans, impacting around 60,000 of the 600,000 Minnesotans currently enrolled in these plans.
“Around 600,000 Minnesotans rely on these Advantage plans, but this year, a few health care provider networks in Minnesota have opted not to participate any longer,” Ellison said in a recent press conference. “This means that Medicare Advantage plan enrollees will see much higher out-of-pocket costs for services at these providers or, even worse, their services at those providers won’t be covered at all.”
Medicare Advantage plans are popular for providing additional benefits beyond traditional Medicare, often offering dental, vision, and wellness perks. However, these plans are managed by private insurers, meaning they can sometimes restrict provider choice, and the recent changes highlight the ongoing tension between providers and insurers over reimbursement rates and service coverage.
Major Providers Dropping Coverage
Starting January 1, 2025, several major health systems will no longer be in-network for specific Medicare Advantage plans. According to the Minnesota Attorney General’s office, Medicare Advantage plans through Humana will no longer be accepted at Allina Health, Avera, Essentia Health System, M Health Fairview, North Memorial, and Sanford Health. In addition, M Health Fairview will not accept Medicare Advantage plans from Aetna, and Mayo Clinic will not accept Medicare Advantage plans through HealthPartners.
Allina Health released a statement clarifying that the change does not affect Humana’s pharmacy plans or group retiree plans. “We negotiated in good faith with Humana over the past several months to remain a participating provider in their Medicare Advantage network. Unfortunately, Humana was unwilling to agree on a new, fair contract,” the statement reads. Allina emphasized that they are proactively communicating with patients to help them understand their options and maintain access to care.
Reasons for the Changes
The Attorney General’s office indicated that the reasons behind these decisions vary but primarily involve issues around reimbursement and coverage. Providers have cited insufficient reimbursements that do not cover the cost of care and delays in payments. Additionally, there are concerns that some plans are denying coverage for necessary medical services. These challenges have led many healthcare networks to reconsider their participation.
Impact on Seniors and Enrollment Trends
The fallout from these changes could be dramatic. Kelli Jo Greiner, Senior LinkAge Line Medicare product manager, expects that enrollment patterns will shift significantly. “Many people have established relationships with their providers over years and will not want to leave said provider,” Greiner noted. As a result, it is likely that seniors will opt to change their Medicare Advantage plans in order to stay within the networks of their preferred healthcare providers. “I think what we are going to see is an increase in certain Medicare Advantage plans and a decrease in others as a result of this provider network problem.”
Encouragement for Families to Discuss Options
With the Medicare open enrollment period closing on December 7, Ellison is urging families to have discussions about their healthcare coverage options during Thanksgiving gatherings. “There will be changes, and these things should be discussed with family,” he emphasized. State officials recommend using the Medicare Plan Finder tool to explore alternative plans and determine what coverage will work best moving forward.
What Seniors Should Do Next
Affected Medicare Advantage enrollees are advised to research and evaluate their options ahead of the December 7 deadline. The changes may require switching to a different Medicare Advantage plan that remains accepted by their healthcare providers or considering original Medicare paired with a supplemental Medigap policy for broader provider access.
Minnesotans who are unsure of their options can contact the Senior LinkAge Line or visit their healthcare provider’s website for updated information on which plans will be accepted in 2025. Attorney General Ellison’s office has also made resources available to help seniors navigate this complex situation and make informed decisions about their health insurance for the coming year.