Medicare coverage options are changing. Here's what beneficiaries should know

It's news that's frustrating and confusing for 350,000 Minnesotans. Because of changes in federal funding, Medicare plans are being cut.

Laurel Heppner sells Medicare plans with the Heppner Group.

"We've actually talked to people that are crying, that have received their letter from the insurance company saying that their plan is no longer going to be available. And they're just confused," Heppner said.

Seniors have three choices when it comes to Medicare. First, you can just have standard Medicare. That means no premium. But if something happens, there's no limit to the out-of-pocket cost you would have to pay. 

Then, Medicare Advantage. Now that's where Medicare has deals worked out with certain companies. The premiums are lower, but you often have to have in-network doctors and referrals for things. 

Another option is supplemental coverage. You would get that through private insurance companies. It does cost more, but you can use any doctors that you want for greater coverage. All these changes are with the middle Medicare Advantage.

For example, the most popular plan has been covering catastrophic care like cancer treatment with a $3,800 out-of-pocket max. With changes in 2027, out-of-pocket will be $5900, and in Hennepin County it's close to $10,000.

A five-night hospital stay in 2026 would cost $400. In 2027, it will be $2,250.

The coverage changes could be concerning for patients and their providers. A doctor at Twin Cities Eye Consultants says 85% of his patients are on Medicare.

"What may happen is that someone who has seen one of our physicians for 10 years, that coverage may not allow them to come here anymore," Charlie Forbush, CEO of Twin Cities Eye Consultants, said. "It's hard to restart that relationship and pick up on that care; that continuity of care goes a long way."

Forbush's team is working with Heppner's Medicare sales team to help patients pick new plans, and do it fast.

Heppner says, most importantly, "If they don't do anything at all, they will go back to original Medicare, and original Medicare has high deductibles and co-insurance, and there's no out-of-pocket maximum. So, it is critical for people to choose some type of plan."

She says the number of plans is limited, so the sooner seniors act, the better.