In 2019, the Centers for Medicare & Medicaid Services (CMS) will require a transition from Medicare Cost plans to Medicare Advantage plans for about 630,000 people. Roughly 400,000 of those people live in Minnesota.
While the majority of the U.S. moved on in the ‘80s from Medicare Cost plans – managed care plans on a cost-reimbursement basis – to Medicare Advantage plans, in which private insurers manage care for beneficiaries, much of Minnesota is keeping the three lone Medicare Cost providers in play. It’s estimated that 66 counties will lose Medicare Cost plans while 21 will continue to offer them.
A competition requirement passed by federal law in 2003 stated that Medicare Cost plans couldn’t be offered where there was significant competition with MA plans. Implementation of the law was put off until 2015, when Congress mandated it take effect in 2019. Blue Cross, Medica, and HealthPartners are sending out letters to their Medicare Cost beneficiaries about the upcoming changes, and when to expect 2019 details.
Of those 400,000 people losing their Medicare Cost plans, around 100,000 people will likely be automatically enrolled in a comparable plan with their current provider, unless they seek out another. Once full plan details are available October 1, beneficiaries can choose between Original Medicare plus a supplement or an MA plan.
With the loss of Medicare Cost plans in much of the state, competitors like UnitedHealthcare, Allina Health System, and Aetna will see an opening for more business. It is not yet known which specific Minnesotan counties will be affected by the coming changes.