Medicare shopping season brings more choices, some premium cuts in Minnesota

Minnesota seniors are once again confronting the recurring, and sometimes daunting, theme of more Medicare plan choices.

A bounty of options mean plenty of work for Bob Besinger this fall as he meets one-on-one with beneficiaries — trying to select health and drug plans — over the coming weeks. Besinger, 76, of Edina, is retired, but is in his third year as a volunteer Medicare counselor at Trellis, an Arden Hills-based nonprofit.

"My professional career was in human resources, so I understood things like co-payments and premiums and networks," he said. "But with Medicare and all the options and the rules, it's much more complicated."

This year, there's extra incentive for Medicare recipients to do their homework given a combination of more choices plus a few more discounts on premiums, said Kelli Jo Greiner, the Medicare product manager at the Minnesota Board on Aging.

The usual caveats, however, still apply.

A lower monthly cost for coverage can mean higher out-of-pocket spending on health care services and prescriptions. And with Medicare Advantage plans, premium savings can come with more limited in-network choices for doctors and hospitals.

Stretching from Oct. 15 to Dec. 7, the Medicare open enrollment period presents different choices to seniors, depending on whether they want medical benefits through the original Medicare program or would rather buy a private Medicare health plan from an insurance company.

Seniors who want their medical coverage through a private insurer can select a Medicare Advantage plan, which typically includes drug coverage. Or, in a few counties in greater Minnesota, they have the option of a Medicare Cost plan.

For next year, insurers are selling 106 different private Medicare health plans statewide, up from 101 last year, according to the federal Centers for Medicare and Medicaid Services. The number of Part D plans is growing from 22 to 24.

Prescription drug plans are sold statewide. The quantity and cost of health plan options vary by county.

In the state's most populous county, Hennepin, seniors can pick from among 47 different Medicare Advantage plans. There tend to be fewer options in rural Minnesota counties.

Medicare Advantage plans are increasingly popular among seniors, although there's debate over whether the shift is a good thing.

Yet, a September review from the Kaiser Family Foundation that looked at beneficiary experience, affordability, service utilization and quality found "few differences between Medicare Advantage and traditional Medicare that are supported by strong evidence or have been replicated across multiple studies." Researchers at the California-based foundation based their conclusion on an analysis of 62 studies published since 2016.

A 2021 study from Kaiser found the federal government spent $321 more per person for Medicare Advantage enrollees than for those in traditional Medicare in 2019 — a difference that might explain the popularity of the plans while adding to Medicare's solvency challenge.

For the current open enrollment period, the Star Tribune reviewed premiums for 31 of the most popular Medicare Advantage, Cost and Part D plans in Minnesota and found that 12 of the plans will reduce premiums next year while another four are holding premiums steady. Last year at this time, premiums were going down for five of these 31 insurance plans and holding steady for another 10.

Carriers for next year are continuing the trend of introducing more premium-free Medicare Advantage plans.

"More and more companies are looking competitive," said Tom Peterson, the owner of Twin City Underwriters, an insurance agency in Roseville. "That creates a real opportunity for consumers because then we can get those drug plans fine tuned and really help people save money."

Chad Levis, president of CAL Financial Inc. in Edina, advises seniors to check their current medication list against drug plan options for 2023. Insurance agents, counselors at the state's Senior LinkAge Line and the Medicare website and call center can help.

"Until you place your [prescription] list into a search, it will be hard to tell if your current plan is still best for you," Levis wrote in an email.

And while a number of plans are lowering premiums, some of the state's most popular plans are raising prices next year.

About 88,000 people who, as of September, were enrolled in the state's largest Medicare Advantage plan — Blue Cross Medicare Advantage Choice (PPO) — are facing premium increases of about 9% or 11%, according to the Star Tribune analysis of 2023 plan options.

The actual increase depends on the enrollee's county of residence, with consumers in the metro seeing smaller jumps. A spokesman for Eagan-based Blue Cross and Blue Shield of Minnesota says that premiums for the health plan in the metro during the previous two years were down 7% and flat for western Minnesota counties facing the bigger increase next year.

Meanwhile, premiums for the state's largest prescription drug plan, Wellcare Value Script, are declining 29%. As of September, this plan had about 55,000 enrollees in Minnesota.

Premiums will rise 9% for about 48,000 enrollees in the second-largest Part D plan, SilverScript Choice. A spokesman for CVS Health, which sells SilverScript coverage, said in an email that "the actual premium change in dollars [is] relatively small at $3.10."

Seniors have many options for getting help with coverage options including: