As the annual shopping season begins for Medicare health plans, seniors in Minnesota are finding more health plan options for 2018 plus premiums that in many cases are either stable or declining.

Open enrollment started Oct. 15, and all five insurance companies that currently sell Medicare health plans in the state will have new offerings for next year.

The annual shopping period ends Dec. 7, and in some ways looks to be the calm before the storm. Most of the popular Medicare Cost plans currently used by more than 350,000 Minnesotans are scheduled to go away in 2019 but will remain through the end of the current open enrollment period.

"Changes actually are going to be pretty minimal for 2018," said Kari Benson, executive director of the Minnesota Board on Aging. "By and large, choices that were available this year are going to be available next year."

About 956,000 Minnesotans receive benefits from Medicare, the massive federal health insurance program for people age 65 and over plus certain special populations. More than half of all beneficiaries in Minnesota are enrolled in Medicare health plans sold by private insurance companies.

A Star Tribune review shows that premiums in Hennepin County will be flat or declining for 17 of 34 Medicare health plans currently on the market. Another 11 plans have percent changes that can be measured in single digits.

In many cases, premiums in Hennepin County match those being charged elsewhere in the state. Overall, premium trends are pretty moderate, said Tom Peterson, an insurance agent with Twin City Underwriters.

"The rate changes for 2018, we're really happy with them," Peterson said. "Clients are not balking at the price points."

The Minnesota health plan market is unusual because it has been dominated by insurance companies that sell Medicare Cost plans, as opposed to Medicare Advantage plans that are prevalent in almost all other states. The two types of Medicare health plans differ in how the federal government reimburses insurance companies.

For many years, the federal government has been taking steps to close the Cost plans. Right now, they are expected to go away in 2019 in counties where two or more sizable Medicare Advantage plans are being sold — a standard that would impact about 70 of Minnesota's 87 counties, if it were applied today.

The expected change is one reason that national health insurers Aetna and UnitedHealthcare plan to expand in Minnesota's Medicare market for 2019. It's also why Medicare consumers shopping for 2018 are seeing new Medicare Advantage plans in some counties from established Cost plan providers like Minnetonka-based Medica and Bloomington-based HealthPartners.

"We wanted to have an additional competitive product in the marketplace for what will be a transition in the future from the Medicare Cost plans to Medicare Advantage plans," said Donna Zimmerman, senior vice president of government and community relations at HealthPartners. "So, we introduced that product in the metro area and St. Cloud."

For 2018, Eagan-based Blue Cross and Blue Shield of Minnesota is introducing two Medicare Advantage plans that will be available in 55 counties. Blue Cross, which currently sells only Cost plans, has the largest share of the state's Medicare health plan market at 45 percent, according to data from the California-based Kaiser Family Foundation.

Medica will sell a new Medicare Advantage plan in nine counties centered around the Twin Cities metro.

The expected "sunset" for Cost plans has been repeatedly delayed over the years, but aspects of the change scheduled for 2019 will start showing up in just a few months. People who are newly eligible for Medicare because they are turning 65 next year will have access to Cost plans only in certain circumstances — another reason insurers that currently sell Cost plans are rolling out Medicare Advantage options for 2018.

"There are a lot of people who have Cost plans who, until it happens, aren't going to be very aware of it," said Tom Lindquist, the senior vice president of government programs at Medica. "And they're going to want to keep their Cost plans."

For now, Medicare consumers should not be anxious because they can stick with their plans for 2018, Peterson said. Over the next year, he added, seniors should talk with their brokers about the differences in Advantage plans.

Some consumers like Cost plans because they give seniors flexibility to pair medical benefits from one insurance company with pharmacy benefits from another, Peterson said. He added that Medicare Advantage plans have network limits that could leave consumers with extra costs if they use out-of-network doctors or hospitals.

Ghita Worcester, the chief marketing officer at Minneapolis-based UCare, countered that her company's Medicare Advantage plans include a network that covers 92 percent of all health care providers in the state, plus "point-of-service" coverage for much of the remainder. Kentucky-based Humana, with also sells Medicare Advantage plans in Minnesota, said in a statement that its enrollees "have access to our nationwide network of health care providers."

UCare for 2018 is introducing a Medicare Advantage plan that will be available in 41 counties across southern Minnesota. Humana is launching a new plan in 60 counties.

Christopher Snowbeck • 612-673-4744

Twitter: @chrissnowbeck