Reporter's notebook: Sorting through all those Medicare choices

You are seeing the ads and the news coverage everywhere, including our front page and homepage this morning, about the changes in Medicare insurance options for 2019.

This is a big year for Minnesotans in Medicare because a popular sort of coverage known as the Medicare Cost plan is disappearing in 2019 across 66 counties. That means more than 300,000 people will be shifting coverage, setting off a big push by health insurers to win their business.

This competition comes during the annual open enrollment period in Medicare, when all beneficiaries can sign up for a Medicare Advantage plan (or Cost plan in the 21 counties where they remain). Open enrollment starts today and runs through Dec. 7, although people leaving Cost plans will have more time via special enrollment periods if needed.

The Minnesota Board on Aging last week published its annual comprehensive guide to the changes. Information is also available at the Medicare website.

For this story, we analyzed federal data to look at what's happening to the breadth of health plan options that Medicare beneficiaries are finding. We found there are two ways to look at it, which roughly correspond to views you can find in the comprehensive guide as well as Medicare.gov.

If you look at the number of insurance offerings that are being sold in Minnesota, the number is clearly going up due to increases in the number of Medicare Advantage and Medicare prescription drug plans being sold. In addition, more companies have been approved to sell Medigap supplement policies, although approval doesn't necessarily mean insurers will actively market the coverage.

In the Board on Aging's comprehensive guide, there are more pages describing the various plan options for 2019.

First, while Medicare Advantage plans are on the rise, they aren't necessarily sold in all counties, whereas Cost plans typically were available statewide. HealthPartners and Medica, for example, were statewide Cost plan carriers, but their Medicare Advantage plans won't be sold in all of the counties where the Cost plans are going away. (Both companies are introducing Medigap options for 2019.)

Second, insurers sold a bunch of Cost plans that didn't include drug coverage. That's because some beneficiaries liked to mix-and-match Cost plans with a stand-alone prescription drug plan from a different companey. With Medicare Advantage, the mix-and-match approach isn't an option. If you want Rx coverage with a Medicare Advantage plan, you buy the coverage from the same insurer as part of an integrated health plan.

The two exceptions are Carlton and St. Louis Counties, where the total number of Medicare health plans held steady in our data. That's because those are two of the 21 counties in the state where the Cost plans aren't going away. Plus, some insurers offering Medicare Advantage in those counties have introduced more options.

State officials and some consumer advocates say that no matter how you look at the quantity of choices, there's still a lot of options and a lot for consumers to consider.

That's all for now. Here's some information, by the way, from the Minnesota Board on Aging with key deadlines for the open enrollment period:

Oct. 1, 2018: Medicare.gov website goes live with 2019 plan data

Oct. 15 – Dec. 7, 2018: Open Enrollment (Annual Election Period) for all Medicare beneficiaries

Oct. 15 – Feb. 28, 2019: Open Enrollment for all affected Cost Plan enrollees who live in one of the 66 counties where Cost Plans are ending

Nov. 2, 2018 – March 5, 2019: Medigap guaranteed issue rights for all affected Cost Plan enrollees who live in one of the 66 counties where Cost Plans are ending

Dec. 31, 2018: Affected Cost Plan enrollees need to make a decision by midnight on this date to have coverage on January 1, 2019, or they will return to Original Medicare with Medicare Part A and B cost sharing