Rising costs and fewer options for 2026 Minnesota Medicare plans
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Medicare’s open enrollment period began on Oct. 15 amid ongoing volatility in the state’s health insurance market.
A combination of rising costs and fewer Medicare Advantage insurers is prompting an unprecedented number of Minnesotans to review their options for 2026.
“We are getting about 2,000 calls a day, and normally we get about 200 to 300,” said Kelli Jo Greiner, Medicare product manager for the Minnesota Board on Aging.
More than 1 million Minnesotans are beneficiaries of Medicare, a federal health insurance program for people age 65 and older. Some younger adults with long-term disabilities also qualify. Significant changes to Medicare are expected in 2026, so selecting the right plan may require extra time and consideration.
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“This is not the year to sit idly by and just expect your changes in 2026 are going to be fine,” Greiner said.
Medicare Advantage
Health systems and providers across the country cite low reimbursement rates, complex billing processes and excessive pre-authorization requirements as reasons for withdrawing from Medicare Advantage plans.
According to Greiner, health care costs in Minnesota are rising faster than in other states, with Medicare Advantage premiums increasing by 18 percent, compared to 10 to 14 percent in most other states.
Several insurers are leaving the Medicare Advantage market in Minnesota. While some providers still participate in Medicare Advantage plans, many health systems, hospitals and pharmacies are ending contracts or altering their participation.
“It's not just UCare; it's also Humana, Aetna, United Healthcare, and Blue Cross Blue Shield,” Greiner said. “Our biggest concern right now is that people are going to do nothing and then, come January 1, they're going to have a slew of surprises. One of those surprises is going to be if their Medicare Advantage plan is ending.”
Supplemental Medicare Advantage plans that offer financial assistance for gym memberships, hearing aids and other benefits are also being reduced or eliminated for 2026 due to cost concerns.
Many plans have changed their list of covered drugs, so Greiner emphasized that people should ensure the prescriptions they are currently taking will still be covered in 2026.
Original Medicare and Medicare Advantage
Original Medicare or Medicare Advantage are the two primary ways to receive Medicare benefits.
The main difference between the two is that original Medicare is a federal government program, while Medicare Advantage plans are private health plans offered by insurance companies. Both options provide coverage for major medical needs.
Original Medicare includes Part A, hospital insurance, and Part B, medical insurance, with standardized deductibles, co-payments and co-insurance. It may have higher monthly costs than Medicare Advantage, as original Medicare typically covers more services. (Most people do not pay a premium for Part A.)
Some people also choose to purchase Medigap policies, which are private Medicare supplemental insurance plans that help cover out-of-pocket costs. Some Medigap policies also cover medical expenses while traveling outside the country.
Health care providers nationwide accept original Medicare. People with Medicare policies, like Medigap, have maximum flexibility to see any doctor accepting Medicare anywhere in the U.S., without needing a referral or prior authorization.
Beneficiaries also have the option to buy a stand-alone Part D drug plan, which is sold by private insurers and comes with different premiums, deductibles, and co-payment tiers for prescription drugs.
Medicare Advantage generally offers lower monthly premiums but may result in higher out-of-pocket costs. These plans can also provide additional benefits, such as vision, hearing and dental coverage, and offerings like annual physical exams or gym memberships that are not available through original Medicare. However, enrollees in Medicare Advantage plans are limited to doctors and hospitals within a preferred network.
Do I need a health screening to purchase a Medigap policy?
For most people, enrolling in a Medicare Part B plan means they do not have another opportunity to purchase a Medigap policy without undergoing a health screening. However, Greiner said that this year is different for many Minnesota beneficiaries, as Medicare Advantage plans are leaving various counties and zip codes across the state. This situation may allow people to buy a Medigap plan if they no longer have access to their current Medicare Advantage plan.
“We tell people when you enroll in Medicare Part B, you get this once-in-a-lifetime opportunity to purchase a Medigap plan without any health screening, also known as underwriting,” Greiner said. “After that, you can still try to apply for a Medigap policy, but you can be denied for having health problems, and the company can refuse to insure you.”
How do I choose the right plan for me?
A Medicare Advantage plan can be a good option for people who can afford the out-of-pocket costs, Greiner said. She emphasized that customers should carefully evaluate their options based on price, prescription drug coverage and provider network.
“If people want to enroll in a specific plan that isn’t covering all their drugs, they can request an exception by consulting with their doctor,” Greiner said. “Not all plans will grant a request, but many will, then the drug would be covered for the full calendar year.”
However, Medicare Advantage might not be the best choice for individuals who leave the state for several months, since using providers outside the network will lead to higher cost-sharing.
When can I enroll in a Medicare health plan?
Open enrollment for original Medicare ends Dec. 7. During this period, individuals can either sign up for Medicare or make changes to their existing health plan and prescription drug coverage, for 2026 plans that will take effect on Jan. 1.
The Medicare Advantage open enrollment, which is only for those currently enrolled in Advantage plans, runs from Jan. 1 to Mar. 31.
Members can switch to a different Medicare Advantage plan or disenroll from their current plan and return to original Medicare. Coverage begins on the first of the month following the insurer’s receipt of the request.
Where can I find more information about Medicare Plans?
The Medicare Plan Finder Tool at www.medicare.gov allows users to narrow down plan options based on specific prescription drugs, in-network pharmacies, out-of-pocket costs and overall coverage costs.
If a provider network does not appear in the Plan Finder Tool, beneficiaries can call their insurance plan provider or visit the plan’s website to check if their provider participates.
For further assistance, call 1-800-Medicare or contact Aging Pathways at 1-800-333-2433.
