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If you aren't thrilled each fall about shopping for Medicare health plans, you're not alone.

Not only can it be complicated, but the sheer quantity of Medicare coverage choices can leave seniors feeling overwhelmed, said Tricia Neuman, a researcher with the California-based Kaiser Family Foundation.

A report released Wednesday by the foundation shows how bad it has gotten — about 71% of Medicare beneficiaries surveyed on the 2018 open enrollment period said they didn't even look at other plan options.

Such widespread avoidance "warrants attention," the Kaiser report warned, "given the potential consequences of year-to-year plan changes for their coverage, access to care and out-of-pocket costs."

Consumer advocates in Minnesota are urging seniors to hold their noses and shop during open enrollment, which started Friday and runs through Dec. 7, because finding the right plan is crucial to financing needed medical care.

"Every year we see major changes in provider networks and formulary coverage," said Kelli Jo Greiner, the Medicare product manager with the Minnesota Board on Aging. "The same is true for this year. For this reason, we strongly encourage all Medicare beneficiaries to review their current plan and review other possible options to make sure they have the best plan for 2022 that will offer the best coverage."

Minnesotans face a mixed bag of changes that makes it difficult to generalize about exactly what's coming for the state's nearly 1.1 million Medicare-eligible residents, but there could be some pleasant surprises.

The average premium for a Medicare Advantage plan is falling nearly 5% to $76.92 per month, according to estimates from the federal government. It marks the third consecutive year that premiums on the most popular plans largely have held "nice and flat" as insurers continue to offer more robust coverage, said Chad Levis, president of CAL Financial Inc. in Edina.

New for 2022: Sanford Health Plan is making its Medicare debut in Minnesota, and the lineup of health plans with no monthly premium continues to expand.

Comparison shopping also helps consumers be smart about potential pitfalls. Most stand-alone "Part D" plans that cover prescription drugs are getting more expensive, for example.

A few health plans are disappearing in some counties, including a big seller of Medicare Advantage plans in St. Cloud, which will force seniors to scramble to find new insurance. And two of the three insurers that sell Medicare Cost plans in greater Minnesota are downsizing their offerings.

The devil, of course, remains in the details. Getting the best deal involves more than just looking at premiums, consumer advocates point out, because costs can add up when a Medicare plan changes the medications or doctors and hospitals it will cover.

Being alert to changes in medication coverage is particularly important because drugs can move among different "tiers" on Part D plan formularies, with steep cost consequences as a result.

"It makes a tremendous difference," said Tom Peterson, owner of Twin City Underwriters, an insurance agency in Roseville. Particularly for those taking five drugs or more, "you should be checking every fall."

Medicare is the traditional health insurance offered through the federal government for most people 65 and older as well as for younger people with certain disabilities. Beneficiaries can elect to get their hospital and medical benefits through private insurance companies via Medicare Advantage and Medicare Cost plans.

As of September, about 504,000 people in Minnesota were covered through the original Medicare program, including about 369,000 who buy Part D plans to cover prescriptions.

Another 504,000 were enrolled in Medicare Advantage plans, where insurers typically bundle benefits for doctor and hospital care along with prescription drugs.

About 62,000 Minnesotans were enrolled in Medicare Cost health plans, which are available in 21 counties. Medicare Cost plans are sold by private health insurers but generally differ from Advantage plans in providing a broader choice of doctors, hospitals and Part D coverage.

The number of Part D drug plan options in Minnesota will shrink from 28 to 23, according to a Star Tribune review of Health Care Choices, the annual e-book for Medicare beneficiaries from the Minnesota Board on Aging. Of the plans returning to the market, 18 will increase premiums by anywhere from 3 to 48%.

"It is the [prescriptions drug plans] that are experiencing the largest premium increases," Greiner of the state Board on Aging said via e-mail.

Options are shrinking due to corporate mergers among companies that previously offered competing drug coverage plans, said Shawnee Christenson, owner of the Crosstown Insurance agency in New Hope.

Yet, several Part D options remain "with terrific drug coverage," Levis said, including one that costs less than $7 per month.

