Big Medicare shift coming to Minnesota
For more than a year, insurers have been sizing up the coming shift with Medicare Cost plans, a specific type of coverage that's distinct from Medicare Advantage plans that are more common outside
This summer, insurers that sell Medicare Cost plans are sending several hundred thousand letters to consumers about the transition. There's no change to coverage in 2018, they point out, while stressing that details about 2019 options aren't yet available.
"Stay calm. Check your mail," said
In the 1970s, the federal Medicare health insurance program for people age 65 and older started signing contracts with managed care plans on a cost-reimbursement basis, creating a private health plan option for some benefits.
Health plans in
In MA plans, private insurers also manage care for enrollees. But as the
A federal law passed in 2003 created a "competition" requirement for Medicare Cost plans, which stipulated the plans could not be offered in service areas where there was significant competition from Medicare Advantage plans.
Whereas roughly 20 million people are covered through Medicare Advantage plans, the federal
"To minimize confusion and ensure that seniors have the resources they need to make informed choices in a timely manner, we urge CMS to provide ... critical information about this transition as soon as possible,"
Only three insurers sell Medicare Cost plans in the state --
Companies that run Cost plans said the program has let them provide higher-quality coverage for enrollees, particularly in rural areas. In a statement,
Final decisions haven't been made on exactly which counties in
While the transition will affect a lot of people, it won't directly affect most of the nearly 1 million Medicare beneficiaries in the state, said
Of the more than 300,000 people losing their Cost plans in
The details that people need for making decisions about 2019 coverage aren't yet available, said
"You don't need to do anything right now," Greiner said. "Enjoy your summer. In the fall, you will receive letters from either your plan or Medicare. That is going to tell you what you need to do."
Once full details from all carriers are available on
MA plans feature a network of doctors and hospitals that enrollees must use to get the maximum payment, whereas supplements tend to provide access to a broader set of health care providers, said
MA plans often include dental, vision and health-club benefits that aren't part of many supplements. Yet people who buy a supplement have the option of buying "stand-alone" Part D prescription drug coverage from any one of several insurers -- a feature touted as one of the selling points for Cost plans, too. People in MA plans, by contrast, are limited to Part D plans sold by their MA carrier, Christenson said.
"Cost plans kind of gave them the best of both worlds," Christenson said. "Now, they're not going to get that -- they're going to have to choose."
Another wrinkle is that people who want a supplement might have a better chance of getting into the coverage during the transition out of their Medicare Cost plan, when the supplement is provided on a "guaranteed issue" basis. Later, insurance companies can ask questions about a senior's health status and deny coverage depending on the answers, said Greiner of the
The coming change provides an opening for new competitors like
It all adds up to a busy fall for Medicare beneficiaries. At Twin Cities Underwriters, an insurance agency based in
"We're setting appointments for October now," Peterson said.
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