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Changes in 2025 Medicare coverage [RAW]
Minnesota Attorney General Keith Ellison shares "urgent warning" for upcoming changes in Medicare coverage during a virtual press conference on Monday.
MINNEAPOLIS (FOX 9) - Several healthcare provider networks in Minnesota are choosing not to accept specific Medicare Advantage plans in 2025 due to ongoing issues with reimbursements and denying coverage for medical services.
What we know
Minnesota Attorney General Keith Ellison held a virtual press conference on Monday to warn of changes coming to Medicare Advantage plans that could affect thousands of Minnesotans who rely on them.
Approximately 60,000 Minnesotans use Medicare Advantage health insurance plans, which are private healthcare plans with additional benefits that aren’t available through the traditional Medicare program. This upcoming year, some healthcare provider networks in Minnesota are not accepting specific Medicare Advantage plans.
According to the Minnesota Attorney General’s Office, these health care provider networks are not accepting the following Medicare Advantage plans:
- Allina will not accept Humana
- Avera will not accept Humana
- Essential Health System will not accept Humana
- M Health Fairview Health Care System will not accept Humana or Aetna
- Mayo Clinic will not accept HealthPartners
- North Memorial Medical Center and their providers will not accept Humana
- Sanford Health will not accept Humana
Providers are choosing to opt out because they insist the plans do not reimburse them in a timely manner, the plans are refusing to cover and pay for services that they believe are medically necessary, and it is taking longer than normal to pay and process claims, according to Kelli Jo Greiner, Senior LinkAge Line’s Medicare Product Manager.
Due to these changes, Ellison warns Advantage Plan enrollees could see higher out-of-pocket costs for services at these providers, or they might not be covered at all.
Officials encourage Medicare users to review their plans for cost changes, formulary changes, and provider changes before open enrollment closes on Dec. 7. If you’d like to make a change to the Medicare Advantage plan after that date, a separate open enrollment period for Medicare Advantage is from Jan. 1 to March 31.
For more information on navigating the Medicare Plan Finder click here. To check whether your current health care provider will be available under your plan, visit www.medicare.gov, according to the Minnesota Attorney General's Office.
What they’re saying
"Health care costs and medical debt are already challenging for far too many Minnesotans. And that could get worse if folks aren't able to make informed decisions. I want to make sure that Minnesotans in every corner of our state take the time to get the facts about which providers and Medicare Advantage plans in their area are working together, [and] which are not. I don't want anyone left holding a bill they didn't expect, or one they can't pay just because they didn't have the facts to begin with," Ellison said during the press conference.