Medicare Advantage insurers next year will offer 83 different plan options in Minnesota, up from 75 this year, although not all plan options are available in all counties.

Premiums will hold steady in about 39 of the 71 Medicare Advantage plans that are returning in 2022, according to a Star Tribune market review. About 15 of the health plans will see premiums go down.

"I think people in general are going to be very happy this year," Peterson said.

While Medicare Advantage enrollment has been growing in Minnesota and across the country, some consumer groups have concerns about the trend because original Medicare provides access to all doctors, health care providers, hospitals and facilities that accept Medicare nationwide.

"We encourage Medicare beneficiaries to choose carefully between traditional Medicare and joining a private Medicare Advantage plan," the Connecticut-based Center for Medicare Advocacy said in a Thursday bulletin. "This is particularly important, as consumer marketing protections have been reduced and public promotions of Medicare Advantage are increasing — including on TV and in the mail."

Here's a look at some headlines in the Medicare market:

  • Minnetonka-based Medica is lowering premiums on most of its Medicare Advantage plans and lowering in all cases the maximum a consumer would pay in out-of-pocket costs. The insurer also is adding Advantage plans in some regions, part of a strategy "to get more competitive throughout the state," said Ann Kinsella, Medica's vice president and general manager of Medicare.

Among its Medicare Cost plans, Medica is dropping two options for 2022, a change that affects about 750 enrollees who automatically will be enrolled in other plans from the insurer.

  • Kentucky-based Humana says it is continuing to invest in benefits offered by its Medicare Advantage plans while introducing one new offering in northern Minnesota and another in the greater Twin Cities. But Humana also is dropping from its service area 12 Minnesota counties including several in the St. Cloud area. The move comes a year after St. Cloud-based CentraCare, the dominant health care provider in the region, dropped out of Humana's network of doctors and hospitals. Members began receiving notification letters in early October, the company said.
  • Competing insurers estimate that some 7,000 beneficiaries in central Minnesota covered by Humana will be looking for a new plan. That helps explain why Eagan-based Blue Cross and Blue Shield of Minnesota opened a new sales office this fall in St. Cloud. Bloomington-based HealthPartners and Minnetonka-based UnitedHealthcare also have expanded into some of the counties that Humana is exiting, said Mark Maloney, an insurance broker with Minnesota National Agency in Sauk Centre.
  • Blue Cross is lowering copays and deductibles for medications while expanding "preferred pricing" status to include almost all pharmacies including Walgreens, said Jeff Snegosky, the Eagan-based insurer's vice president of Medicare markets. Premiums are holding steady or going down for seven Medicare Advantage options at Blue Cross, while increasing at five others.
  • At Minneapolis-based UCare, premiums will increase 4 to 8% for a few plans, but monthly costs for most options will hold steady. UCare also is adding a $0 premium health plan in some counties. It will close a plan called M Health Fairview Care Advantage, which has about 300 members.
  • HealthPartners is shrinking its Medicare Cost plan service area to just 11 counties, which means more than 300 people will need to find new coverage. At the same time, the Bloomington-based insurer is dramatically expanding from 14 to 58 the Minnesota counties where it sells Medicare Advantage plans. "As we gain more experience and work with the Medicare Advantage product, we see a real opportunity," said Dr. Pat Courneya, HealthPartners' chief health plan medical officer.
  • UnitedHealthcare is dropping two Minnesota counties while adding six others, generating a net expansion of the insurer's Medicare Advantage service area to 54 counties. Allina Health Aetna will grow from 20 to 21 counties.
  • Consumers again will have the option of Medicare Advantage medical savings accounts from Lasso Healthcare. A Wisconsin-based insurer called Quartz will continue selling Advantage plans across five counties in southeast Minnesota. And new for 2022, South Dakota-based Sanford Health Plan will launch Medicare Advantage coverage in six western Minnesota counties.

Consumers can compare plans using the Plan Finder feature at Medicare.gov, the federal website that lists all options. Insurance agents and operators at the state's Senior LinkAge Line (800-333-2433) can help individuals sort through choices. The Board on Aging's e-book, Health Care Choices, also summarizes what's coming for the new year.