The federal government on Monday let insurers begin fully marketing Medicare health plan options for next year, when more than a quarter million Minnesotans will need to find new coverage due to a change in federal law.
Five health insurers next year will sell
While a health plan with no premium might sound good, state officials caution that consumers should read the fine print. "There will be more premium-free plans," said
"There are several other things they need to look at," Greiner added. "Does their [health care] provider participate with that plan? Does their pharmacy participate, and are their drugs going to be covered?"
This year's annual shopping season for Medicare coverage is unusual because an estimated 320,000 Minnesotans with a type of coverage known as "Medicare Cost" health plans will find their policy disappear due to federal law. For more than a decade, the government has been pushing to "sunset" the Cost plans as part of a bipartisan push to simplify the administrative structure in Medicare, policy experts say, while also pushing insurers take financial responsibility for managing health care use.
Cost plans are being eliminated in counties where there's significant competition from "Medicare Advantage" plans, which are similar since consumers also obtain their Medicare benefits via private insurers. The competition rule means Cost plans will disappear in 66 counties across
Cost plans in
Another eight health plan options are priced at less than
Across the country, about 46 percent of enrollees are in Medicare Advantage plans that will continue to have a zero premium for 2019, the federal government says. Zero-premium plans are possible because of the way the federal government structures payments to Medicare Advantage insurers, said
"The monthly payment from Medicare to the plans is, on average, between
While things like zero-premium plans and health insurer marketing efforts will put a lot of attention on Medicare Advantage plans, consumer advocates say Minnesotans shouldn't lose sight of a different option where beneficiaries return to original Medicare and also purchase a "Medigap" supplemental policy.
Medigap coverage in many cases comes with a higher premium, but the policies might be a better fit for people with significant health problems or for those who travel a lot, according to consumer advisers.
"Traditional Medicare lets you see any physician across the country that takes Medicare, whereas in Medicare Advantage you have more restricted choices or you're required to pay more to see other physicians outside the network," Jacobson said.
Medicare Advantage insurers also can require referrals, prior authorization and other measures that could make it more difficult for individuals to obtain the services they want, Jacobson said. She pointed to a study last week from the inspector general at the
"There's never been any data before on the frequency with which plans deny coverage, so it's really the first study that shows how often plans are using this ability to do so," Jacobson said of the report, adding that it doesn't provide information about denial rates by particular insurance companies.
Another wrinkle is that people losing Cost plan coverage have a one-time opportunity during the upcoming sign-up period to get into a Medigap policy without answering health questions that could block them from enrollment down the road.
Cost plans in
All five of those companies are selling Medicare Advantage plans for 2019 in addition to two newcomers:
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